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

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171–180 of 318 posts

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

#171

Earlier quoted context omitted.

Congrats on having a relatively easy time losing weight, but you're not the only person in the world, and not everyone's body works the same as yours. Your scolding of a clinically proven weight loss approach for not being what you did is solipsistic and ignorant. Your approach is, like the others, one among many that will work for some people.

> Your scolding of a clinically proven weight loss approach for not being what you did is solipsistic and ignorant. Far from ignorant. It is an absolute fact --thermodynamics-- that no human being needs a pill to lose weight. So, stop with the holier-than-thou come-back and think. This is no different from selling crap weight loss supplements to people. Why? Because they do not need that either. The fact that somethi…

You clearly care a lot. I respect that.

My prompt for you: do you care about the people suffering, or do you care more about moral posturing & fist shaking?

If you care about the people suffering, drop me an email on richie@joinfella.com and I will help you however I can to empower you to tackle whatever you see as the root cause.

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

#172

Earlier quoted context omitted.

The complete fasting approach is pretty common among Fellas I've spoken with. Lot of the guys have powerful "all-or-nothing" traits, where it feels easier to have a strict intense rule than a more nuanced approach. The issue comes when you therefore become so hungry your body drives you to eat a lot of food all at once. But I'm interested that you notice your hunger sensations actually diminish over time.

Isn't it actually well known that you are not hungry when fasting (after a couple of days)?

Yep I've just been reading up on this now actually: ghrelin & leptin changes after day 2 of a fast.

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

#173
post #142

Earlier quoted context omitted.

Extreme hunger, like others said. I'd class it as a subset of impulsive behavior, which is basically your primitive brain doing it's caveman shit and not listening to you , the conscious mind. Apparently some people don't have this problem, which makes me incredibly envious (or would if I could feel anything). It's this nagging thought of "JESUS CHRIST YOU'RE GONNA DIE IF YOU DON'T EAT A LOT RIGHT NOW!" I've experien…

I used to have that problem with sleeping and hunger. For me it just went away eventually.

Interesting. How long is eventually by the way?

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

#174
post #142

Earlier quoted context omitted.

Extreme hunger, like others said. I'd class it as a subset of impulsive behavior, which is basically your primitive brain doing it's caveman shit and not listening to you , the conscious mind. Apparently some people don't have this problem, which makes me incredibly envious (or would if I could feel anything). It's this nagging thought of "JESUS CHRIST YOU'RE GONNA DIE IF YOU DON'T EAT A LOT RIGHT NOW!" I've experien…

> 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..…

> "eat an insane amount of food. The food tastes 10x better, and the sensation when eating it is pure bliss"

This stuck out for me. Especially interesting that taste & eating sensation are both heightened.

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

#175
post #160

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've really never thought about that flip before.

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

#176

Earlier quoted context omitted.

Agree it's early days in terms of longitudinal follow-up studies. We're looking forward to playing a part in those studies ourselves.

As mid-fifties person, I have a shorter "long term" than many readers on this site. :) For me, there are the very real and immediate risks of being overweight, versus a potential for longer term risks from the medication.

Well said. These are the kinds of nuanced conversations that our Fellas have with their doctor.

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

#177
Congratulations on the launch! I’m on one of your waitlists. Do you work with any T1 diabetics? My understanding is I wouldn’t qualify for Victoza since I haven’t demonstrated sufficient ineffectiveness of Metformin. Does the weight loss prescription bypass that whole line of questioning?

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

#178

Earlier quoted context omitted.

I used to have that problem with sleeping and hunger. For me it just went away eventually.

Interesting. How long is eventually by the way?

It's hard to say, but probably not more than a month. I think I compensated a bit by saving some calories to eat directly before bed, but there was definitely some time of simply powering through it. If the Fella plan makes things like this easier then that sounds pretty cool.

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

#179
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 my bad for not tailoring our language enough for a HN post.

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

#180
post #152

Earlier quoted context omitted.

I understand. You need to protect a YC-funded startup from criticism. No problem. I get it. Money is more important. Just go ahead and delete everything I have written on this thread. That will be the easiest path. Lesson learned, don't be critical of YC companies. Got it.

People criticize YC-funded startups all the time on HN. Just look at the beating these guys took yesterday: https://news.ycombinator.com/item?id=28247379 . We go out of our way to moderate threads less when a YC startup is involved ( https://hn.algolia.com/?dateRange=all&page=0&prefix=false&qu... ), but your behavior in this thread has been so egregious that I don't have a choice. "Less" doesn't mean "zero".

> your behavior in this thread has been so egregious that I don't have a choice

From the FDA notice on the approval of this drug:

"The most common side effects of Wegovy include nausea, diarrhea, vomiting, constipation, abdominal (stomach) pain, headache, fatigue, dyspepsia (indigestion), dizziness, abdominal distension, eructation (belching), hypoglycemia (low blood sugar) in patients with type 2 diabetes, flatulence (gas buildup), gastroenteritis (an intestinal infection) and gastroesophageal reflux disease (a type of digestive disorder).

The prescribing information for Wegovy contains a boxed warning to inform healthcare professionals and patients about the potential risk of THYROID C-CELL TUMORS. Wegovy should not be used in patients with a personal or family history of medullary thyroid carcinoma or in patients with a rare condition called Multiple Endocrine Neoplasia syndrome type 2 (MEN 2).

Wegovy should not be used in patients with a history of severe allergic reactions to semaglutide or any of the other components of Wegovy. Patients should stop Wegovy immediately and seek medical help if a severe allergic reaction is suspected. Wegovy also contains warnings for inflammation of the pancreas (pancreatitis), gallbladder problems (including gallstones), low blood sugar, acute kidney injury, diabetic retinopathy (damage to the eye's retina), increased heart rate and suicidal behavior or thinking. Patients should discuss with their healthcare professional if they have symptoms of pancreatitis or gallstones. If Wegovy is used with insulin or a substance that causes insulin secretion, patients should speak to their health care provider about potentially lowering the dose of insulin or the insulin-inducing drug to reduce the risk of low blood sugar. Healthcare providers should monitor patients with kidney disease, diabetic retinopathy and depression or suicidal behaviors or thoughts."

It is interesting what we choose to label as egregious. My first reaction was very raw: I could not believe YC though it OK to effectively become drug pushers. You are funding a startup that will expose people to all of the above, and then some.

Here's the key message: See that list? Well, that list goes away. Completely. If we push for better food rather than popping pills. Gone.

You are entitled to moderate HN as you wish, of course. This does not alter the obscenity that is the idea of looking for a billion dollar exit by preying on desperate people by pushing drugs. At the end of the day, that's what all weight loss programs do.

From a Harvard article on weight loss drugs:

"You may remember some disturbing reports about previous weight-loss medications. Dexfenfluramine and fenfluramine were taken off the market after they were linked to heart valve damage. Sibutramine (Meridia) was removed after it was linked to heart attack and stroke in people at highest risk for them.

The options on the market today come with their own cautions. The ingredient phentermine—a component of Adipex-P, Ionamin, and Qsymia—isn't usually recommended for people who have high blood pressure or other heart conditions. Topiramate, another component of Qsymia, has been linked to an increased risk of birth defects, so women who take it should take special precautions not to get pregnant."

A lot of people don't remember what some of these approved drugs did to people, perhaps because they are too young...they don't even know the history.

What does FDA approved actually mean?

Have a good weekend. Going for a walk.

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