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Head-to-head · WeighScore

1st Optimal vs Metabolyz

1st Optimal
Graded #291

Higher grade

vs+2
Metabolyz
Graded #339

Lower grade

The verdict

1st Optimal takes it — 61.6/100 to 59.6/100, 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. Metabolyz is close behind and may still be the better fit — see the factor split below.

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 & formulation1st Optimal +11
51
40
Clinical oversightMetabolyz +4
77
81
Labs & monitoring1st Optimal +34
97
63
FulfillmentMetabolyz +26
60
86
Contract termsMetabolyz +18
37
55
1st Optimal · left barMetabolyz · right bar

The numbers

Metric1st OptimalMetabolyz
WeighScore61.6/10059.6/100
GradeCC
Scorecard rank#291#339
SemaglutideNot disclosedNot disclosed
TirzepatideNot disclosedNot disclosed
CoverageCoverage not publishedAll 50 states
Brand-name accessCompounded onlyCompounded only
Oral / sublingualYesInjection only
1st Optimal

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
Metabolyz

Graded #339 · C

Strengths

  • Three GLP-1 programs: standard semaglutide, dual-agonist tirzepatide, and a microdose protocol for near-goal or dose-sensitive patients
  • Nutrition, movement, and lifestyle coaching included in all programs at no extra charge
  • Medication compounded in licensed 503A/503B US pharmacies with temperature-controlled, unmarked direct-to-door delivery
  • Licensed provider supervision with direct messaging access and structured check-ins throughout
  • Telehealth across all 50 states; BMI 27+ eligibility (25+ with weight-related condition)

Where it loses points

  • Pricing is fully gated — not disclosed until after consultation, preventing upfront cost comparison
  • Compounded GLP-1 only — no brand-name options (Wegovy, Zepbound) available
  • No LegitScript certification or named medical leadership found on public-facing pages
  • Labs not mentioned as included — unclear whether baseline or follow-up bloodwork is offered
  • Newer brand with no external reviews, published outcomes data, or notable accreditations

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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