Doctor Holding Weight Loss Pills

Although weight loss startups may offer new drugs, do they provide quality care?

Many Americans resort to the latest fad diets and fitness crazes to lose weight. These are rarely the miracle cure that people seek.

A new breed of drug companies is offering online behavioral coaching and access to a new type of drug. However, there are already concerns.

Blue-chip venture capital firms have provided hundreds of millions of dollars of funding to these startups. These startups have already signed up over 100,000 patients. They could also reach millions more. Patients pay hundreds of dollars to have access to new drugs called GLP-1 agonists. They also receive online coaching to promote healthy habits.

In the beginning, startups positioned themselves in high-profile terms. Calibrate Health’s 2020 marketing analysis stated that “This is your last weight loss program.” Michelle Wellington, a spokesperson for the company, said the document did not reflect Calibrate’s current marketing strategy.

While doctors and patients love the new model, some customers are unhappy with the lack of buildup. They complain that they received canned advice and unresponsive physicians. Some even reported not being able to get the latest drugs.

Calibrate Health, an NYC-based startup, announced earlier this year that it had served 20,000 patients. Found, which is based in San Francisco, claims it has served 160,000 patients in the past year, according to CEO Sarah Jones Simmer. Patients pay nearly $1600 per year for Calibrate, not including the cost of drugs which can reach nearly $1500 per month without insurance according to GoodRx, a price comparison site that tracks drug prices. Patients claim that GLP-1 agonists are covered by insurance in certain circumstances. A spokesperson for Found said that Found offers a six-month plan for $600. (This price does not include generic drugs or the more recent GLP-1 agonists like Wegovy.

According to Crunchbase tracking, which is a repository for venture capital investments, the two companies have received more than $200 million in combined venture financing. Both companies claim they are at the forefront of weight management, citing biology and other scientific factors to be key ingredients.

These startups have huge market potential. According to the Centers for Disease Control and Prevention (CDC), just over 4 out of 10 Americans are obese. This increases their risk for Type 2 diabetes and cardiovascular disease. It is difficult to find effective medical treatment.

The centers that offer this specialty care are “oversubscribed,” Dr. Fatima Stansford, an obesity medicine specialist at Massachusetts General, Boston, which is a Harvard-affiliated teaching hospital. Her clinic has a waiting list of 3,000.

Stanford said that she has advised many of these telemedicine startups and is optimistic about their potential.

Dr. Scott Butsch, the director of obesity medicine at Cleveland Clinic, stated that startups can

provide care without stigma and judgment. They are also more convenient.

Butsch, who discovered the model through consultations, with patients and colleagues, is curious if the startups are trying to “strategically find which patients respond” to which drugs. He suggested that they work closely with behavioral specialists as antidepressants and other medications could be contributing to weight gain. He said that obesity is a complicated disease that requires complex treatments. I believe programs without a multidisciplinary team are less thorough and less effective in the long term.

Startups market a dual-purpose product. The first is the new class GLP-1 agonists. These medications can be effective in promoting weight loss. However, Segovia is one of only two approved in this class. Novo Nordisk, its maker, says that it is currently in short supply. Other medications in this category can also be prescribed off-label. Stanford stated that doctors aren’t usually familiar with the medication. Startups can help bridge those gaps by offering more skilled and knowledgeable clinicians.

There’s also the second prong, behavioral changes. To help patients adopt new eating and exercise habits, the companies offer television and online coaching with nutritionists and coaches. Novo Nordisk claims that weight loss rates of up to 15% were attributable to participants in clinical trials.

These ads are everywhere on social media, from podcasts to Instagram. Meta’s ad database reveals 40,000 ads on Facebook and Instagram between these two companies.

These ads complement users’ posts on social media. Numerous groups on Facebook are dedicated to this new drug. Some even focus on helping patients with side effects like changes in bowel movements. According to Morgan Stanley investment bankers, the buzz around GLP-1 agonists is quantifiable.

The startup’s clientele has a strong, feverish desire to purchase these drugs. Alexandra Coults, a former consultant pharmacist for Found, said that patients often complained about friends getting drugs they didn’t want. Coults stated that patients might have misunderstood the bait-and-switch effect when in fact, prescribing decisions are influenced by clinical reasons such as drug contraindications.

Coults stated that patient expectations can influence care. She said that customers came to her with ideas that were influenced by New Year’s resolutions and fad diets. “Quite a few people would sign-up for one month, and then not continue.

“Interviews with KHN and online complaints raised questions about the quality of patients’ care. Some patients claimed that the intake process, which involved filling out a form followed by an online consultation with a doctor, was a waste of time. They said that once the medication was started, counseling regarding side effects was slow to be answered. Jess Garrant, Found patient, recalls feeling “absolutely strange” after being prescribed zonisamide (a generic anticonvulsant that has been shown to aid with weight loss).

In a blog post, she said that “I was up all night and I thought my thoughts were racing.” She got sores in her mouth.

KHN told her that she sought advice from Found physicians but that their responses were not quick. Nonemergency communications are routed through this portal.

She said that it took her a week to switch medications and receive a new prescription. She said that she visited an urgent care clinic to treat her mouth sores.

Company executives stated that Found often prescribes generic medications, sometimes off-label, rather than the new GLP-1 antagonists. Found stated that older generics such as zonisamide are easier to find than GLP-1 agonists, which they advertise on social media and their websites. Butsch and Stanford both confirmed that they have successfully prescribed zonisamide. Butsch stated that increasing the dosage too quickly can lead to side effects.

However, Dr. Kim Boyd of Calibrate’s chief medical officer stated that the older drugs “just don’t work.”

Both patients and employees of both companies have criticized the startup’s behavioral care, which experts agree is crucial to weight loss. Some patients felt that they were just getting canned advice.

Others said that they experienced ups and downs with coaches. Dana Crom, an Attorney, stated that she has had many coaches through Calibrate. Some cheerleaders were effective and good; others weren’t so great. She said that the coach was unable to assist her with any kinks in the program. Crom stated that while the coach may report problems with the app or medications, they are not more effective than messages sent through portals.

What about her subscription that lasts for a year? Crom stated that she would consider continuing with Calibrate.

The business model is dependent on the ability to build relationships with coaches. According to Dr. Rekha Kumar, Found’s chief medical officer and chief medical officer, patients’ success is dependent on how committed they are to lifestyle changes.

Although startups provide care in a wider geographic area, it is not clear if the patient demographics are any different from traditional brick-and-mortar clinics. According to Calibrate, the majority of patients are white. More than 8 in 10 have at minimum a bachelor’s degree and more than 8 in 10 are female.

Its marketing strategies in the past reflected this. The September 2020 “segmentation” document outlined three types of customers that the company could aim to attract: working mothers with similar incomes; perimenopausal and menopausal females with incomes ranging between $75,000 to $150,000 per year; and “men.”

Calibrate CEO Isabelle Kenyon stated that the company is now looking to expand its reach and partner with large employers. This will allow for more diversification of its patient base.

Patients must be convinced that this model is more affordable and more accessible for them.

Garrant, who is no longer using Found, wrote in her blog that she had reflected on her experience and expressed her desire for more follow-up and a more personal approach. She stated that she doesn’t believe it is a good way to lose weight.

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