Innovating Solutions to Curb American Obesity

Mark Bagnall
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One of the things I’m most excited about as a long-time health care entrepreneur and business manager is the chance to make real headway in addressing large-scale health problems in the United States.

At Health2047, we focus on audacious early-stage health care companies and help them figure out who to hire and how to grow to successfully impact their space. We aim to ensure that companies we help are fully prepared to launch — and fully prepared to grow, scale, and make a difference in fundamental areas of health care.

If you feel that there’s a huge unmet need in a particular specialty that you work in and you have a promising solution, you should come and see us at Health2047 — just as Phenomix Sciences did.

Phenomix Sciences began with a mission to bring personalized medicine to the field of obesity treatment. Their solution is enabled through a simple blood test.

Here’s the backstory. For the past several years, a couple of very high-profile obesity specialists at Mayo Clinic, Dr. Andres Costa and Dr. Michael Camilleri, have worked to identify different subsets or “phenotypes” of obesity. They’ve identified that four phenotypes account for over 90% of patients with obesity.

They’ve also demonstrated that drugs, devices, and surgery now used to treat obesity have shown to be more effective if the phenotype is identified first. Each phenotype calls for a different combination of treatment approaches for the best probability of successful outcome. Obesity phenotypes can be determined with a simple blood test. With the knowledge that test generates, doctors can actually intervene more effectively with patients right away.

In fact, studies conducted over the past seven years have demonstrated that if you know the phenotype before you treat the patient for obesity, you will be able to double the weight loss of any individual patient, as well as double the chance that you elicit some weight loss.

Health2047 was interested in this work because chronic diseases comprise an important and difficult public health problem and most are exacerbated by if not directly correlated to obesity.

According to the Centers for Disease Control and Prevention (CDC), the prevalence of obesity in the United States increased from 30.5% in 1999/2000 to 42.4% as of 2017/2018. The prevalence of severe obesity increased from 4.7% to 9.2% during the same time frame. Obesity-related medical conditions include heart disease, stroke, and type 2 diabetes, which are consistently some of the leading causes of preventable, premature death. In fact, a Milken Institute study published in 2018 estimates obesity drives $480 billion in direct healthcare costs annually in the U.S. Obesity is a huge and growing problem.

I think it’s important to understand that obesity medicine is really still in its infancy. It was only classified as a disease in 2013. And at the time, there were only about 500 certified obesity specialists, which is remarkable given that well over 35% of adult Americans had the disease then. Even today, there are only 4000 obesity specialists. It’s growing as a specialty, but there’s still really not significant coverage. We know from our experience with COVID, that obesity puts people at higher risk for numerous conditions.

Many health care companies have struggled over the past 20 years to develop appropriate drugs and interventions for obesity, but Health2047 could see that Phenomix Sciences had something special. As a founder, Dr. Acosta is an engaged and energetic physician/scientist. He widely published in the field of obesity, well regarded, and has a significant following as an obesity specialist.

Additionally, we were impressed that the foundational work had been done at Mayo Clinic, which has an amazing reputation for quality science. Phenomix Sciences did the groundwork that really exemplified caliber: very thorough and very detailed investigation of the mechanisms underlying obesity and establishing the relationship of those mechanisms to the four discovered phenotypes. It’s just first rate science, and something that we at Health2047 particularly appreciate.

When we began our collaboration, the founders had already set up a business to commercialize the blood test, and had an operational lab and a couple of very talented executives to run that lab. But Health2047 knows from clinical experience that bringing products into the chronic disease arena is really difficult. And so our role was really to dig into the science, then the business opportunity and the future marketplace, and understand where the new venture would fit. We interviewed numerous obesity specialists, we interviewed people with regulatory background, people with reimbursement background, we talked to data scientists, and concluded that:

  • The science was superb
  • The market opportunity was excellent
  • We could put all the right pieces in place quickly to demonstrate that the product could be successful within a year of launching the company

As a result, Health2047 set to work on accelerating the corporate structure, business model, business plan, and capital team with Dr. Acosta and his colleagues.

Chronic diseases, in particular, manifest themselves in different ways in different people, and require developing products that need to be used over the long term rather than short term. Sadly, despite all the money invested in obesity treatments and obesity programs and new nutritional products every year, we have inevitably seen the percentage of Americans with obesity going up. We need to reverse that trend. We often see drugs, for example, that initially show promise, but don’t deliver on it measurably. For example, an obesity drug may initially indicate potential for 15–20% weight loss. But when it finally completes phase-three clinical trials, it demonstrate only 5% weight loss, which is akin to consumer-based programs that aren’t stemming the obesity tide. Health2047 aims to back health care companies that bring products to market that make a significant impact — really slow the progress of disease for the patient, and also for the population.

An important definition of success is that the people who are struggling with obesity also gain the upper hand over their disease. Our product allows them to get better treatment, which allows them to feel physically better, and live healthier lives.

With obesity, we’ve really treated it as a single disease until now, even though it’s been established that different people react to different interventions. That’s where Phenomix Sciences comes in. By phenotyping, we can accurately predict which intervention will work for which patient — and that dramatically improves the outcomes for those patients. Ultimately, that will dramatically improve the obesity statistics at national scale, and that’s worthy of excitement.

— Mark Bagnall is CEO at Phenomix Sciences.

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