Head-to-head · WeighScore
1st Optimal vs Fitstry
The verdict
1st Optimal takes it — 61.6/100 to 61.2/100, but only just.
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. Fitstry is close behind and may still be the better fit — see the factor split below.
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Factor by factor
The same six graded dimensions, side by side. See the methodology.
The numbers
| Metric | 1st Optimal | Fitstry |
|---|---|---|
| WeighScore | 61.6/100 | 61.2/100 |
| Grade | C | C |
| Scorecard rank | #291 | #300 |
| Semaglutide | Not disclosed | $179/mo (annual plan, plus a separate fee, compounded) |
| Tirzepatide | Not disclosed | $269/mo (annual plan, compounded) |
| Coverage | Coverage not published | Coverage not published |
| Brand-name access | Compounded only | Compounded only |
| Oral / sublingual | Yes | Yes |
Graded #291 · 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 #300 · C
Strengths
- Transparent pricing before you commit — compounded semaglutide from $179/mo, tirzepatide from $269/mo, oral GLP-1 from $209/mo (annual plan)
- Free screening with a one-time $99 program fee that is fully refunded if a clinician can't prescribe ('Approved, or Your $99 Back')
- Monthly price bundles a lab panel (CMP, A1c, lipids, TSH), unlimited clinician access, bi-weekly care coaching and a 24/7 Care Line
- Runs under Weightstry, LLC, a LegitScript-certified practice with an independently verifiable seal, a named support email and phone
- Full compounded lineup — weekly injection, daily oral tablet and microdosing options
Where it loses points
- Month-to-month pricing is notably higher than the annual plan ($249 vs $179 semaglutide, $339 vs $269 tirzepatide)
- Compounded semaglutide and tirzepatide only — no brand-name (Wegovy/Zepbound) options
- Framed for women 40+, and serves 49 states rather than all 50 (the excluded state isn't disclosed publicly)
- Works with state-licensed compounding pharmacies but doesn't name a specific pharmacy partner on the Fitstry page
- Compounded GLP-1s are not FDA-reviewed or approved — a different evidence and regulatory tier than brand-name
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.