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

#191

Post by noduerme » Sun, Aug 22, 2021, 2:17 AM UTC

rich-cartwright wrote: post #179

issa wrote: post #166

I am curious if this question has come up in company marketing discussions. One of the most common and off-putting things about the weight-loss industry is the vague medicine promise. Have you considered just saying "semaglutide" instead of "a breakthrough medication"? I honestly almost stopped reading because it comes off as so huckster-ish to me.

I think a lot about our framing and I know for sure we haven't nailed it yet. It's fair to say your avg HN reader is very different to your avg American. For example, you seem already somewhat clued up about Semaglutide. You're likely interested in the biology behind it, and probably aren't afraid to parse the journal article about it. I really wanna emphasize how different this is to your avg American. So it's more…

Consider hacker mentality. You have a complex system that's not functioning the way it should. Do you drill to the root problem or just patch it temporarily? Weight gain is a problem, and the possible environmental contaminants and other causes behind society-wide weight gain are of interest as a big problem to solve. Workaround hacks like producing more insulin don't drill into the root cause. My first impulse (and probably that of most people here) is to identify what is being sold and then read what's known about the biological pathways it leverages. Not that we wouldn't all mind being fitter. But some argument needs to be made that altering basic cellular biochemistry for up-to 15% weigh loss has a risk/reward profile better than seeking root causes and addressing those, which any coder worth their salt would try to do first.

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

#192

Post by rich-cartwright » Sun, Aug 22, 2021, 2:22 AM UTC

nevinera wrote: post #190

jimmaswell wrote: post #37

Earlier quoted context omitted.

> 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…

This is what's known as an 'anecdote', and is at the crux of the issues surrounding men's weight loss. This approach, and other very obvious and straightforward ones do indeed work perfectly well for a fair fraction of the population, but they perform poorly for another large fraction, and fail abysmally for yet a third. While there are no doubt plenty of people that could lose weight fairly readily if they gave it s…

Really nicely put.

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

#193

Post by rich-cartwright » Sun, Aug 22, 2021, 2:23 AM UTC

jimmaswell wrote: post #186

rich-cartwright wrote: post #184

Earlier quoted context omitted.

re: powering through, any tactics you used? Or literally just there in bed promising yourself not to move?

Water helped to an extent. I believe at some point I just lied there for a while and didn't give in. Eating just a little but not enough to not have a deficit anymore also helped. I've done this whole thing very slow and steady in general, and I think that helps with consistency. Someone here or on reddit once had a problem with their mind keeping them up for either hunger or to check their phone or something, and th…

Helpful to know, thanks!

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

#194

Post by rich-cartwright » Sun, Aug 22, 2021, 2:27 AM UTC

robg wrote: post #189

You mentioned stress eating, how does the coaching help stress and sleep management? As our self-regulatory cognitive defenses drop across a long stressful day, how to help encourage sleep not eating?

The stress eating side takes inspiration from a CBT-based approach. Lots of aspects to CBT, but an important part is to recognize what we're use the tool (relieve stress) & when we're using the tool (late evening) - then to find a better tool to replicate that stress relief.

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

#195

Post by O_H_E » Sun, Aug 22, 2021, 2:32 AM UTC

nevinera wrote: post #190

jimmaswell wrote: post #37

Earlier quoted context omitted.

> 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…

This is what's known as an 'anecdote', and is at the crux of the issues surrounding men's weight loss. This approach, and other very obvious and straightforward ones do indeed work perfectly well for a fair fraction of the population, but they perform poorly for another large fraction, and fail abysmally for yet a third. While there are no doubt plenty of people that could lose weight fairly readily if they gave it s…

Oh Wow, just wow.

You just explained and expanded on my thoughts and conversations about my ADHD very well.

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

#196

Post by rich-cartwright » Sun, Aug 22, 2021, 2:33 AM UTC

noduerme wrote: post #191

rich-cartwright wrote: post #179

Earlier quoted context omitted.

I think a lot about our framing and I know for sure we haven't nailed it yet. It's fair to say your avg HN reader is very different to your avg American. For example, you seem already somewhat clued up about Semaglutide. You're likely interested in the biology behind it, and probably aren't afraid to parse the journal article about it. I really wanna emphasize how different this is to your avg American. So it's more…

Consider hacker mentality. You have a complex system that's not functioning the way it should. Do you drill to the root problem or just patch it temporarily? Weight gain is a problem, and the possible environmental contaminants and other causes behind society-wide weight gain are of interest as a big problem to solve. Workaround hacks like producing more insulin don't drill into the root cause. My first impulse (and…

Noted. For reference, I've very much tried to design Fella to tackle all the root causes of obesity, which vary person to person: metabolic condition, stress, sleep, exercise, food types & volume, and hormone imbalances.

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

#197

Post by rich-cartwright » Sun, Aug 22, 2021, 2:36 AM UTC

lkrubner wrote: post #188

rich-cartwright wrote: post #179

Earlier quoted context omitted.

