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Head-to-head · WeighScore

1st Optimal vs Zera Health

1st Optimal
Graded #291

Lower grade

vs+13.199999999999996
Zera Health
Graded #63

Higher grade

The verdict

Zera Health takes it — 74.8/100 to 61.6/100.

Zera Health grades higher on WeighScore, our editorial score across cost value, dose & formulation, clinical oversight, labs & monitoring, fulfillment and contract terms. Zera Health is a telehealth platform for compounded GLP-1 weight loss — semaglutide from $149/mo, tirzepatide from $199/mo, plus oral and low-dose microdose options — prescribed by licensed physicians in…

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 valueZera Health +35
45
80
Dose & formulationZera Health +24
51
75
Clinical oversightZera Health +5
77
82
Labs & monitoring1st Optimal +44
97
53
FulfillmentZera Health +32
60
92
Contract termsZera Health +18
37
55
1st Optimal · left barZera Health · right bar

The numbers

Metric1st OptimalZera Health
WeighScore61.6/10074.8/100
GradeCC
Scorecard rank#291#63
SemaglutideNot disclosed$149/mo (compounded)
TirzepatideNot disclosed$199/mo (compounded)
CoverageCoverage not publishedAll 50 states
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
Zera Health

Graded #63 · C

Strengths

  • Compounded semaglutide from $149/mo and tirzepatide from $199/mo, plus a $129/mo microdose option
  • Flat pricing — the same monthly cost at every dose as you titrate up
  • All-inclusive: medication, unlimited 24/7 provider messaging, and free shipping bundled in
  • Names its compounding pharmacy — Strive Pharmacy (licensed 503A)
  • Available in all 50 states with same-day approvals

Where it loses points

  • Operates as a technology platform, not the medical provider itself
  • Compounded GLP-1s are not FDA-approved (the site discloses this honestly)
  • Aggressive marketing results claims (e.g. '18% average', '93% kept it off') with 'results not typical' disclaimers
  • Legal entity name not published (footer shows only 'Zera Health')

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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