1st Optimal vs Onyx Weight Loss
An in-depth comparison of two leading GLP-1 Providers
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1st Optimal
Best for: coaching bundled into the price rather than sold separately
Visit 1st Optimal →
Onyx Weight Loss
Best for: starting below a standard dose, with microdose tiers
Visit Onyx Weight Loss →Two GLP-1 Providers chasing the same patients, trading off price, geography and what lands in the box differently. On our scoring, Onyx Weight Loss starts at $99/mo, and Onyx Weight Loss finishes ahead, 8.3 to 3.9. What follows: the prices, what each plan actually covers, the six-dimension score, where each one is weak, and who should pick which.
Pricing
1st Optimal
Pricing not publicly listed.
Onyx Weight Loss
Verbatim: 'Starting at $228/month' (GLP-1 Agonist plan). Includes medication and supplies shipped to home. Entry tier only; higher-dose pricing not disclosed.
Verbatim: 'Starting at $280/month' (GLP-1/GIP Agonist plan). Includes medication and supplies. Entry tier only; specific drug name inferred from GLP-1/GIP dual agonist designation.
Verbatim: '$99/MONTH' (GLP-1 Microdosing plan). Low-dose gradual-start option.
What’s included
1st Optimal
Covered by the monthly price
Medication
Not stated
Clinician visits
In the price
Shipping
In the price
Lab work
Not stated
Coaching
In the price
Onyx Weight Loss
Covered by the monthly price
Medication
In the price
Clinician visits
In the price
Shipping
In the price
Lab work
Not stated
Coaching
Not stated
Score breakdown
Both providers are scored on the same six-dimension framework. The gradient bar marks the stronger side on each dimension.
1st Optimal
3.9/10
Onyx Weight Loss
8.3/10
Value25%
Effectiveness25%
User Experience15%
Trust & Safety15%
Accessibility10%
Support10%
Features & Coverage
| Feature | 1st Optimal | Onyx Weight Loss |
|---|---|---|
| Starting Price | — | $99/mo |
| Features | 8 features | 8 features |
| States Available | Not disclosed | 8 |
| Compounded | — | ✓ Yes |
| Brand Name | — | — |
| FSA/HSA Accepted | — | — |
| FDA Warnings | None | None |
About 1st Optimal
Neither a monthly price nor a list of states is published. 1st Optimal operates out of Michigan across telehealth and functional medicine, writing the GLP-1s semaglutide and tirzepatide either as a weekly injection or as a daily oral tablet. Around the prescription it stacks at-home lab testing, interpretation of the blood work, coaching without limit and protocols built individually, all framed as long-term weight loss and longevity. Credentialed providers work virtually, treatment goes to the home, and nothing binds you to a long contract.
Read our full 1st Optimal review →About Onyx Weight Loss
GLP-1 (semaglutide-type) plans begin at $228/month; GLP-1/GIP (tirzepatide-type) plans at $280/month. There is also a $99/month GLP-1 microdosing option for anyone wanting a gradual-titration start. Onyx Weight Loss runs a nurse-practitioner-led telehealth clinic out of Mooresville, NC, set up by Madalyn Vangile RN and Tasha Vangile FNP-C, and it covers 8 states with HRT and peptides sold beside the GLP-1s. Its partner Strive Pharmacy ships medication and supplies home.
Read our full Onyx Weight Loss review →Pros & Cons
1st Optimal
What we like
- The monthly figure covers consult, shipping, coaching
- No FDA warning letter matched this operator when we searched our enforcement register
- A live video visit with a clinician is required before a prescription, which is slower than a form and is the more careful intake
- Baseline bloodwork is required before a prescription
Watch-outs
- No price appears until the medical intake is complete, so the cost cannot be compared before health information is submitted
- No state list is on record here, so whether it serves your state cannot be confirmed from this page
- No dispensing pharmacy is named in our record, so its accreditation cannot be looked up from here
Onyx Weight Loss
What we like
- Semaglutide at $99 a month, 48% below the $189 median for the same drug and form across this register
- Publishes a price on its own site before the medical questionnaire, so it can be compared without handing over health information
- The monthly figure covers medication, consult, shipping
- No FDA warning letter matched this operator when we searched our enforcement register
Watch-outs
- Coverage is published for 8 states only, so this may not reach you
- No dispensing pharmacy is named in our record, so its accreditation cannot be looked up from here
- Its semaglutide and tirzepatide are compounded rather than FDA-approved, so they have not been reviewed by the agency for safety, effectiveness or manufacturing quality
Our Verdict
Onyx Weight Loss takes it, 8.3 against 3.9, and it is especially strong on starting below a standard dose, with microdose tiers. 1st Optimal is no weak second and may fit you better on coaching bundled into the price rather than sold separately.
Choose 1st Optimal if…
You want coaching bundled into the price rather than sold separately.
Choose Onyx Weight Loss if…
You want starting below a standard dose, with microdose tiers and an opening price near $99 a month.
Ready to start? Vetted GLP-1 providers
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Strut Health
Semaglutide at $99/month, 48% under the register median
From $99/mo
Get started →Oak
Semaglutide at $119/month, 37% under the register median
From $119/mo
Get started →Found
Tirzepatide at $169/month, 37% under the register median
From $99/mo
Get started →1st Optimal vs Onyx Weight Loss: FAQ
Glossary
The words sellers use, defined. Tap any term.
- Semaglutide · Drugs and brands
- Tirzepatide · Drugs and brands
- Compounded GLP-1 · Pharmacy and drug forms
- 503A pharmacy · Pharmacy and drug forms
- PCAB accreditation · Pharmacy and drug forms
- Prior authorization (PA) · Insurance and regulatory
- Off-label use · Insurance and regulatory
- FDA Drug Shortage List · Insurance and regulatory
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