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Head-to-head · WeighScore

1st Optimal vs Belle Health

1st Optimal
Graded #288

Lower grade

vs+15.399999999999999
Belle Health
Graded #48

Higher grade

The verdict

Belle Health takes it — 77/100 to 61.6/100.

Belle Health grades higher on WeighScore, our editorial score across cost value, dose & formulation, clinical oversight, labs & monitoring, fulfillment and contract terms. Belle Health is a national DTC telehealth platform offering compounded semaglutide and tirzepatide with flat-rate pricing — the same monthly cost at every dose, with no escalation surcharge as you titrate up.

We may earn a commission if you start care through some of these links, at no extra cost to you. It never moves the WeighScore, which is the weighted average of the six factors shown for every provider, and what we write about a provider is the same either way. See our disclosure.

Factor by factor

The same six graded dimensions, side by side. See the methodology.

Cost valueBelle Health +47
45
92
Dose & formulationBelle Health +21
51
72
Clinical oversight1st Optimal +6
77
71
Labs & monitoring1st Optimal +25
97
72
FulfillmentBelle Health +25
60
85
Contract termsBelle Health +18
37
55
1st Optimal · left barBelle Health · right bar

The numbers

Metric1st OptimalBelle Health
WeighScore61.6/10077/100
GradeCC+
Scorecard rank#288#48
SemaglutideNot disclosed$119/mo
TirzepatideNot disclosed$199/mo (all doses, 3-month plan, compounded)
CoverageCoverage not publishedAll 50 states
Brand-name accessCompounded onlyCompounded only
Oral / sublingualYesInjection only
1st Optimal

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
Belle Health

Graded #48 · C+

Strengths

  • Five named compounding pharmacy partners disclosed (Striker, Strive, OptioRx, Enovex, Braun PharmaCare)
  • Flat-rate pricing — $119/mo semaglutide, $199/mo tirzepatide — doesn't rise at higher doses
  • Free weekly registered-dietitian sessions included
  • Operating since 2017
  • LegitScript Certified

Where it loses points

  • $199 tirzepatide price requires a 3-month bundle commitment
  • Compounded medications are not FDA-approved
  • Multi-pharmacy model — formulations may differ across orders
  • FDA issued this company a warning letter dated 20 February 2026; 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.

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