#10 - GLP-1: A VC’s Personal Experience

In a world captivated by criticism, it's easy to overlook the groundbreaking technologies shaping our future. Let's shine a light on innovators who are propelling us forward. As the most active venture capital firm in the US, we have an exceptional view of tech's real-world impact. Join us as we explore, celebrate, and contribute to the stories of those creating tomorrow. Welcome to The Tech Optimist. As a reminder, the Tech Optimist podcast is for informational purposes only. It is not personalized advice, and it is not an offer to buy or sell securities. For additional important details, please see the text description accompanying this episode. Hi everyone, welcome to another episode of the Tech Optimist. Switching things up a little bit today, and this time Mike is actually the one being interviewed. So the interviewer is Grant Demeter. He's a principal here at Alumni Ventures, and they're talking about the intriguing topic of Ozempic, a GLP-1 drug that Mike personally used, actually. And so Grant and Mike are sort of talking about Mike's personal experience with the drug, and you know kind of how this drug is. sort of changing the investment world. They're sort of talking about it like an investment thesis and sort of, you know, what other future endeavors can come out of the success of Ozempic. So this is a really cool, insightful conversation between Grant and Mike, and we seriously hope you enjoy.

Hello, everybody. My name is Grant Demeter. I'm a principal here at Alumni Ventures. And today I'm interviewing Mike on his journey with Ozempic treatment, a GLP-1 weight loss drug. We did a couple previous pieces on this with Ron Levin, managing partner on our team, where we talked about Ron's journey starting the drug and ramping up. Mike has recently ramped off and totally tapered off the drug, and so we want to counterbalance that with his story coming off and then close off with talking about some implications for the space more broadly as investors. So Mike, care to briefly introduce yourself and your professional journey?

Yeah. So, I'm the founder and CEO of Alumni Ventures. Started out in the '80s in venture capital. And really, my whole career has been at this intersection of technology and entrepreneurship and venture capital. Yeah. And I'm a pretty active investor. Obviously through Alumni Ventures. So, you know, was, was very curious about this technology and really like, I think a lot of people, you know, I just hit 60 and, you know, was an athlete in college, you know, put on a pound here, pound there, you know, COVID and, you know, you turn around and you're probably 40, 50 pounds over what you really should be. And so, you know, I had been following the technology in the space and, you know, was starting to see numbers go, you know, not in the direction I wanted in like blood sugar and, you know, kind of metabolic issues related to, you know, heart health. And so I thought it was the right choice for me. And, you know, worked with my GP and, you know, frankly had to bring him along a bit. I think, you know, I think I had done a lot more work and research on the, on the drug. So, you know, but we agreed that we were going to give this a try. And, you know, and I did it in the context, Grant, of really a pretty holistic approach to health, right? So, you know, good sleep. I've always been a very, you know, disciplined sleeper. Exercise, part of my daily life. You know, so it was, it was not just, it was a tool for me. And actually went on the Eli Lilly version of the GLP, Mounjaro. Oh. I think Ron, you know, started his journey even before the FDA approval of the Eli Lilly drug. But, you know, I found that it, I was really a super responder and, you know, I, I was, I, I started about 6 months ago. I lost really 50 pounds in 6 months. Kind of hit my target weight. And then, I was learning and studying it more as I, beyond just kind of controlling a blood sugar and food noise and things like that, there was increasing things that were coming out for additional potential benefits of this drug. So I actually responded on kind of a very low dose and really had no side effects. Again, you know, everybody's mileage varies, I'm sure, but it was like, it was really a profound experience for me. Just not really, I think the idea of kind of thinking about food, food noise, cravings, snacking, all of that stuff that is you know, fairly hardwired and in a modern society kind of very difficult. It really helped with. And so, you know, and then kind of the tapering off was really, I'd really reached my goal weight. And then I had foot surgery coming up. And one of the things that they really you know, if you have a surgery, they really want you off of these drugs for, you know, 3 or 4 weeks beforehand. So I went off it for a month before my foot surgery. And, you know, I would say my experience was I definitely, you know, noticed not a lot for the first week or two. But as we hit the one-month period, I was starting to definitely feel food noise come creeping back into my life and, you know, had put on a couple of pounds, nothing crazy. I was still in my kind of target weight zone. But I think, you know, one of my mindset changes was really, you know, Thinking of this, and this was kind of the Oprah show too hit on this, is like, you know, we, we tend to think of weight loss as a character issue and a discipline issue. And I think that's really misframing it.

