Head-to-head · WeighScore
1st Optimal vs Onyx Weight Loss
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.
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Factor by factor
The same six graded dimensions, side by side. See the methodology.
The numbers
| Metric | 1st Optimal | Onyx Weight Loss |
|---|---|---|
| WeighScore | 61.6/100 | 58.8/100 |
| Grade | C | C |
| Scorecard rank | #288 | #359 |
| Semaglutide | Not disclosed | $228/mo (starting dose, compounded) |
| Tirzepatide | Not disclosed | $280/mo (starting dose, compounded) |
| Coverage | Coverage not published | 8 states |
| Brand-name access | Compounded only | Compounded only |
| 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 #359 · C
Strengths
- Competitive entry pricing: semaglutide from $228/mo and tirzepatide from $280/mo with medication + supplies included
- Nurse-practitioner-led care: founder Tasha Vangile FNP-C (20+ years) and Stephanie Robison APRN-CNP (27 years experience)
- Low-cost $99/mo GLP-1 microdosing option for patients who prefer a gradual titration start
- Strive Pharmacy partnership implies compounded 503A-quality supply chain from a known pharmacy
- Multi-modal clinic: GLP-1 + peptides + HRT + nutrition coaching available under one provider team
Where it loses points
- Only 8 states (NC, CO, ME, VT, VA, IA, NH, PA) — excludes the majority of the US
- No LegitScript certification; credentialing evidence limited to local 2025 Best of Iredell award
- Specific drug names (semaglutide/tirzepatide) never stated on website; compounded status inferred, not disclosed
- Labs not included or mentioned; no baseline bloodwork protocol published
- Pricing shown as 'Starting at' with no dose-escalation tier pricing disclosed publicly
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.