Head-to-head comparison
1st Optimal vs Fitish
Two GLP-1 providers, one scorecard. Both are graded on the same six Desk Score dimensions — here is how they stack up, and which one fits you.
Desk Score
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.
Marked down on: No public monthly pricing disclosed
Desk Score
Oral-capable, LegitScript-verified, and nationwide — trust signals are strong, but pricing sits mid-to-high.
$219/mo sema · $339/mo tirz
Marked down on: Higher pricing than the value leaders
FDAWarning letter issued to FITISH in June 2026. See the FDA warning-letter database.
Fitish takes this head-to-head with the higher Desk Score, 86/100 (B) against 46/100 (C) for 1st Optimal. 1st Optimal still holds its ground where its strengths line up with yours.
Desk Score, dimension by dimension
Same six measured dimensions for both. The red flag marks the stronger side. See the methodology.
1st Optimal
46/100
C
Fitish
86/100
B
Price transparency
State access
Molecule range
Onboarding speed
Support responsiveness
Licensing & trust
The spec sheet
| Field | 1st Optimal | Fitish |
|---|---|---|
| Semaglutide | Not listed on 1st Optimal's site (checked July 2026) | $219/mo$219/mo |
| Tirzepatide | Not listed on 1st Optimal's site (checked July 2026) | $339/mo$339/mo |
| Coverage | Not listed on 1st Optimal's site (checked July 2026) | All 50 states |
| Brand-name | Compounded only | Compounded only |
| Oral option | Yes | Yes |
| Best for | Patients wanting GLP-1 therapy within a lab-driven functional-medicine program. | People who prioritize a verified pharmacy and oral options over finding the lowest rate. |
| Desk Score | 46/100C | 86/100B |
The verdict
Desk pick — FitishFitish takes this head-to-head with the higher Desk Score, 86/100 (B) against 46/100 (C) for 1st Optimal. 1st Optimal still holds its ground where its strengths line up with yours.
Choose 1st Optimal if…
Patients wanting GLP-1 therapy within a lab-driven functional-medicine program.
Choose Fitish if…
People who prioritize a verified pharmacy and oral options over finding the lowest rate.
$219/mo sema · $339/mo tirz · All 50 states
FDAWarning letter issued to FITISH in June 2026. See the FDA warning-letter database.
Assume any provider we list may compensate us — we may earn a referral commission at no extra cost to you, and what we write about a provider reads the same either way. Read full breakdowns: 1st Optimal · Fitish.
Also here
CoreAge Rx leads the whole ranking at 94/100
Whichever of these two you lean toward, our #1-rated provider outscores them both. One price at every dose, both molecules, all 50 states. The $99 and $149 figures are 12-month plans paid up front, not a monthly bill.
More head-to-heads
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- BetterMe Rx vs Fitish
Or see the full comparison hub and the complete ranking.
Pricing and verification reflect each provider's public disclosures at last scoring; the Desk Score is our editorial judgment per the methodology. Prices change — confirm on each provider's own site. Not medical advice; see our disclosure.