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And, you know, and I think for many, for people, this is kind of more of a chronic disease framing is more appropriate. And yes, some people can smoke and not get lung cancer, right? Kind of thing. And some people can eat like crap and not exercise and be thin, not necessarily healthy, I don't think, but they could be thin. But I think other people, you know, are very disciplined, try their best, and it is— they're dealing with some dysregulation in their body. And it is a medicine now that can really change the frame where this is a treatable chronic condition. And I, and I think that shift hasn't happened in our culture. I know that hasn't happened in people in my life. You know, that this is kind of viewed as cheating or why don't you just diet or why don't you just exercise more? And I just, my experience has been one that that is really misunderstanding and a misframing of the problem and the solution. And so, um, yeah, I mean, I think, again, all these things are personal, but I think that, that you want to be on as few drugs as you can. You want to— we all understand what a healthy lifestyle is. We also understand that, you know, the data suggests is like no alcohol in your life, but it's like, you know, I think people want to enjoy life too. So, you know, having a drink now and then, I've decided is I'm going to have a drink now and then, even if it isn't maximizing that one vector. So I think it is a tool. I will say again, anecdotally, you know, I now, I think in my extended family have, you know, I think I was the first to go on it, which is not surprising. But there are now, I think, 4 extended family members that are either on it or about to go on it, who are all dealing with either significant kind of blood sugar issues and/or obesity, you know, BMI issues. So, you know, and there's huge shortages and that whole dynamic is going on. But I have decided, you know, I, I'm going to stay at my target weight. I'm gonna feel, and I'm gonna take as little medication as I need to, to, to, to kind of stay there. So, you know, I am, I am planning to kind of go on it at a very low dose. And, you know, typically people take a shot a week on Mounjaro or Zepbound. You know, I think it's, I'm gonna try like every 2 weeks kind of thing, which again, approval from my doctor to give that a go when I'm, kind of off of this surgery thing. But I think, yeah, that's my journey. Again, not giving any medical advice here, but just sharing my, you know, one person's thoughtful experience on it.

Thanks for sharing. Sounds like there's a couple things that are unique about your journey. The first one, which makes sense as a technologist, you discovered this product actually before your doctor was that familiar with it. And so you had to co-bring your, your general practitioner along for the journey. Uh, and as I understand, these are in some ways administered and oversaw journeys in, in that a doctor has to have oversight and long consultative process. It's a weekly shot. So what was your kind of consultative process with your doctor? And then you had this foot, foot surgery upcoming. Did you taper off with the doctor's advice? Did you go cold turkey? Uh,

yeah. So again, you know, I had been studying this for probably a year and, you know, I have pretty good access to, cuz one of the first things you say is like, oh, this is new. I don't wanna be a lab rat. You know, what are the side effects? Am I gonna be on this for life? And again, I have access to people that not everybody has access to. And, and as I studied, I got very comfortable that this is a class of drugs that has actually been around a long time and, you know, for whatever purpose, but they've been in lots and lots of patients for decades, not a couple of years. And, you know, I really, you know, with anything you do in life, it's a risk-reward and a percentile. And, you know, I felt very comfortable in that kind of trade-off. You know, and I, you know, I could really go to my— because, you know, my first encounter with my GP was like, oh, you know, why don't I set you up with a dietitian? Why don't I, you know, why don't you, you know, be more rigorous in your exercise? And it's like, you know, so I had to kind of say, hey, you know, I know, I know what's going on with diet. We, you know, most educated people, most of our listeners know how one should eat. And, you know, again, I've, I've tried diet exercise repeatedly, like a lot of people. It's very hard. You know, it's very hard to keep weight off once you lose it. There's kind of a natural plateauing curve, et cetera. Yeah. But so yeah, I had to kind of bring him along through that process and again had pretty good data. And, you know, again, I don't want to say it was like convincing him, but it was just like that was not— he, they, the average GP, I don't think has been adequately trained about this stuff yet. It is too new and too much in the culture. But I think it's coming and I think it's coming pretty quickly. So yeah, I, I think it was a matter of bringing him along and then it was clearly we worked together on scheduling this foot surgery. It was well known that this is a drug that you want to be off before a surgery like that. So I had already gone tapered down to kind of the lowest dosage. So it was, it was, it was easy for me to kind of just say, hey, I'm gonna stop it, just not take my shots for the, you know, the month that I'm having the surgery. So, and then just again, being super kind of data-centric, you know, I was looking at a bunch of my numbers. I do a lot of independent testing and just seeing like, you know, it's not just the weight, but how are my, How are my sugar numbers? How are, you know, all these other, you know, risk factors going? So, yeah, I, I definitely where I am today and again, subject to change and humility, I think this is a drug that I'm gonna want to be on longer and want to be on at kind of a very low maintenance dosage to be sure that all of my important numbers are where I want them to be. And my weight is where I want it. But I would also say, Grant, that there's, you know, there's good positive flywheels in losing 50 pounds. You know, exercise is easier, you know.

Right.

