rich-cartwright

Fella Health (YC W20/S21) = telehealth clinic for men with obesity

location = fully REMOTE

role = founding engineer

you'll take over work from our technical co-founder, executing in both growth & product teams. This role is a critical part of the broader founding team because you'll build the technical foundations of the company for the coming years.

feel free to drop me a line on richie @ joinfella . com

link here: https://jobs.ashbyhq.com/Fella?utm_source=NzppYKZdY5

This is the same ineffective trope said repeatedly without grounding in practical solutions which help real people get to a healthier weight.

Well written.

Yep we've actually had that happen already. Happy to help if you'd like.

To reiterate thought: I have nothing against these programs, from the outside they look really solid & I overall really support the direction of treatment.

Thanks for sharing, important to hear anecdotal evidence.

I feel like this is a pretty bold statement, and I'm not sure how much evidence there is behind this.

Understood and good points. Thank you for the candor: I got caught up and quickly typed a throwaway comment. Definitely my bad.

Spot on.

Really interesting, thanks for sharing.

Didn't know this! Assume it's this study: https://www.nature.com/articles/d41586-021-02195-1

Was posted on HN 4 days ago: https://news.ycombinator.com/item?id=28239113

(in case other people want to check it out)

Definitely an area with compelling evidence. Lot of uncertainty though.

They did! Spoken with the founder.

Thank you for the support! Where in the world are you based btw? Always interested to follow the approvals of Semaglutide.

Makes a ton of sense, and really helpful to know. Thank you.

Understood. I thought the easiest way to do this would be to link to the articles which talk about this in more detail. Should probably have added a small paragraph which talked about the bio of it.

Good to hear you'll be talking about it your endocrinologist.

Couple things:

Injectable Semaglutide was first FDA approved in 2017 as Ozempic. Wegovy is also injectable Semaglutide. The key difference is the approved dose: Ozempic is 1.0mg, Wegovy is 2.4mg. The FDA approval is also very important for future insurance remibursement.

Semaglutide is a GLP-1 RA. These medications stimulate a receptor in your body which results in three main effects: 1 - Slowing down gastric emptying so food stays in your stomach for longer (this is thought to be why there is sometimes nausea when starting the medication) 2 - Making you feel full by working on your central nervous system 3 - Managing glucose control (which is why it's used for people with diabetes too)

[1] gives you a great summary of the field up to now and how it works.

[1] https://blogs.sciencemag.org/pipeline/archives/2021/02/15/gl...

Biologically: mostly similar, although some important hormonal differences. More research coming on this.

Psychologically & socially: very different.

We're starting to do more research into hormone-based treatments. We definitely have hesitancy as hormone treatments are a bigger life decision, and telehealth regulation is murky. We'll look into it more.

The doctors prescribe both GLP-1s & meds like Phentermine, among others. I just didn't wanna list them all out!

We plan to store it until we expand to more states. If you'd like us to delete it, send me an email on richie@joinfella.com & I'll sort it.

Interesting to hear this personal experience.

If you're interested in some research behind this:

"Long-term persistence of hormonal adaptations to weight loss" - [1] and [2] are both interesting papers on this. With the summary being that weight loss results in prolonged changes in your hormones associated with increased appetite and thus weight regain. This results in a strong negative feedback cycle.

[1] https://pubmed.ncbi.nlm.nih.gov/22029981/ [2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5764193/

tldr: our bodies make it v difficult for folks!

Really nicely put.

Yep we're British founders so would love to expand to Europe in the future. Sadly won't be for a couple of years though - lots of work to be done first in the US!

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.

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!

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!

Thank you Brian! Appreciate your support.

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.

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.

Interesting to hear!

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

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.