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

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251–260 of 318 posts

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

#251

Earlier quoted context omitted.

I said that you may be an extreme outlier. You're also larger than every NFL player in history, everyone in World's Strongest Man, etc. A 10 mile jog (let's say 80-100 minutes of uninterrupted running) is the sort of "I could eat 50 eggs" number people pull out. At 6'5", you are an outlier. 2kcal is too low, much as it's too high for the average woman. This doesn't mean that metabolism is a "colloquial" term. It mean…

> It's that "I cut calories and I lost weight" is not anecdotal. It's factual. It simplifies the problem though, because for many, that approach has side-effects that seriously affect quality of life, like sleep, concentration, mood swings, depression etc. Speaking of depression, I often get a similar vibe in those threads, where undoubtedly someone will jump in and say "all you have to do is lift heavy weights and c…

Really nicely put.

I've wanted to bring up how physicians treatment of depression has radically changed in the last few decades (to have a much greater appreciation of the medication-assistance), but I didn't want to bring it up myself as I thought it may be too confusion/controversial.

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

#252
post #235
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…

Have you heard of Pavlovs Dog, that started salivating when he rang a bell? Normally it's seen as an example of conditioning. But I think it's an illustration of something I noticed in my own life: That the primary cause of hunger feelings is expecting a treat. When I haven't eaten in a while and know food isn't coming, I don't really feel hungry, I just feel tired.

Interesting to hear!

"hunger" is a simple word for a pretty complex mix of biological, psychological, and environmental factors.

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

#253
post #240

Interesting offering, definitely an important market. > So we started researching effective, evidence-based treatments for obesity Fasting has a tremendous amount science supporting it [1], can you articulate why you're pursuing the prescribed semaglutide approach instead? [1] Fasting: Molecular Mechanisms and Clinical Applications https://www.sciencedirect.com/science/article/pii/S155041311...

Fasting is a migraine trigger for me. Many other migraineurs agree. Other migraineurs see benefits from fasting. My point being: there is no "one size fits all" approach to weight loss.

Important to hear this. I'd say there's a huge lack of empathy (understanding that someone can have a very different experience) in this space because of how it's tied in with society's take on individualism & moral responsibility.

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

#254

I am glad to see this. I was involved in a similar startup that became bogged down due to reasons that had nothing to do with the validity of the approach you are taking. As I am sure you are aware, obesity is a complex issue and many of the suggestions sufferers get such as eat less, exercise more, try fasting, go keto, etc. are simply not helpful in and of themselves. Neither is just prescribing the latest medicati…

Agree - I think psychology is everything. It's odd that drinking too much and drugs is always put down to trauma, stress, and psychological treatment is seen as number 1, whereas with food addiction - it's often ignored to the very last. People can argue until they're blue in the face but if you eat less calories than you burn you will lose weight. The problem is people with trauma plus a food addiction are not able…

We're definitely a big proponent of a psychological approach for a lot of Fellas. And "food addiction" is a controversial but rapidly growing area of research.

That said, important to state a psychological-only approach sadly isn't sufficient for the majority of people.

I've never looked for research on this, but the environmental & social pressures are definitely believable why they may produce this outcome. I also wonder how important selection effect is here for your Bondi Beach example.

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

#256

Would have loved to know you're only live in Texas before I went through the ~10 page survey about all my personal information.

Really sorry about this. We tried to make this clear in the post, but you're right we can definitely make this clearer on our website.

Before launching on HN we haven't had an non-Texas traffic so there are some bits we need to change to our infra!

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

#257

I'm non-binary, assigned male at birth. I totally agree that having a program aimed at men and building supportive communities for men is important, as they are often under served by existing support infrastructures. I'm curious if you'd consider non-binary folks as well? Should I not sign up if I'm nonbinary? Or even anyone who is ok with a 'primarily for men' atmosphere?

You're 100% welcome here. Would love it if you wanted to sign up.

Or if easier, you can drop me an email on richie@joinfella.com and we'll sort you!

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

#258

Ever think of branching into addiction? That's another place where evidence based care is sorely lacking.

Isn't obesity a result of food addiction?

It's one important cause - although "food addiction" is interestingly quite controversial in the research space, and the literature is fast growing here.

It's certainly something we tackle head on in our program.

But food addiction is not representative of everyone's struggles.

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

#259
post #241

Earlier quoted context omitted.

> 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. That sound a bit wrong to me. Fat needs energy to maintain itself? Isn't it just an energy store? If you're 465lbs with th…

It's more that the muscles (assuming same muscle mass) have to do comparatively more work if they are carrying around more weight.

That is true but I don't think that accounts for all the metabolism. There's probably something to say about having to maintain your temperature, but I don't know if it consumes more or less energy in general as fat isolates. Wikipedia (https://en.wikipedia.org/wiki/Basal_metabolic_rate) says that 70% of the metabolism comes from the organs, 20% the muscles and 10% thermogenesis. All probably grow as you gain weight, but I seriously doubt that an obese person weighing 400lbs consumes twice as much energy as someone weighing 200lbs. What I'm trying to say is that the idea that you have to eat enormous quantities of food to maintain a high weight seems wrong to me, and that simply saying that the person must be missing some calories that they consume or lying about their level of activity seems condescending to me.

To change the subject, do you plan on expending Fella to Europe at some point? I really like your approach.

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

#260
post #241

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…

> 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. That sound a bit wrong to me. Fat needs energy to maintain itself? Isn't it just an energy store? If you're 465lbs with th…

>Fat needs energy to maintain itself?

Yes. Stored fat isn't just inert fat, but fatty tissue. Made of cells that need energy to stay alive.

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