I don't snore anymore. My knees, you know, after I go for a run, my knees don't hurt because I'm not— I don't have a backpack with 50 pounds on it. It's extra. So, You know, and and again, you know, managing protein, resistance training, water, you know, all of that stuff has been I think part of the reason that I've been successful. Plus, you know, just genetically we're all different. I think people respond differently to every medication. So I think from a bigger trend perspective, I think there's several things going on. I think this is is a great example of. Personalized medicine, which I think is a trend, meaning, oh, let's take the fact that half of the population is obese. They should all go on this drug and we are going to expect the exact same outcomes is kind of how we treat medicine. And it's not that. And I think that's a perfect example of like, you're going to have people that are like me, a super responder, and then you're going to have other people who, for whatever reason, have more side effects, or this drug only works at much higher dosages. So I think it's just like, that's, that's the way we are as humans. And so much of our, you know, healthcare is kind of still industrial and like, here's the standard of care and, you know, everybody is the same far too often. So, you know, I do think that this is I've talked about before, which is I think this is a drug category that has very profound implications for investing. I mean, when you have half of the population overweight and you have a kind of a food industrial complex, you know, feeding it, And all of a sudden people are, you know, not craving chicken wings while they're watching the football game. How does that change food? How does that change exercise? How does that exercise impact travel? So I think there's a lot of kind of knock-on effects that are coming. I think the other thing one really has to understand, which is the pipeline of drugs in this category now, is very, very robust. And we're talking about pill form and we're talking about variations where I think, again, over the next 5 or 10 years, just if, if there was broad implementation of these drugs as is, you're going to see huge impacts, let alone what you're going to see because there's so much money and value available in this drug category that I think you're going to have a huge area of investment. And so I think in 10 years, I think for a vast swath, I'm not saying for everyone, but I think one's weight is going to be much more of a choice than it has been, you know, in the last 100 years. And I think that has huge implications for our society. To the positive, mostly.

Yeah. I would draw a parallel here with the advent of SSRIs, which are used to treat anxiety, depression, and other kind of forms of mental illness. When those initially came out, right, they were seen as a crutch, or when they were not seen as a crutch and they started to become normalized, they were seen as a way to get back to baseline and then wean off those things. Now, and this varies from practitioner to practitioner, We see people on SSRIs for extended time periods. Now, over time though, we are starting to see that these SSRIs do come with long-term longitudinal side effect profiles, and they make you more susceptible to things like dementia. On one hand, we do have some precedence of GLP-type drugs being used for longitudinal kind of long-term time periods. On the other hand, we don't for this specific modality of the drug.

Yeah.

And it seems based on what you shared here that a lot of the people who I've spoken with see this as a way to get back to baseline. I'm just going to take it for a little bit, get to my target weight, wean off it, and try to see if I can hang on to the weight. But you're a proponent of proper normalization of this being a long-term weight management, and not just weight management, but broader health management treatment, which means that you're planning to take it for the foreseeable future. How do you feel about Maybe unknown long-term effects of this drug and you being an early adopter. And what do you, what do you think about that?

No, I mean, I think this is, you know, a classic risk-reward analysis. Here's my framework is we know very clearly the long-term risks of obesity, just taking that one particular thing. Cancer, heart disease, diabetes, like the 3 Horsemen of Death right there, right? So that is well known, right? So you have a known, very strong risk on one side of the ledger and potential long-term risk on the other, right? So I think that is part of the framing, right?

Yeah.

That one has to consider. 2 is we are really in the early days of this class of drugs. So my view is that there will be future versions of this drug that are more targeted, that have fewer side effects, that You know, you know, one, one, one of the absolute things is when you lose 50 pounds, you're, you're going to lose some muscle mass, which is a negative. You want muscle mass, right? There are future ver— there are versions in the pipeline now that give you, you know, all of this, all these positive things versus the negative things. So I think you're gonna— there, there's so much money to be had here. Yeah. I think there are a lot of companies and a lot of research going to go into this category. So I personally don't think I'll be on even a low dose of Mounjaro more than a few years before I'm on the next generation. So it's also, you know, and this is, this is part of what people diagnosed with cancer often deal with, right? It's like I have I have a disease. I have a potential cure that comes with some side effects. And there's— I would obviously not want to be on chemotherapy long term. But one, I need to stop. The risk reward of not going on the drug is one. And then 2, if I can just survive another 5 or 10 years, there may be new options medically for me. So I think it's— I think you have to view option value of not being obese until the next generation of things go on. I will also say is I don't think it is so black and white that I take it to lose weight and then I go off of it and The weight for all people goes right back on. I think there are some, the studies basically say, you know, there's a cohort of people that are able to keep it off without the medication. There's a group of people that are able to kind of keep it off at a very low dose and over a long period of time. And they may decide I can be off of it for 2 years, go off back on it for 6 months, and I don't have to lose 50 pounds this time. I have to lose 10 pounds this time. So I, again, I think it is very customized. I don't think that there are definitive answers. I think this is very personal between you and what you want and your risk reward and your, you know, the advice of your physician. So, but again, just kind of sharing my own calculus of risk reward, I think again, it comes into this Kind of false framing that this is, this is something that you can 100% control as a person. And listen, at 28, I could control it too. You know, I, I could eat whatever I want. I could sleep as much as I want. I could, you know, do whatever and eat 6,000 calories a day. And, you know, I was at 3% body fat. You know, that system was really well tuned. at age 30, less tuned, 40, you know, and by age 60, you know, I needed help. And I just don't think people should be shamed or, or understanding that they don't need medical help in the same way. Listen, as society, as you point out, Grant, we went through this with kind of mental health, which is just like— Yeah. You know, we've evolved in our thinking of that as a disease. I think we've thought through that as with with addictive certain addictions. That this is chemistry, brain wiring, very complicated stuff. And I think we've we are learning that one's appetite, one's one's metabolism, the way one processes food, food noise. The way the body regulates. You go, you go on a diet, and all of a sudden your body starts saying it increases its appetite, so it's— and lowers your metabolism. So it's, it's a kind of a system dynamic approach to thinking about things and making it less about, you know, one's character.

