Head-to-head · WeighScore
1st Optimal vs AM Rx
The verdict
1st Optimal takes it — 61.6/100 to 49.9/100.
1st Optimal grades higher on WeighScore, our editorial score across cost value, dose & formulation, clinical oversight, labs & monitoring, fulfillment and contract terms. 1st Optimal is a Michigan-based telehealth and functional-medicine platform offering GLP-1 weight loss medications, including semaglutide and tirzepatide, as once-weekly injections or daily oral tablets.
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Factor by factor
The same six graded dimensions, side by side. See the methodology.
The numbers
| Metric | 1st Optimal | AM Rx |
|---|---|---|
| WeighScore | 61.6/100 | 49.9/100 |
| Grade | C | C |
| Scorecard rank | #288 | #490 |
| Semaglutide | Not disclosed | $151/mo (quarterly plan, plus a separate fee, compounded) |
| Tirzepatide | Not disclosed | Not disclosed |
| Coverage | Coverage not published | Coverage not published |
| Brand-name access | Compounded only | Yes |
| Oral / sublingual | Yes | Injection only |
Graded #288 · C
Strengths
- Offers both semaglutide and tirzepatide with injectable and oral formats
- Functional-medicine approach with at-home labs and blood-work interpretation
- Unlimited coaching and ongoing support included
- No long-term contracts
- Board-certified doctors and nurse practitioners referenced
Where it loses points
- No public monthly pricing disclosed
- No published state availability list
- Compounded vs branded sourcing not clarified on site
- Pricing only revealed after quiz or consultation
Graded #490 · C
Strengths
- Insurance coordination for brand-name GLP-1s — as low as $25/mo
- All four major brand-name GLP-1s available (Ozempic, Wegovy, Zepbound, Mounjaro)
- HSA and FSA accepted
- Video visits available with providers averaging 10+ years' experience
- Compounded semaglutide from $151/mo on the quarterly plan
Where it loses points
- Active FTC/DOJ lawsuit over deceptive billing and subscription practices
- Novo Nordisk false-advertising lawsuit (Aug 2025)
- Parent company Zealthy holds a BBB D- rating with 2,370+ complaints
- Trustpilot 2.0/5, with 85% one-star reviews citing billing disputes and unreachable support
- FDA has issued this company a warning letter; the letter is public in FDA's warning-letter database
Also worth a look
Neither is our top-graded pick — CoreAge Rx leads the scorecard
Across all 499 providers, CoreAge Rx grades highest at 91.8/100 (A−). Top of the scorecard: flat transparent pricing, both molecules, nationwide — no teaser-rate games.
Pricing/verification reflect each provider's public disclosures at last grading; the WeighScore is our editorial judgment per the methodology. Prices change — confirm on each provider's site. Not medical advice; see our disclosure.