Head-to-head · WeighScore
1st Optimal vs Zealthy
The verdict
1st Optimal takes it — 61.6/100 to 46.7/100.
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 | Zealthy |
|---|---|---|
| WeighScore | 61.6/100 | 46.7/100 |
| Grade | C | C |
| Scorecard rank | #291 | #496 |
| Semaglutide | Not disclosed | $286/mo (starting dose, plus a separate fee, compounded) |
| Tirzepatide | Not disclosed | $351/mo (starting dose, plus a separate fee, compounded) |
| Coverage | Coverage not published | 34 states |
| Brand-name access | Compounded only | Compounded only |
| Oral / sublingual | Yes | Injection only |
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
Graded #496 · C
Strengths
- Serves 34 states — meaningful nationwide footprint
- Asynchronous model removes friction for patients who don't want a video visit
- Independent licensed prescribers retain full clinical authority
Where it loses points
- Active Novo Nordisk false-advertising lawsuit alleging trademark infringement and marketing compounded drugs as FDA-approved alternatives
- Active DOJ/FTC enforcement alleging undisclosed subscription terms, locked cancellation, and unauthorized health-data sharing
- Founder previously ran Cerebral, which settled with the FTC in 2024 over similar deceptive practices
- Recently rebranded to Gronk Inc. amid active enforcement
- FDA issued this company a warning letter dated 1 September 2025; the letter is public in FDA's warning-letter database
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.