Metabolic and obesity related care will become a huge portion of healthcare spending in the coming decade.
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Primary care and metabolic health focused company Knownwell announced today that it will be opening its newest clinic in Atlanta, Georgia. This now marks 10 total locations across the United States, indicating the significant traction and explosive growth the company has experienced over the last year.
Knownwell is focused on metabolic health as a whole, with a key eye towards comprehensive obesity management services. At a macroscopic level, very few players are working in this niche space; while the urgency of addressing obesity and metabolic health is certainly well-recognized, few clinical services exist to address the problem with focused attention. In fact, most do not offer wrap-around primary care services, a virtual platform, or a specialist oriented approach to tackle a patient’s holistic healthcare needs.
Tackling obesity is not new; many of the larger pharmaceutical giants as well as smaller startups are spending billions of dollars to innovate in this arena. Take for example Novo Nordisk, known for its huge market penetration in the obesity care landscape with Wegovy and Ozempic; the company recently reported nearly 67% growth in sales in this area. Eli Lilly similarly stated “38% year-over-year revenue growth driven by robust sales of Zepbound and Mounjaro,” significantly boosting its own guidance and future forecasts for obesity related therapeutics.
While the pharmaceutical market is certainly hot for metabolic health, the actual care delivery function is not so easily available. Physicians that want to practice obesity medicine often have to join generic primary care practices and try to offer their specialized knowledge on an as-needed basis. For those that want to solely specialize their practice on the topic, they often have to resort to starting their own dedicated clinic, which is incredibly challenging in the current landscape of primary care. Conversely, for patients, very few niche clinic systems exist that focus purely on metabolic and obesity care; rather, they typically have go to general primary care or get referred out to a specialist.
This is where Knownwell is attempting to redefine the model by providing infrastructure specifically tailored for obesity and metabolic health. Brooke Boyarksy Pratt, knownwell Co-Founder and CEO, explains that metabolic health is going to become one of the highest spend categories of healthcare in the next decade; millions of patients want access to specialized care in this area, and moreover, physicians increasingly want to practice obesity medicine in conjunction with primary care.
Furthermore, she explains that expanding brick-and-mortar locations is not an easy feat. There are challenges; for example, even Walmart, which already has a massive brick-and-mortar footprint across the Untied States, shut down its healthcare offerings in physical locations, citing that “the challenging reimbursement environment and escalating operating costs create a lack of profitability that make the care business unsustainable for [Walmart] at this time.”
But knownwell is keeping these challenges top of mind as it scales; it continues to maintain nearly 80% of its business within the realm of virtual care for its patients, which accounts for the majority of its revenue. The physical locations remain important because there is still high demand from patients: “a huge percentage of patients still want to go into the clinic.” Boyarsky Pratt also notes that brick-and-mortar locations give knownwell an opportunity to innovate by allowing them to participate in clinical trials and partner with health systems. Regarding the former, the company is already partnering with and providing trial sites for major pharmaceutical players, yet another key differentiator.
Dr. Vineeta Agarwala, M.D., PhD and general partner at a16z, thoughtfully explains that these are the key differentiators for knownwell that ultimately benefit patients: its ability to offer optionality in how patients engage with healthcare (virtually OR in physical locations), its ability to act as a key partner for innovative new therapies, and ultimately, its hyper-focus on taking care of the patient in a holistic manner.
Why is all of this important?
New CDC data indicates jarring facts about obesity and metabolic health generally: “population data from 2023 show that in 23 states more than one in three adults (35%) has obesity. Before 2013, no state had an adult obesity prevalence at or above 35%. Currently, at least one in five adults (20%) in each U.S. state is living with obesity.”
Furthermore, the World Health Organization noted that in 2024 alone, nearly 35 million children under 5 years of age were considered overweight.
These figures allude to massive headwinds for the healthcare system in the coming decade, including the numerous co-morbidities, downstream health impacts, and billions of dollars in systemic healthcare spend that will undoubtedly emerge.
The time for innovation in this field is now.