Head-to-head · WeighScore
LillyDirect Foundayo vs Silhouette MD
The verdict
Silhouette MD takes it — 69.4/100 to 67.2/100.
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.
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Factor by factor
The same six graded dimensions, side by side. See the methodology.
The numbers
| Metric | LillyDirect Foundayo | Silhouette MD |
|---|---|---|
| WeighScore | 67.2/100 | 69.4/100 |
| Grade | C | C |
| Scorecard rank | #165 | #123 |
| Semaglutide | Not disclosed | $149/mo (compounded) |
| Tirzepatide | Not disclosed | $299/mo (compounded) |
| Coverage | All 50 states | Coverage not published |
| Brand-name access | Yes | Compounded only |
| Oral / sublingual | Yes | Yes |
Graded #165 · C
Strengths
- Cheapest legal path to a brand-name GLP-1 in 2026 ($25/mo with savings card for commercial insurance)
- Direct from manufacturer — no compounding, no third-party reseller
- Daily oral pill, no injections, no refrigeration
- Available in all 50 states
Where it loses points
- Lower mean weight loss vs Wegovy (14.9%) and Zepbound (20.9%) — labeled-dose 11.1% per Foundayo PI
- Requires existing prescription from a separate prescriber (LillyDirect does not write the prescription)
- $25 savings card requires commercial insurance — Medicare and Medicaid not eligible
- Strict empty-stomach 30-minute window may be hard for some patients to follow
Graded #123 · 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.