We sat down with Dr. Katherine Saunders, the Co-Founder of Intellihealth, a company changing the perception of obesity and the way it is treated through technology enabled and evidence-based obesity treatment and weight loss solutions.
Dr. Tara Bishop: Tell us about your background. How did you get interested in Obesity Medicine?
Dr. Katherine Saunders: As a medical student and Internal Medicine resident at New York-Presbyterian Hospital / Weill Cornell Medicine, I treated patients for numerous obesity-related comorbid health conditions without the knowledge or tools to address the underlying cause – their overweight or obesity. As soon as I met my mentor, Dr. Louis Aronne (world-renowned obesity researcher and clinician), I knew immediately that I wanted to specialize in Obesity Medicine. After training as the first Clinical Fellow in Obesity Medicine at Weill Cornell Medicine, I joined Dr. Aronne’s faculty practice.
Dr. Tara Bishop: I remember when you told me you were doing a fellowship in Obesity Medicine. Could you talk a little more about the specialty and the workforce of obesity trained specialists?
Dr. Katherine Saunders: There is a massive supply demand mismatch between the millions of individuals with obesity who are eligible for a medical weight intervention and the very few of us providers who are specialty trained. In 2015, I was the first fellow in Obesity Medicine at Weill Cornell Medicine and one of the first fellows in the whole country. Now there are 120 fellowship-trained Obesity Medicine physicians. Interest in this field is growing, and it is actually the fastest growing field of medicine. More and more physicians are taking the American Board of Obesity Medicine exam every year and almost 7,000 are credentialled; however, we are never going to catch up with the number of patients who need our help.
Dr. Tara Bishop: What does an Obesity Medicine specialist do and how has the field evolved?
Dr. Katherine Saunders: Obesity is an extraordinarily complex, chronic disease that is refractory to treatment for most individuals. Because the disease is so heterogeneous, there cannot be a one-size-fits-all approach to treatment. When we initially meet a patient, we do a very comprehensive evaluation. We ask many questions about weight history and medical history, and we examine a variety of labs in order to identify every factor that leads to weight gain and every barrier that prevents weight loss. This allows us to design a personalized treatment program that addresses all these factors, with the cornerstone being lifestyle intervention (dietary strategy, physical activity, behavioral approaches).
For most individuals with obesity, however, lifestyle intervention is not sufficient for clinically significant and more importantly, sustained weight loss. This is where our expertise comes in, and we use every agent in our limited, but growing armamentarium to personalize pharmacological treatment. This field is very exciting right now because of the pipeline of anti-obesity medications. When I went into Obesity Medicine, the most effective medications were associated with 5-10% weight loss, and now we have medications that are associated with over 20% weight loss. These newer agents enable individuals to achieve bariatric-surgery-level weight loss without needing surgery. In the near future, there will be even more efficacious medications and specifically some that will enable people to lose weight while preserving muscle mass, which is a big topic in the field.
Dr. Tara Bishop: It’s clear that obesity is a major public health issue and contributor to downstream health conditions. Tell us a bit about your journey founding Intellihealth.
Dr. Katherine Saunders: Once I joined the faculty at Weill Cornell Medicine, my clinical schedule filled up, and I developed a waiting list in no time. At the same time, my husband, Sloan Saunders, whose background is in finance and entrepreneurship, was intrigued by the opportunity here given that I have an expertise that not many physicians have and so many people need this kind of care. He was excited to start a company in order to bridge this supply demand mismatch and help many, many individuals. In 2019, the two of us teamed up with Dr. Arrone to launch Intellihealth. Our mission is to scale and democratize access to the high-level, comprehensive, compassionate obesity treatment we deliver.
We initially started with technology to train and support other providers to deliver care to their own patients, but we quickly had many requests to treat patients ourselves, so we now have two parts of the company. One is our software program and app, called Evolve, and the other is our telemedicine practice or clinical services, called Flyte Medical, which is powered by our technology.
Dr. Tara Bishop: Could you talk about the role of technology in supporting these changes for individuals with obesity?
Dr. Katherine Saunders: Technology plays a huge role in this field for three main reasons. One is that there are not enough providers who have expertise in this area, so we use technology to train providers on what obesity is, why it is a disease, how to conduct obesity-specific evaluations, and how to personalize treatment approaches including lifestyle interventions, pharmacotherapy and surgical options. On an ongoing basis, we have clinical and medication decision support, so providers can learn, as they practice and become more comfortable with the treatment protocols. On the patient side, technology supports every aspect of their journey. There are courses and articles, and patients can track food, exercise, medications, goals, and weight. The last part (that is most exciting!) is our data. Through our analytics, we refine the algorithms that feed into our clinical decision support and medication decision support so we can deliver the ultimate personalized, effective treatment to our patients.
Dr. Tara Bishop: At Intellihealth, you are able to capture information from a mobile app and see what happens outside of visits. Is that something you had access to in your previous role and in the more traditional brick and mortar types of practices?
Dr. Katherine Saunders: No, this was one of the reasons we started the company. We can leverage technology to improve our ability to care for patients. For example, without technology, we may know a patient’s starting weight and their lower weight at the follow up visit, but we don’t have insight into when they lost this weight and if they are still losing weight. With remote monitoring, we can see if and when they stopped losing weight, so we know exactly when to intervene. This is just one example of a problem for both providers and patients that Intellihealth is solving.
Dr. Tara Bishop: I know it is often not the typical career path for doctors to start companies and it can be quite a change from what you have done in the past. I would love to hear more about what you were thinking when starting Intellihealth and any advice you might have for clinicians looking to build a career in health innovation.
Dr. Katherine Saunders: Healthcare innovation comes with a lot of uncertainty. When I debated transitioning to voluntary faculty at Weill Cornell Medicine and joining Intellihealth full-time, I spoke with every single physician I knew who had left academic medicine to pursue healthcare innovation. Everyone was incredibly encouraging, and they empowered me to feel great about this decision. It is certainly a different skill set and a steep learning curve. My advice to any physician who is passionate about something and wants to use their expertise to help people at a larger scale is to do it! And don’t feel like you need to do it all yourself. Hire a great team. Healthcare is so broken right now, and there is so much room for disruption.