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

I personally struggled with stress eating for 6 years. During that time, I was at Cambridge University, then built and sold my first company working with the UK government. It was tough, and poor eating habits as a teenager became a coping mechanism as an adult.

Fella first started as a "CBT+community" product to help men battling stress eating. It resonated due to the stigma around men's eating struggles. But we realized we were only half-serving most of our customers: even when no longer stress eating, most guys weren't getting to a healthier weight.

So we started researching effective, evidence-based treatments for obesity. When I say "we", I really mean my co-founder Luke. He studied medicine at Cambridge University, developing a patented AI approach to detecting cancer at a YC bio company, before moving to Microsoft Research. He parses bio papers better than me...

Obesity treatment is about to radically change. This is thanks to a breakthrough medication — NY Times called it a "game changer" in Feb 2021 [1]. The medication was approved by the FDA in June 2021 [2]. It leads to an average 15% decrease in body weight, efficacy close to bariatric surgery [3]. However, medication-assisted treatment for obesity is still stigmatized by family doctors and therefore hard to access.

Moreover, only 10% of those using weight management services are men, despite men representing 50% of those with obesity. This is because almost all programs market to women, placing too much emphasis on looks and not enough on health for a male audience. Stress eating is widespread among bigger guys, but mostly ignored — with too much focus on willpower and "eat less, move more". This needs to change.

So we pivoted to the Fella you see today: a telehealth experience with a board-certified obesity doctor for FDA-approved medication, combined with personalized health coaching. We went live in Texas in July, and are soon to be live in California and New York. Fella is a 12-month program and costs $149/month, paid quarterly. We’ll bring costs down over time to improve accessibility.

We still have lots of difficulties ahead. The main one could be insurance reimbursement: the latest wave of medications are expensive and insurers don't like to cover them [4].

We’re excited to hear your ideas, questions, concerns, feedback — and maybe any personal stories. I’ll be responding to comments all day, or feel free to shoot me an email at [email protected].

[1] https://www.nytimes.com/2021/02/10/health/obesity-weight-los...

[2] https://www.fda.gov/news-events/press-announcements/fda-appr...

[3] https://www.nejm.org/doi/full/10.1056/NEJMoa2032183

[4] https://www.bloomberg.com/opinion/articles/2021-07-19/weight...