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

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

#1
Hey HN! I'm Richie from Fella (https://www.joinfella.com), a telehealth clinic for men with obesity. Fella helps men get to a healthier weight by matching them with a board-certified obesity doctor to prescribe an FDA-approved medication, while they undertake personalized health coaching.

I personally struggled with stress eating for 6 years. During that time, I was at Cambridge University, then built and sold my first company working with the UK government. It was tough, and poor eating habits as a teenager became a coping mechanism as an adult.

Fella first started as a "CBT+community" product to help men battling stress eating. It resonated due to the stigma around men's eating struggles. But we realized we were only half-serving most of our customers: even when no longer stress eating, most guys weren't getting to a healthier weight.

So we started researching effective, evidence-based treatments for obesity. When I say "we", I really mean my co-founder Luke. He studied medicine at Cambridge University, developing a patented AI approach to detecting cancer at a YC bio company, before moving to Microsoft Research. He parses bio papers better than me...

Obesity treatment is about to radically change. This is thanks to a breakthrough medication — NY Times called it a "game changer" in Feb 2021 [1]. The medication was approved by the FDA in June 2021 [2]. It leads to an average 15% decrease in body weight, efficacy close to bariatric surgery [3]. However, medication-assisted treatment for obesity is still stigmatized by family doctors and therefore hard to access.

Moreover, only 10% of those using weight management services are men, despite men representing 50% of those with obesity. This is because almost all programs market to women, placing too much emphasis on looks and not enough on health for a male audience. Stress eating is widespread among bigger guys, but mostly ignored — with too much focus on willpower and "eat less, move more". This needs to change.

So we pivoted to the Fella you see today: a telehealth experience with a board-certified obesity doctor for FDA-approved medication, combined with personalized health coaching. We went live in Texas in July, and are soon to be live in California and New York. Fella is a 12-month program and costs $149/month, paid quarterly. We’ll bring costs down over time to improve accessibility.

We still have lots of difficulties ahead. The main one could be insurance reimbursement: the latest wave of medications are expensive and insurers don't like to cover them [4].

We’re excited to hear your ideas, questions, concerns, feedback — and maybe any personal stories. I’ll be responding to comments all day, or feel free to shoot me an email at richie@joinfella.com.

[1] https://www.nytimes.com/2021/02/10/health/obesity-weight-los...

[2] https://www.fda.gov/news-events/press-announcements/fda-appr...

[3] https://www.nejm.org/doi/full/10.1056/NEJMoa2032183

[4] https://www.bloomberg.com/opinion/articles/2021-07-19/weight...

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

#5

Only available in Texas currently. When's the nationwide rollout? Any more precise than "soon"?

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.

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

#6

Only available in Texas currently. When's the nationwide rollout? Any more precise than "soon"?

Not affiliated, but I believe with every telemedicine company, the care providers need a medical license in each and every state they have patients in. So it will likely be a long time before they have “nationwide” coverage. This is why many telemedicine startups are only in a select handful of states.

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

#7
post #4

Looks like you're using a common and old Diabetes medication to control glucose, changing the regulation of appetite? I'm curious why this works best for men? Does it work in women?

Yep GLP-1 RAs are the gold-standard, if insurance coverage permits (because they are expensive if you have to pay out-of-pocket). The effect is roughly equal in men & women. The big breakthrough was the latest GLP-1 RA called Semaglutide, FDA approved in 2017 for diabetes and June 2021 for weight management. The main paper for that is here if you're interested:

https://www.nejm.org/doi/full/10.1056/NEJMoa2032183

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

#8

Only available in Texas currently. When's the nationwide rollout? Any more precise than "soon"?

Not affiliated, but I believe with every telemedicine company, the care providers need a medical license in each and every state they have patients in. So it will likely be a long time before they have “nationwide” coverage. This is why many telemedicine startups are only in a select handful of states.

Exactly this! Got there before me.

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

#10
This is really interesting as someone who works as part of a group who takes products similar to this to market! Thank you for sharing.

You mentioned the medication is as effective in women as it is in men. While I understand men are underserved in this space and so I respect the decision to focus on that population on that basis, I'm curious if there are business elements to that decision as well? Would you ever expand to serving women, given that they seem to be a larger potential customer pool?

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