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Head-to-head · WeighScore

1st Optimal vs MDLive

1st Optimal
Graded #288

Higher grade

vs+2.8000000000000043
MDLive
Graded #358

Lower grade

The verdict

1st Optimal takes it — 61.6/100 to 58.8/100.

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.

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 valueEven
45
45
Dose & formulationMDLive +2
51
53
Clinical oversightMDLive +8
77
85
Labs & monitoring1st Optimal +43
97
54
FulfillmentMDLive +2
60
62
Contract termsMDLive +18
37
55
1st Optimal · left barMDLive · right bar

The numbers

Metric1st OptimalMDLive
WeighScore61.6/10058.8/100
GradeCC
Scorecard rank#288#358
SemaglutideNot disclosedNot disclosed
TirzepatideNot disclosedNot disclosed
CoverageCoverage not publishedCoverage not published
Brand-name accessCompounded onlyYes
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
MDLive

Graded #358 · C

Strengths

  • Prescribes FDA-approved branded GLP-1s including Wegovy and Zepbound
  • Covered through insurance and employer benefits for 50M-plus people
  • Board-certified physicians averaging about 15 years of experience
  • Part of Evernorth/Cigna, a large established healthcare organization
  • Offers full primary care, not just a single weight-loss funnel

Where it loses points

  • GLP-1s only at clinician discretion in a Primary Care routine visit
  • Anti-obesity meds not available in FL, LA, MS or NJ
  • Distributed mainly via insurers and employers; cost varies by plan
  • No transparent published monthly cash price for GLP-1 care

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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