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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

#181

Post by rich-cartwright »

1123581321 wrote: post #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?

We do work with T1 diabetics, and the weight loss prescription does bypass that line of questioning.

BUT. Cards on the table about qualifying for GLP-1 RAs: most insurance policies still don't include weight management medication, and if they do it is difficult to know how your insurance will react until the doctor writes the prescription. I know people smarter than me are working on changing this about the US healthcare system!

So we'd have to see exactly which medication was a fit after a conversation with the doctor.

Which state are you in by the way?

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

#182

Post by 1123581321 »

rich-cartwright wrote: post #181
1123581321 wrote: post #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?

We do work with T1 diabetics, and the weight loss prescription does bypass that line of questioning. BUT. Cards on the table about qualifying for GLP-1 RAs: most insurance policies still don't include weight management medication, and if they do it is difficult to know how your insurance will react until the doctor writes the prescription. I know people smarter than me are working on changing this about the US health…

Makes sense. I’m in IL and my doctor would be quite willing to have that conversation. :)

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

#183

Post by rich-cartwright »

1123581321 wrote: post #182
rich-cartwright wrote: post #181

Earlier quoted context omitted.

We do work with T1 diabetics, and the weight loss prescription does bypass that line of questioning. BUT. Cards on the table about qualifying for GLP-1 RAs: most insurance policies still don't include weight management medication, and if they do it is difficult to know how your insurance will react until the doctor writes the prescription. I know people smarter than me are working on changing this about the US health…

Makes sense. I’m in IL and my doctor would be quite willing to have that conversation. :)

Nice. Working hard to get to you as soon as we can!

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

#184

Post by rich-cartwright »

jimmaswell wrote: post #178
rich-cartwright wrote: post #173

Earlier quoted context omitted.

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

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

#185

Post by civilized »

robomartin wrote: post #150
civilized wrote: post #25

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…

Me: Your personal experiences aren't sufficient basis to say what is right for everyone on the planet.

You: Nonsense, and to prove it, here's another long personal anecdote.

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

#186

Post by jimmaswell »

rich-cartwright wrote: post #184
jimmaswell wrote: post #178

Earlier quoted context omitted.

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: 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 they started doing pushups every time it happened, and some part of the brain learned the association and cut it out. I never did that but it might be worth trying.

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

#187

Post by AussieWog93 »

rich-cartwright wrote: post #167
stef25 wrote: post #110

Earlier quoted context omitted.

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…

Thanks for sharing man. Important to emphasize there is a large variety of causes: stress eating is certainly a big part for a lot of people, but it's far from universal & far from the whole story. "Something that can be fixed by just putting your mind to it shouldn't have to be treated with pills" is I think an interesting statement. I'm unconvinced "putting your mind to it" is as simple as it's made out to be.

>I'm unconvinced "putting your mind to it" is as simple as it's made out to be.

Back when I was in university, I decided to simply "put my mind to it" and went from 100kg->65kg in one year. That weight stayed off for the better part of half a decade.

"Simply" doing the same thing now, though, with all of the competing priorities I have (young child, growing business, burned out wife and a constantly shifting set of rules and uncertainty with the pandemic), is a different story. I think men especially are hesitant to come to terms with this because it means admitting weakness.

Thanks for creating this product, Rich. I really wish you success.

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

#188

Post by lkrubner »

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…

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 that also included selenium disulfide and piroctone olamine and therefore could have sold themselves as anti-dandruff shampoo, but the other shampoos instead went after the general market and they almost all failed. Head & Shoulders started with a niche and eventually became a giant:

"By 1982, it was the "number one brand" of shampoo, and it was noted that "No one hair care brand gets so many ad dollars as Head & Shoulders, a twenty year old brand, and no other brand matches its sales", despite it being a "medicated" shampoo."

https://en.wikipedia.org/wiki/Head_%26_Shoulders

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

#190

Post by nevinera »

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…

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 some basic effort, most of the people who are actively trying to do so (enough to pay for a service that supports that, for example) are in the second and third categories. And yet every time anyone posts in a non-dedicated forum anything about systems and plans to help that group solve their problems, there are a dozen people like you popping in to tell us "it's not that hard, just give it a try!"

I regularly make 60 mile bike rides, I can jog 10 miles (though I can't walk the next day when I do), I play tennis about 7 hours a week. I weigh 465 pounds. Trust me, I've tried the approach you're describing here. I once managed to hold onto it for 8 months, during which I lost about thirty pounds and then plateaued, while constantly fighting my body. I was sick twice as often as usual, and I had to carefully micromanage my calorie intake to make sure I had available calories for any physical activity I wanted to engage in, all while constantly battling cravings for dozens of foods _I don't even like_.

It would be a simpler world if all of us fat people were just fat because we're lazy, but the truth is that people vary really a lot, physically and metabolically. Your experience of the world is valid, but not universal.

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