An Interview with Jeff Hyman (Continued)
Adam: Many would call this just a high-tech "diet." What would you say to those individuals?
Mr. Hyman: It's not a diet, and we don't use the word "diet." We don't believe in starvation. We don't believe in restricting people from all their favorite foods. That's not sustainable, right? We can teach balance and portion control. Why am I eating a gallon of ice cream at night if I'm not hungry? That's not a food issue. That's a behavioral issue. Is that stress eating, emotional eating, binge eating, eating out of boredom, eating out of depression? We have all these reasons that we all turn to food — what we believe is almost an addiction. So we do this little by little over 365 days, and that's the program.
We were lucky to recruit Dr. Robert Kushner, who runs the obesity program at Northwestern, and Dr. Jim Hill, who runs the program at the University of Colorado. With Doctors Kushner and Hill, we have developed a protocol that 500 clients are on. If you do it in a sustainable way for enough time, changes take hold. The average diet is going to last nine weeks. This is not a diet. It's true commitment. It's a one-year program. After you have joined, we lock the door behind you. And so that alone, I think, weeds out people that aren't serious.
Adam: How successful are people at losing weight while on Retrofit?
Mr. Hyman: Ninety-five percent of our customers are losing weight on the program. The majority of our customers are on track to lose at least ten percent of their weight. Experts have told me this has never been seen before in the industry. It's transformative. But it's not rocket science. We're just keeping people on the straight and narrow for a year. We've got many, many hundreds of people who are slowly but surely succeeding on the program. Time will tell if they keep the weight off over time. But what gives us confidence is that based on our advisory board's experience, most people fall off the wagon after two to three months. So the fact that we've now kept these people on for six, nine, coming up on 12 months next month, is in and of itself remarkable because most people will have failed.
Adam: You mentioned that the behavioral side of Retrofit is one aspect that makes it unique. Can you talk about that approach?
Mr. Hyman: The protocol that we use is really interesting. Dr. Kushner, who has over 30 years of experience, identified 21 distinct personality types that prevent you from losing weight. He calls them lifestyle patterns, which he summarized in a very good book called Dr. Kushner's Personality Type Diet. Couch potato, meal skipper, constant muncher, midnight snacker — all these are different eating patterns. And sure enough, you'll read it and say, "Yeah, that's me." Dr. Kushner developed a 50-question quiz that identifies your lifestyle patterns. It's on our home page and 15,000 people have taken it. We email results to people totally free. And then if you choose to join Retrofit, that becomes the basis of your protocol.
It's a very, very personalized service, which is why you get better results than a group meeting where you often must dumb it down to the lowest common denominator. It's not possible to personalize because you have twenty people in the room. We have clients who have diabetes or are vegetarians or travel all the time. For the latter, as an example, you'd have to figure out how to exercise in their hotel room.
Paying for Retrofit
Adam: Is it possible you could obtain reimbursement either in the United States or in the UK or other countries?
Mr. Hyman: Yes. Right now, half of our business is direct to consumers. They come to the website and just put it on their credit card. The other half is through employers and most of that is subsidized. A recent study found that 59% of employers are now contributing or giving employees some money to apply to wellness and weight loss. They understand that that's way less expensive than treating diabetes later, especially self-insured employers. Now that we've got some outcome data, we are starting to get calls from insurance companies. That is the next level, and we're still having those discussions.
Insurance companies spend hundreds of millions of dollars treating all the diseases that are caused by obesity. Medications, gastric bypass, the list is endless. We're starting to engage in those discussions with insurers. It's my premise that eventually, the US Government will have to do something about it. I can't say when. But if you look at the numbers, if we keep going at this rate, in 25 years our healthcare system is in trouble.
So it strikes me that, at some point, the government will get involved. And in addition to starting to curtail this food advertisement to kids and a bunch of other things, I believe that the government will start to offer some kind of support, financial support, for effective programs. The programs will have to work, which is again why I'm maniacally focused on outcomes. I'm not trying to be the cheapest program. I just want to have the best outcomes, because ultimately, someone will pay for it, either the consumer or their employer or the insurance company or the government.
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My diabetes is changing. Until a few years ago, my morning readings were reasonable and within the desired range of under 100 mg/dl. About two years ago, they started slipping upwards into the less-desirable but apparently not-worrisome range of 100-110 mg/dl. Now, this was what was recorded by my Abbott Freestyle Lite meter, which is known to record at the lower end of the home-glucometer variability range, but with my A1c firmly in the high 5s and low 6s, the meter's tendency to...