I think a lot about our framing and I know for sure we haven't nailed it yet. It's fair to say your avg HN reader is very different to your avg American. For example, you seem already somewhat clued up about Semaglutide. You're likely interested in the biology behind it, and probably aren't afraid to parse the journal article about it. I really wanna emphasize how different this is to your avg American. So it's more…

I assume you've heard the advice that small startups should start in a niche and then expand towards the wider markets? Have you thought about initially focusing on Hacker News types, the types who read up on the technical documentation behind a drug? You've probably heard the story about Head & Shoulders shampoo? This is taught in a lot of marketing classes. The year it launched there were other shampoos launching t…

Hadn't heard about H&S.

Will give it more of a think about best early adopters.

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

#198

Post by noduerme » Sun, Aug 22, 2021, 2:41 AM UTC

nevinera wrote: post #190

jimmaswell wrote: post #37

Earlier quoted context omitted.

> 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…

This is what's known as an 'anecdote', and is at the crux of the issues surrounding men's weight loss. This approach, and other very obvious and straightforward ones do indeed work perfectly well for a fair fraction of the population, but they perform poorly for another large fraction, and fail abysmally for yet a third. While there are no doubt plenty of people that could lose weight fairly readily if they gave it s…

That's what's known as an anecdote. This is what's known as a counterexample. And one thing is certain: No method has 100% success. To me the more important question isn't what percentage of cases something addresses, but whether it's a self fix where the benefits outweigh the risks. The risks of intermittent fasting are relatively low, and it may have side benefits like prolonged lifespan and slower telomere degradation as shown in animal models. The risks of essentially hacking your own insulin production to upregulate it if you're not diabetic are not nearly as well understood. On an individual basis, whatever gets you to where you're happy is great. Personally I've fasted every day my entire adult life and still have to work to keep weight off. But when someone puts a slick marketing package on fasting or drugs or surgery or anything else, I have to question whether they really have my best interests at heart. And usually the answer is obviously not.

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

#199

Post by evol262 » Sun, Aug 22, 2021, 2:45 AM UTC

nevinera wrote: post #190

jimmaswell wrote: post #37

Earlier quoted context omitted.

> 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…

This is what's known as an 'anecdote', and is at the crux of the issues surrounding men's weight loss. This approach, and other very obvious and straightforward ones do indeed work perfectly well for a fair fraction of the population, but they perform poorly for another large fraction, and fail abysmally for yet a third. While there are no doubt plenty of people that could lose weight fairly readily if they gave it s…

This is what's known as an 'anecdote', and is at the crux of the issues surrounding weight loss.

Virtually every _controlled_ study shows that metabolic differences between adults are within a margin of +/- 15%, with essentially no way to eat the same amount of calories as a 200lb person and stay at 465lbs. Not least of which because your basal metabolic rate is much higher at that weight.

Virtually every study shows that overweight people significantly underestimate their input (whether intentionally deceptive or simply unaware) and overreport their physical activity, like "I can jog 10 miles", or "I play tennis about 7 hours a week", or "I regularly make 60 mile bike rides". If you do, you're the extreme outlier, and it doesn't change the data. Assuming you can do those things, you're almost certainly still in your 20s, and the health effects of your weight haven't really caught up with your body yet.

Very simply, it's far more likely that you miss some of the calories you consume, either because you don't actually weigh your food or you discount the signficance of "small" things. A pound of fat is 3500 calories. That's more complicated inside metabolic processes, but it means that "an apple a day" is 10lbs per year.

That isn't to say that "prescribe more medication instead of correcting the underlying issue" (trauma, self-medication, dopamine flush, whatever) is the answer, but that diets perform poorly for a large fraction and fail abysmally for another third because we are bad at tracking things, we are bad at being uncomfortable, and we bad at self control, etc. Diets do work. It's sticking to the diet and recognizing when you're off the rails which is difficult.

It's also difficult to acknowledge that this "diet" is not temporary and you can go back to old eating habits once the weight is off. The new caloric consumption is forever, because that's what brought you to the new homeostatis.

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

#200

Post by nevinera » Sun, Aug 22, 2021, 2:45 AM UTC

noduerme wrote: post #198

nevinera wrote: post #190

Earlier quoted context omitted.

This is what's known as an 'anecdote', and is at the crux of the issues surrounding men's weight loss. This approach, and other very obvious and straightforward ones do indeed work perfectly well for a fair fraction of the population, but they perform poorly for another large fraction, and fail abysmally for yet a third. While there are no doubt plenty of people that could lose weight fairly readily if they gave it s…

That's what's known as an anecdote. This is what's known as a counterexample. And one thing is certain: No method has 100% success. To me the more important question isn't what percentage of cases something addresses, but whether it's a self fix where the benefits outweigh the risks. The risks of intermittent fasting are relatively low, and it may have side benefits like prolonged lifespan and slower telomere degrada…

I'm not arguing in favor of any particular approach (in particular the one posed by the original poster, which I have done zero research into). If and when they launch in a meaningful way I'll bother doing that research, but I am also a cynic about people offering to make a difficult thing easy for a recurring fee.