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Head-to-head · WeighScore

1st Optimal vs Silhouette MD

1st Optimal
Graded #291

Lower grade

vs+7.800000000000004
Silhouette MD
Graded #131

Higher grade

The verdict

Silhouette MD takes it — 69.4/100 to 61.6/100.

Silhouette MD grades higher on WeighScore, our editorial score across cost value, dose & formulation, clinical oversight, labs & monitoring, fulfillment and contract terms. Concierge-style GLP-1 telehealth offering compounded semaglutide and tirzepatide in both injectable and oral forms, with provider oversight and full-service support included on every plan.

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 valueSilhouette MD +29
45
74
Dose & formulationSilhouette MD +24
51
75
Clinical oversightEven
77
77
Labs & monitoring1st Optimal +43
97
54
FulfillmentSilhouette MD +7
60
67
Contract termsSilhouette MD +18
37
55
1st Optimal · left barSilhouette MD · right bar

The numbers

Metric1st OptimalSilhouette MD
WeighScore61.6/10069.4/100
GradeCC
Scorecard rank#291#131
SemaglutideNot disclosed$149/mo (compounded)
TirzepatideNot disclosed$299/mo (compounded)
CoverageCoverage not publishedCoverage not published
Brand-name accessCompounded onlyCompounded only
Oral / sublingualYesYes
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
Silhouette MD

Graded #131 · C

Strengths

  • Compounded semaglutide and tirzepatide in both injectable and oral formulations
  • Concierge-level support — monitoring, expert guidance, and check-ins included on every plan
  • Transparent, published pricing starting at $149/mo for semaglutide injection
  • Prescriptions issued and fulfilled by licensed clinical partner OpenLoop Health

Where it loses points

  • Tirzepatide ($299/mo) and oral options ($263–$325/mo) priced above many compounded competitors
  • State availability not published
  • Newer brand with limited independent review history
  • Medications are compounded, not FDA-approved 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.

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