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…
Launch HN: Fella (YC W20) – Tackling men's obesity using medication and coaching
301–310 of 318 posts
Re: Launch HN: Fella (YC W20) – Tackling men's obesity using medication and coaching
#302You can simply eat less but better quality food.
Re: Launch HN: Fella (YC W20) – Tackling men's obesity using medication and coaching
#303Earlier quoted context omitted.
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…
There's also recent evidence that consuming fructose increases your intestine's absorption of nutrients from the food you consume. The rapid integration of fructose into everyday foods (i.e. high fructose corn syrup being put into bread & sauces as a bulking / thickening agent) may be connected to the western world obesity crises.
Was posted on HN 4 days ago: https://news.ycombinator.com/item?id=28239113
(in case other people want to check it out)
Re: Launch HN: Fella (YC W20) – Tackling men's obesity using medication and coaching
#304Over the last 4 years, I've brought my weight down from nearly 310lb to under 240lb using an approach that seems to resemble closely what you're describing here (Liraglutide / Semaglutide, combined with nutritional and psychological coaching). At 50+, I had more or less given up on losing a significant amount of weight, but due to increasing mobility issues and a diabetes risk, I wanted to give it another shot, and I…
Re: Launch HN: Fella (YC W20) – Tackling men's obesity using medication and coaching
#305My wife is a doctor specialized in obesity management and works in a hospital daily where patients come in with BMIs well over 40. Besides semaglutide, which isn’t availble in this part of the world yet, they also prescribe liraglutide. I’d say that if someone is extremely obese, it’s unlikely they’ll be able to bring their weight down just through medication and counseling because most people lack the motivation or…
Semaglutide makes it a lot easier to eat healthy though, at least for me. When you aren't super hungry all the time it's easier to make healthier choices or just not eat at all.
Re: Launch HN: Fella (YC W20) – Tackling men's obesity using medication and coaching
#306Earlier quoted context omitted.
Honestly this is a pretty good description of the Fella program: "A holistic approach which addresses trauma, reasons for emotional eating, lifestyle replacements, recalibration of palate, satiation even at a deficit, and all the rest." We designed Fella because "throwing drugs at it" is not the best solution for patients. The crucial difference to your approach is the addition of the medication. Which if you speak t…
> Please do not let moral posturing cause you to underrate the importance of a holistic approach which includes medication-assistance. I get that you're a founder. It would be great to not cast aspersions on people. "I think your approach sucks" is not "moral posturing", and I'd question how many ethical doctors would recommend something insurance will not cover with an unknown end date to the treatment plan as "phar…
Re: Launch HN: Fella (YC W20) – Tackling men's obesity using medication and coaching
#307Earlier quoted context omitted.
> 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…
If calorie restriction is causing those side effects, it is an indicator that the person is "doing it wrong" by either restricting their intake far more than is healthy or more likely their diet is very sub optimal (eg, 100% carbs causing blood sugar to spike and then crash when they "run out" of calories). These are problems of application which are easy to fix with a food journal and perhaps a bit of research, not…
Re: Launch HN: Fella (YC W20) – Tackling men's obesity using medication and coaching
#308Interesting 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...
As someone who has tried both: semaglutide and smaller diet changes have been a lot easier for me than fasting, which did work but was stressful and extremely difficult to do long term.
Re: Launch HN: Fella (YC W20) – Tackling men's obesity using medication and coaching
#309Earlier quoted context omitted.
Sweet what's the group you're part of? Sounds interesting. It's obviously a great question about the focus on men, and something we think a lot about. My take: the whole industry is focused on women, and there are already cool companies taking a medication approach with branding clearly focused on women: https://www.joincalibrate.com/ , https://joinfound.com/ , https://www.formhealth.co/ I'm a fan of what these folks…
Do you have any options for people in one of those programs to transfer over?
To reiterate thought: I have nothing against these programs, from the outside they look really solid & I overall really support the direction of treatment.
Re: Launch HN: Fella (YC W20) – Tackling men's obesity using medication and coaching
#310Earlier quoted context omitted.
Unsure how helpful this slapdown is after the guy is sharing something pretty vulnerable.
Diets don't fail because they're inherently flawed and the system is more complex than we think it is. Diets fail because people fail. "I tried and I failed, but I still do all this physical stuff or could if I wanted to" is dishonesty, whether intended or not. Asserting that, for some unspecified (but large) fraction of the population, tracking your caloric intake and energy expenditure versus the number on the scal…
As a thought experiment, imagine if, for every 100 calories of deficit in their daily consumption, a random tenth of the population felt substantial and increasing physical pain. Would you describe their inability to consistently lose weight as a 'failure' on their part? As essentially due to a lack of sufficient discipline? What if it were nausea? Exhaustion?
Now picture a world in which that is the actual norm, and those people are subjected to frequent ridicule for their lack of willpower and bombarded with the message that they are inferior because of it. If they'd just man up and stomach the pain for the rest of their lives, they'd have no trouble losing weight, it's simple physics.
This isn't an accurate representation of reality of course. I don't feel physical pain when I run a hundred calorie deficit, I just feel tired most of the time, and I lose the energy to enjoy physical pursuits. I'm confident that if I applied enough effort (again), I'd lose some weight (again), and keep it off for as long as I continued spending that effort. Again.
> Asserting that .. tracking your caloric intake and energy expenditure versus the number on the scale is inherently flawed is dangerous, misleading, and probably false.
That's not what I'm asserting. And I think that's been pretty clear, really! There are millions of fat people who are actively trying to be thinner in various ways and repeatedly "failing". Do you really think that telling all of those people to "just try harder" is a useful thing to do?
I don't personally expect drugs to be the answer to the problem, and I don't have any opinion on the "Fella" business model or likely effectiveness. My position this whole time has just been that fat people are mostly not fat because they don't understand that restricting calories will make them thinner. Understanding the actual reasons is important, and it's far more difficult to do when any real conversation on the topic is inundated with comments to the effect of "have you tried not eating as much? It's really easy, just eat less."