Launch HN: Fella (YC W20) – Tackling men's obesity using medication and coaching • Hacker News Board

Re: Launch HN: Fella (YC W20) – Tackling men's obesity using medication and coaching

#101

Post by criticaltinker » Sat, Aug 21, 2021, 7:26 PM UTC

dlevine wrote: post #95

I have done just about everything over the years to lose weight. I tend to exercise a ton naturally, so it has been more about eating less than exercising more. I would say that my natural weight is slightly overweight but not obese. I've tried various brands of keto (Atkins/4 Hour Body), Weight Watchers, eating slowly, cutting out sugar and wheat, juice fasts. Everything has worked for a time, but the weight has eve…

> I've read the research on willpower being a resource that you use up, and definitely agree with it

I don't enjoy subjecting you to cognitive dissonance here...but some highly cited research shows this belief may be a self fulfilling prophecy.

> Study 1 found that individual differences in lay theories about willpower moderate ego-depletion effects: People who viewed the capacity for self-control as not limited did not show diminished self-control after a depleting experience. [1]

> Study 2 replicated the effect, manipulating lay theories about willpower. [1]

> Study 3 addressed questions about the mechanism underlying the effect. [1]

> Study 4, a longitudinal field study, found that theories about willpower predict change in eating behavior, procrastination, and self-regulated goal striving in depleting circumstances. [1]

> Taken together, the findings suggest that reduced self-control after a depleting task or during demanding periods may reflect people’s beliefs about the availability of willpower rather than true resource depletion. [1]

[1] Ego Depletion—Is It All in Your Head? Implicit Theories About Willpower Affect Self-Regulation http://icelab.psych.uw.edu.pl/wp-content/uploads/2016/02/job...

[2] Beliefs about willpower determine the impact of glucose on self-control https://www.pnas.org/content/pnas/110/37/14837.full.pdf

Re: Launch HN: Fella (YC W20) – Tackling men's obesity using medication and coaching

#102

Post by lharries » Sat, Aug 21, 2021, 7:28 PM UTC

jimmaswell wrote: post #37

rich-cartwright wrote: post #21

Earlier quoted context omitted.

Spot on about fasting, and keto has solid evidence as well - https://www.virtahealth.com/ are a great company focused on this. The issue is we're starting to have a more nuanced understanding of the metabolic resistance people face when they undergo dietary changes - basically the body fights hard against you as you try to lose weight by dieting. So it's now industry-standard among obesity specialist doctors to see o…

> basically the body fights hard against you as you try to lose weight by dieting. I used to weigh 310lbs, now I'm 215lbs. All I did was count calories to maintain a deficit and the results were essentially the same as predicted by the math. I was a bit hungry sometimes at first as I adjusted to it but that's really it. Prioritizing protein and fat over carbs helps with that. What ways does the body tend to fight aga…

Great to hear you've had success.

[1] is an interesting paper which gives you some hormonal examples. Effectively when you try and lose weight your body responds by increasing the hormones associated with greater satiety and weight regain. And these change may persists for a while — this papers documenting the change lasting past a a year. This will very by person however so if you have something which works for you keep going.

[1] https://pubmed.ncbi.nlm.nih.gov/22029981/

Re: Launch HN: Fella (YC W20) – Tackling men's obesity using medication and coaching

#103

Post by criticaltinker » Sat, Aug 21, 2021, 7:29 PM UTC

lharries wrote: post #100

criticaltinker wrote: post #63

Earlier quoted context omitted.

Thanks for your response and taking the time to answer these questions. > basically the body fights hard against you as you try to lose weight by dieting Anecdotally I think many folks would agree. Any citations or references you could provide on this point would be greatly appreciated - I'm struggling to find any solid literature with the phrase "metabolic resistance" in the context of dietary changes. > So it's now…

(Richie's co-founder here) You're spot on with the link between mental health and obesity and the need for a holistic approach. For many of the guys stress and anxiety will play a key part in their food habits. This is something that our coaches actively ask about and help manage if relevant. For other guys it might be sleep [1] or it might be macro-nutrients. The coaching will depend on the person and we make these…

Thank you for the excellent response and citations. I think you and Richie are on to something here - wishing you the best of luck.

Re: Launch HN: Fella (YC W20) – Tackling men's obesity using medication and coaching

#104

Post by rich-cartwright » Sat, Aug 21, 2021, 7:31 PM UTC

newman8r wrote: post #45

rich-cartwright wrote: post #5

Earlier quoted context omitted.

It's tough with the state-by-state regulation. CA & NY are in the coming month or two. Then the plan is the next 5-10 states by end of Q1 2022. We'll be sprinting to go fully nationwide by end of 2022.

Is this just because of the prescription drug element of your program? If there weren't any medications involved, would you need any state certifications?

Yep exactly - the prescription drug element requires state-by-state medicine licenses.

