Head-to-head · WeighScore
1st Optimal vs Signos
The verdict
1st Optimal takes it — 61.6/100 to 61.4/100, 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. Signos 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 | Signos |
|---|---|---|
| WeighScore | 61.6/100 | 61.4/100 |
| Grade | C | C |
| Scorecard rank | #288 | #293 |
| Semaglutide | Not disclosed | $199/mo (6-month plan, compounded) |
| Tirzepatide | Not disclosed | $199/mo (starting dose, compounded) |
| Coverage | Coverage not published | Coverage not published |
| 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 #293 · C
Strengths
- Bundles compounded GLP-1 (semaglutide) with an FDA-cleared CGM and app — glucose-guided weight loss, not just medication
- Starting at $199/mo on a 6-month program, with the CGM included at no extra cost
- Free rapid shipping; HSA/FSA eligible
- Real-time glucose insights and app coaching to help sustain results after GLP-1
Where it loses points
- Compounded GLP-1s are not FDA-approved finished products
- Headline price is a 6-month-program rate, not month-to-month
- Only semaglutide is shown in the program; tirzepatide availability is not confirmed
- Compounding pharmacy partner and state availability are not published on the landing page
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.