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

#211

Post by hourislate » Sun, Aug 22, 2021, 3:46 AM UTC

noduerme wrote: post #207

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…

There is no such thing as "Daily Fasting", it called Time Delayed Eating not Fasting. Have you lost 100 lbs, if not you are not qualified to comment on what works and what doesn't. You should refrain from all future discussions on this matter.

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

#212

Post by rich-cartwright » Sun, Aug 22, 2021, 3:57 AM UTC

halfmatthalfcat wrote: post #204

rich-cartwright wrote: post #197

Earlier quoted context omitted.

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...

Helpful to know. Thank you.

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

#213

Post by rich-cartwright » Sun, Aug 22, 2021, 3:58 AM UTC

noduerme wrote: post #202

rich-cartwright wrote: post #196

Earlier quoted context omitted.

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 parti…

Yep more research being done on the hormone imbalance side. Nascent area though.

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

#214

Post by rich-cartwright » Sun, Aug 22, 2021, 4:01 AM UTC

mitchellst wrote: post #210

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 k…

Thanks man. Just so I've fully understood here:

> "The person who got the surgery would often lose only the plurality of the weight, and sometimes not even that."

By this you're meaning the whole family lost weight after one individual had bariatric surgery?

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

#215

Post by rich-cartwright » Sun, Aug 22, 2021, 4:03 AM UTC

throwaway330935 wrote: post #208

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,…

Okay all important context, thanks for this. Which state are you in?

If you drop me an email on richie@joinfella.com, we'll talk it through

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

#216

Post by rich-cartwright » Sun, Aug 22, 2021, 4:13 AM UTC

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…

Unsure how helpful this slapdown is after the guy is sharing something pretty vulnerable.

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

#217

Post by rich-cartwright » Sun, Aug 22, 2021, 4:16 AM UTC

nevinera wrote: post #201

evol262 wrote: post #199

Earlier quoted context omitted.

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…

Agreed about the willpower rambling and the usefulness. This is the crux for me.

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

#218

Post by rich-cartwright » Sun, Aug 22, 2021, 4:17 AM UTC

O_H_E wrote: post #195

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…

Oh Wow, just wow. You just explained and expanded on my thoughts and conversations about my ADHD very well.

Interesting parallel.

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

#219

Post by Sunspark » Sun, Aug 22, 2021, 4:19 AM UTC

One thing that helps is to not buy candy from Costco.

Just don't. If you have it at home, it's going to get eaten even if you have it on another floor.

Better to buy smaller candy from elsewhere. It'll still get eaten, but at least there'll be no more, and you aren't going to go out again that night to get more candy.

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

#220

Post by rich-cartwright » Sun, Aug 22, 2021, 4:27 AM UTC

noduerme wrote: post #203

nevinera wrote: post #200

Earlier quoted context omitted.

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.

Guess I gotta step in here to protest "magic baldness cream".

We're not offering anything magic. The medication side has a compelling & growing evidence base: https://www.nejm.org/doi/full/10.1056/NEJMoa2032183

For the vast majority obesity doctors, a medication-assisted approach is now the gold standard.

The program side is also no magic. We do tough work, but with a strong evidence base, a powerful support structure and we give ourselves enough time (12-month program). We focus on the root causes of poor metabolic health: stress, sleep, exercise, dietary. From both the behavioral & psychological angles.

No magic here, just evidence-based interventions.