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

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

#201

Post by nevinera »

evol262 wrote: post #199
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…

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…

> 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

I'm 37, and 6'5". and if you're calling me a liar, you can fuck right off.

>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.

I was not trying to indicate that the actual metabolic burn rate of humans varies by huge factors, "metabolism" is a colloquial term that encompasses a poorly defined set of features. The physical, psychological, and emotional components of your experience of a calorie deficit are what causes the experiential variance I'm describing.

Of course if I could eat a 2000 calorie diet consistently for a long period of time I would lose weight! I've performed that process numerous times, with various caloric deficits (my basal is a bit past 3k, so 2k is a pretty serious deficit - I wasn't able to hold that one past three weeks). This is when most thin people start rambling about "willpower", but maybe just skip that part this time? It's not useful to any of us actual fat people.

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

#202

Post by noduerme »

rich-cartwright wrote: post #196
noduerme wrote: post #191

Earlier quoted context omitted.

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.

Beyond personal causes like metabolism or diet, there've been some fascinating discussions here in the past few months about why technologically advanced societies seem to have an exponential obesity problem starting around 1980, relative to other cultures that exercise less and take in more calories. I can't find the thread. But it definitely bears consideration. I think the view would be that hacking your way partially out of a problem isn't necessarily bad, but we've seen decades of data used to incorrectly imply one chain of causality or another and there's a larger problem to solve than a drug or a tummy tuck can tackle.

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

#203

Post by noduerme »

nevinera wrote: post #200
noduerme wrote: post #198

Earlier quoted context omitted.

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.

Sure. And well we should be. Identify what people view as a personal problem, then offer a solution. This is the second YC startup I've seen today that falls under the category of magic baldness cream.

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

#204

Post by halfmatthalfcat »

rich-cartwright wrote: post #197
lkrubner wrote: post #188

Earlier quoted context omitted.

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.

As someone who knows nothing about Semaglutide and is an HN type, I can tell you that anecdotally, marketing yourself as a breakthrough medicinal weight loss solution sounds very similar to packaging found on gas station counters.

Ephedrine was also a breakthrough weight loss treatment...until it wasn't...

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

#205

Post by noduerme »

issa wrote: post #160
rubicon33 wrote: post #155

Earlier quoted context omitted.

> I've experienced it after hard days at work (construction), multi hour lifting, cycling 50km. Same shit every time. Surprisingly, unlike what my dumbass brain says, I don't die if I eat only a little and just go to sleep. I too have experienced this sensation my whole life under such situations. In fact, one of my favorite things to do in life is go for a 6-7 mile run, come home and lift weight for an hour or two..…

As someone whose weight has been all over the place in my life, I really appreciate hearing this. I've known it is true forever, but it is rare to hear other people saying it. There is much more to weight than calories in/out. Some people can skip a meal without noticing, others count the minutes until the next meal. I always flip it on its head. For some reason it is easy for people to understand that certain people…

I was questioned in high school in the 90s whether I had an eating disorder. I just ignore hunger until it goes away... I simply don't want food. I don't like to eat around other people, either. When I do eat, around 2am every day, I've really looked forward to it so it's pleasurable. But as a functional alcoholic I fully understand counting the minutes to something. This where "eating disorder" self control comes into play. I think of myself drunk just like I think of myself fat with a face covered in food in front of other people, and it's been enough to stop me for 20 years from hitting the bottle until work is over. On the subject of self control, everyone is a hero if you can find any at all.

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

#206

Post by hourislate »

As someone who lost 100 lbs (from 278 to around 175)and kept it off, my advice is to stop eating shit food, eat a clean diet (do not go out to eat). Pick a 6 hour window to have your meal(s) and every month over a weekend or your time off take 3 days (72 hours) and don't eat a thing. Wash rinse and repeat. In one year you will lose more weight than you ever thought imaginable. The nice thing is exercise is optional but if you want to then just take long walks as much as you like.

No medication/drugs/gyms.