Re: Launch HN: Fella (YC W20) – Tackling men's obesity using medication and coaching

#105

Post by rich-cartwright » Sat, Aug 21, 2021, 7:33 PM UTC

f6v wrote: post #91

danpalmer wrote: post #76

Earlier quoted context omitted.

What was the reason for going after the US market instead of the UK market? I'm in the UK and would love to try Fella, especially if I could get it on the NHS with a GP referral.

> What was the reason for going after the US market instead of the UK market? Might have something to do with exorbitant amount of money in the US healthcare.

Bigger spend is definitely important. Drug approval, decentralized decision making, consumer norms all also important.

Re: Launch HN: Fella (YC W20) – Tackling men's obesity using medication and coaching

#106

Post by reilly3000 » Sat, Aug 21, 2021, 7:33 PM UTC

dlevine wrote: post #95

I have done just about everything over the years to lose weight. I tend to exercise a ton naturally, so it has been more about eating less than exercising more. I would say that my natural weight is slightly overweight but not obese. I've tried various brands of keto (Atkins/4 Hour Body), Weight Watchers, eating slowly, cutting out sugar and wheat, juice fasts. Everything has worked for a time, but the weight has eve…

Hate to say it but marriage is a sure formula for men’s weight gain.

Re: Launch HN: Fella (YC W20) – Tackling men's obesity using medication and coaching

#107

Post by lharries » Sat, Aug 21, 2021, 7:34 PM UTC

criticaltinker wrote: post #103

lharries wrote: post #100

Earlier quoted context omitted.

(Richie's co-founder here) You're spot on with the link between mental health and obesity and the need for a holistic approach. For many of the guys stress and anxiety will play a key part in their food habits. This is something that our coaches actively ask about and help manage if relevant. For other guys it might be sleep [1] or it might be macro-nutrients. The coaching will depend on the person and we make these…

Thank you for the excellent response and citations. I think you and Richie are on to something here - wishing you the best of luck.

Thank you! I enjoyed your great comments too

Re: Launch HN: Fella (YC W20) – Tackling men's obesity using medication and coaching

#108

Post by rich-cartwright » Sat, Aug 21, 2021, 7:36 PM UTC

diskzero wrote: post #82

I am glad to see this. I was involved in a similar startup that became bogged down due to reasons that had nothing to do with the validity of the approach you are taking. As I am sure you are aware, obesity is a complex issue and many of the suggestions sufferers get such as eat less, exercise more, try fasting, go keto, etc. are simply not helpful in and of themselves. Neither is just prescribing the latest medicati…

Thank you very much for this. Kind message.

What was the previous startup by the way? Always interested in improving my knowledge of the space!

Re: Launch HN: Fella (YC W20) – Tackling men's obesity using medication and coaching

#109

Post by mylons » Sat, Aug 21, 2021, 7:41 PM UTC

jimmaswell wrote: post #59

speeder wrote: post #46

Earlier quoted context omitted.

I will use myself as an example: I have Hashimoto disease, and even treated my metabolism can get so slow that I need to eat so little that I start to have nutrient deficits, for example one of the past dieting attempts resulted in hair loss, brittle nails, cracking skin, because I needed so little calories that when I consumed exactly what I needed, I ended with a protein deficit. Only solution I found that worked w…

That's interesting. That weight isn't necessarily unhealthy if it's largely muscle from all the training. Did you end up with a low body fat percentage despite the weight?

i’m in a similar spot as the OP. lifting helps, but i’m still pretty fat. 5’11” 250lbs. worksets are 355lb squat, 225lb bench, 425lb deadlift, 175lb overhead press. it’s hard to tell i’m strong, but i’m slightly more slender at this weight than i was before lifting. it definitely helps with aches and pains i used to have, primarily back pain.

Re: Launch HN: Fella (YC W20) – Tackling men's obesity using medication and coaching

#110

Post by stef25 » Sat, Aug 21, 2021, 7:42 PM UTC

TeeMassive wrote: post #28

robomartin wrote: post #20

[flagged]

>WE DO NOT NEED PILLS! >Yes, I am yelling. If pills work then what's the problem? It seems to me that you're making an appeal to nature ( https://yourlogicalfallacyis.com/appeal-to-nature ). Given all the health problems associated with obesity from cancer to cardiovascular problems then whatever side effects the pills have are probably negligible in comparison. > Weight management isn't at all about eating less. It'…

Assuming obesity is largely due to mental issues like stress eating, the solution should also be a mental one. It's basically an addition. Most people are perfectly capable of quitting but don't because it's easier not to.

This includes myself. I recently put on a bit of weight and I know exactly why: second servings, having a few beers, difficulties sticking to a diet with kids and dietary allergies in the house, no time or too lazy for exercise. It's all on me.

Something that can be fixed by just putting your mind to it shouldn't have to be treated with pills.

For some people it will probably be the hardest thing they ever do - I'm not downplaying this. So, for people who don't have the willpower pills is probably the best solution.