Many Americans are turning to the latest big idea to lose weight. Fad diets, fitness frenzy, dubious herbs and pills, and bariatric surgery, just to name a few. They are rarely the magical solutions people dream of.
A series of start-ups are now offering access to new categories of drugs combined with intensive behavioral coaching online. But concerns are already emerging.
These start-ups, spurred by hundreds of millions of dollars in funding from blue-chip venture capital firms, have enrolled well over 100,000 patients and could reach millions more. I have. These patients pay hundreds, if not thousands, of dollars to access new drugs called GLP-1 agonists and online coaching to encourage healthy habits.
The startup initially positioned itself on lofty terms. “This is the last weight loss program you’ll try,” says his 2020 marketing analysis by his Calibrate Health startup, designed to reach one of his target demographics: “working moms.” said in a message. (Company spokesperson Michelle Wellington said the document does not reflect his Calibrate’s current marketing strategy.)
But while doctors and patients are intrigued by the new model, some customers are complaining of a lack of reality online.
New York City-based startup Calibrate Health reported serving 20,000 people earlier this year. Found, another San Francisco-based startup, has served 135,000 patients since July 2020, CEO Sarah Jones Simmer said in an interview. Calibrate costs patients nearly $1,600 a year, according to drug-savings site GoodRx. This does not include drug prices. (Insurers will reimburse her GLP-1 agonist in limited circumstances, the patient said.) Found offers her a six-month plan for nearly $600, a company spokeswoman said. said. (This price includes generics, but not new her GLP-1 agonists like Wegovy.)
Together, the two companies are beneficiaries of more than $200 million in venture funds, according to the venture capital investment repository Crunchbase. These companies claim to be pioneers in weight management, citing the influence of biology and other scientific factors as key elements of their approach.
These startups have a potentially large market. More than four of her 10 Americans are obese, increasing her risk of cardiovascular disease and her type 2 diabetes, according to the Centers for Disease Control and Prevention. Effective treatments are elusive and difficult to access.
The center that provides this specialty care is “overwhelmed,” said Dr. Fatima Stanford, an obesity medicine specialist at Massachusetts General Hospital in Boston. Her clinic has her waiting list of 3,000 people.
Stanford, who has advised several telemedicine startups, is bullish about the potential.
Dr. Scott Bucci, director of obesity medicine at the Cleveland Clinic, says the start-up can offer less judgmental and biased treatment than its face-to-face peers. It’s also more convenient.
Butch, who learned about the model through consultancies, patients and colleagues, wonders if the startup is working to “strategically find which patients respond to which drugs.” He said antidepressants and other medications may be driving weight gain, so he needs to work well with behavioral experts. “I think programs without interdisciplinary teams are less comprehensive and less effective in the long run.”
The start-up sells two products. First, in the new class he is a GLP-1 agonist. These drugs are effective in inducing weight loss, but Wegovy, one of two in this class specifically approved for this purpose, manufactures according to manufacturer Novo Nordisk. The supply is in short supply due to the above problem. Others in the category can be prescribed off-label. But doctors aren’t generally familiar with drugs, Stanford said. In theory, startups could fill some of these gaps. They provide more professional and knowledgeable clinicians.
Now there’s another problem. It’s a change in behavior. Companies are using TV visits with nutritionists and coaches and her online messages to help patients adopt new eating and exercise habits. According to Novo Nordisk, the amount of weight loss achieved by a participant in a clinical trial of the new drug—up to 15% of her body weight—was associated with such changes.
Social media sites are flooded with ads for these startups, from podcasts to Instagram. A search of Meta’s ad library reveals 40,000 of his ads for both companies on Facebook and Instagram.
This ad complements what people post on social media. Many Facebook groups are working hard on new types of drugs, some even focusing on helping patients manage side effects such as bowel changes. Buzz is quantifiable. New references to his GLP-1 agonist on TikTok have tripled from his June of last year to his June of this year, according to an analysis by Morgan Stanley investment bankers.
There is now a frenzied and anticipated appetite for these drugs among the startup’s customers. I was complaining that I got it. Coults said patients may perceive a kind of bait-and-switch when, in fact, clinical reasons, such as drug contraindications, guide prescribing decisions.
Coults said patient expectations influence care. Customers came in with ideas shaped by fad diet culture and New Year’s resolutions, she said. “Quite a few people signed up for a month and didn’t stay.”
In interviews with KHN and online complaints, patients also questioned the quality of care they received. Some said that starting with filling out a form and going online to see a doctor was perfunctory. Once the medication was started, they said, they responded slowly to requests for counseling about side effects.
Discovered patient Jess Gallant recalled feeling “absolutely strange” after being prescribed zonisamide and then generic anticonvulsants that have been shown to help with weight loss. rice field.
“I was up all night and my thoughts were spinning,” she wrote in a blog post.
She asked the found’s doctors for advice and help, but their response “wasn’t prompt,” she told KHN. Non-urgent communications are routed through the company portal.
It took a week for the drug switch to be completed and the new prescription to arrive at my home. Meanwhile, she went to an urgent care clinic for a sore mouth.
Found frequently prescribes generic drugs (often off-label) as well as new GLP-1 agonists, company executives said in interviews. Older generics like zonisamide are more readily available than his GLP-1 agonists, which are advertised on his social media and on his website, Found said. Both Butsch and Stanford say they have successfully prescribed zonisamide. Butch said increasing the dosage too quickly can increase the risk of side effects.
But Dr. Kim Boyd, chief medical officer of competitor Calibrate, said the old drug “had no effect at all.”
Patients from both companies have criticized the startup’s behavioral therapy online and in interviews. Some patients, however, felt that they had merely received canned advice.
Other patients said they had their ups and downs with their coach. Lawyer Dana Crom said she has experienced many coaches about Calibrate. Other than that, not so good. But when program kinks arose, she said coaches couldn’t help her navigate them. It seems less effective than messages sent through the portal.
And what happens when her one-year subscription ends? Crom said she would consider continuing with Calibrate.
Given the need to change behavior, coach relationships are a key component of our business model. The found’s chief medical officer, Dr. Rekha Kumar, said patient outcomes “depend on how well they adhere to lifestyle changes.”
While the start-ups are providing care to a larger geographic footprint, it’s not clear if the demographics of the patient population differ from those of the traditional brick-and-mortar model.Calibrate’s patients are predominantly white. is. More than 8 out of 10 have at least a bachelor’s degree. More than eight in 10 are women, according to the company.
And its early marketing strategy reflected that. In a “segmentation” document from September 2020, he presented three types of customers the company hopes to attract. A working mother with similar income. and “male”.
Calibrate CEO Isabelle Kenyon said the company now wants to expand into partnerships with larger employers, which will help it diversify its patient population.
Patients need to be confident that a more affordable and accessible model is right for them. Garrant, who no longer uses Found, reflected on her own experience and wrote in her blog post that she wanted more follow-up and a more personal approach. “I don’t think it’s a way to help you lose weight,” she said.
KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism on health issues. KHN is one of his three major operational programs in the United States, along with policy analysis and polling KFFMore (Kaiser Family Foundation). KFF is a donated non-profit organization that provides information on health issues to the public.
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