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

#207

Post by noduerme »

hourislate wrote: post #206

As someone who lost 100 lbs (from 278 to around 175)and kept it off, my advice is to stop eating shit food, eat a clean diet (do not go out to eat). Pick a 6 hour window to have your meal(s) and every month over a weekend or your time off take 3 days (72 hours) and don't eat a thing. Wash rinse and repeat. In one year you will lose more weight than you ever thought imaginable. The nice thing is exercise is optional b…

life long daily faster here. Going out to eat is not the problem if you eat good food. I go weeks without cooking at home, and live on massive orders of Indian, Thai and Ethiopian food that I keep in the fridge and dive into once a night. If "eat out" means fast food or processed food, then, sure - avoid it. But $50 worth of mostly vegan Indian food can last me 5 days. I trust the ingredients and it's more efficient than cooking at home.

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

#208

Post by throwaway330935 »

I'm currently working on losing weight and having a fair bit of success, largely because my wife is also extremely serious about it now. I'm basically feeding off her success, and supporting her is making it easier for me to make changes in my diet.

Over the last 2 months she's lost almost 30lbs, and I'm at over 20. Largely this has been serious changes in diet: Little to no carbs, basically a lot of grilled veggies, Soylent, protein drinks, yogurts, fruits... A little more exercise.

Really, the trick has been: She got a sleeve surgery a week ago, and for around 6 weeks before that she was basically on the reverse after-surgery diet to get used to it. And I've been kind of following her diet, though she encourages some tweaks to make sure I'm getting what I need. And this week when she's been just having a cup of broth a day, I've not been anywhere near that.

Short story long, She's on this path enforced by surgery. I want to support her, but I also want to use her journey to help me with my own. I'm fairly healthy, but want to make some activities easier, and I've been having some arthritis in my hips that make me want to ease their burden.

Fella sounds interesting as a way of further supporting my journey. Sounds like it's not available outside of TX, which I assume is related to "board certified". Also a little hard to tell what the final cost is going to be, $450/quarter plus whatever the drug is? I saw one of the other similar drugs on goodrx at $1K (a month? a quarter? Not sure), but looks like my insurance might cover it to the tune of ~$100. Boy, sure hope there's no tie to pancreatic cancer though. :-)

On the one hand, extra support might be nice. On the other hand, we've been going for 2 months and I'm about 20% of the way to my goal, and it hasn't been so hard, but I could also see it getting harder. I've previously lost almost double what I've lost so far, and then plateaued and gained it back over ~5 years. But now I have my wife going through it as well, so maybe it'll be different? Or maybe not...

At $250/mo for the program and drugs, it seems worth trying, but doesn't sound like it's even an option outside of Texas. Thoughts?

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

#209

Post by TeeMassive »

stef25 wrote: post #110
TeeMassive wrote: post #28

Earlier quoted context omitted.

>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…

> Assuming obesity is largely due to mental issues

Obesity increased with the increase of meal size, average caloric intake and urbanization based around cars.

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

#210

Post by mitchellst »

Wow. This is really interesting and important. I’m not your target customer and don’t know a ton about health tech, so I’m not sure I can help you, but I wish I could. thank you for taking this on. Someone should. Sometimes the science and medicine is there but branding, marketing, and positioning in a bigger value prop aren’t things that doctors and hospitals are prepared to handle at scale. So, this is cool.

I do know one thing about your space, from pure happenstance. I live in Texas and my wife is a fourth-year medical student here. One of her profs is a bariatric surgeon and she spent time in his clinic. One of the interesting things she learned was the correlation between weight loss for one adult and weight loss of a household. I don’t remember the exact stats, but this doc would have whole families weigh in at his clinic, before and after. The results were astounding. The person who got the surgery would often lose only the plurality of the weight, and sometimes not even that. It’s something to consider messaging around as you target men and try to get through the stigma to persuade them to seek treatment. You are doing something good for your family; this is about more than just you. Texan men in particular are likely to hold more traditional values about being the head of their household, however unfashionable that may be. Help these fellas— and help their families.

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