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Very well put. You mentioned some potential predictions for the future. You, you even mentioned your personal experience with exercise. Some people feel that after a course of these GLP-1 drugs and people are lighter, they'd be more likely to exercise.

Yeah.

And enjoy their new bodies. And some people feel that, hey, at that point, what's the point of exercise? I'm already feeling good and looking good. The same thing people say for food or eating out. On one hand, you'll be craving food less. On the other hand, you may be more apt to be seen out and about, more excited to be spending time with friends outside of the home, and have higher energy levels to do more social activity. There's, there's people on both sides of each of these things. What are a couple Predictions that you have around food, fitness, health, and other parts of broadly American life, maybe 10, 20 years down the line as a result of these drugs?

Yeah, I mean, I, I think, uh, I think food's going to change. I think people will end— when you eat less food and you have less food noise, it becomes a more rational decision versus an emotional decision. So again, I'll speak from my own experience. My— the food quality that I craved and eat has gone way, way up. I still go out and have dinner with friends, but just the portion that I'm interested in eating, what, what, what, you know, I enjoy food. It doesn't affect your taste or food enjoyment. For me, it was just, you know, I'm satisfied with less. And so, you know, I, you know, there are little hacks, you know, I, I, I tend to prefer like tapas, you know, restaurants now that I, you know, I eat less frankly. But I think, you know, I think people definitely are gonna continue to go out. I think you have a higher energy level. I think you've developed confidence. Many people when they lose weight, I think you want to exercise more. I think it's, you know, the joy of exercising and movement. Yeah. and the ability to go on a hike for, you know, without, you know, again, just feeling kind of overwhelmed and achy and tired. I think, sure, you're gonna hear anecdotes about the other side, but I really think that this is gonna end up, you know, in more active, social, healthy people generally. I think what one of the things that You know, I think this is just tamping down on something that is in your monkey brain, which is, you know, we, for millions, hundreds of thousands of years, you know, we, we as humans, as an animal, have dealt with scarcity. And so there was a survival hardwiring that went into things like calories and sugars and fats and all kinds of things that were, you know, dopamine. And so for me, this kind of just tamps down a little bit of like evolutionary, you know, overzealous behavior that we don't need anymore. So for me, it's kind of more just, again, putting on the rational brain and just not dealing with kind of engineered food and, you know, evolution that has really taken that system out of whack. I mean, I don't think half of our culture is overweight because, you know, people are, you know, lazy. I think that there is a lot of evolution and a lot of environmental factors that make it practically impossible for people as they get older, they have kids, they, you know, that I, I think that this is something that, um, you're going to see more good things than bad things come out of. But I think it's going to be change for sure. Uh, you know, so I think it's a, you know, I, I, yeah, you know, I often think about like, where does one invest in, in, if this is, if I'm right about this thesis, You know, how do you invest in it? And so, you know, I think there's, I think there's a category of kind of this area of peptide hormones that I think is very promising. I think we're starting to see data now on Parkinson's disease and sleep apnea and all of these other things. But I think that there's, I think there's a lot of work to be done in kind of antimicrobial work. Hmm. I think there's cancer work. I think there's chronic disease issues. I think there's a class of kind of drugs, broadly speaking, coming out of this thrust that I think are going to be very profound. So I definitely— we're definitely interested in that space. I think there's a class of kind of what I'm going to call kind of telemedicine. Yep. Because as we talked about, you know, prescribing the drug is one thing, but if you've been morbidly obese or significantly obese for the last 30 years and all of a sudden you lose 100 pounds or, or more, there is a whole set of other things that you have to deal with as a human being. So I think having a Telehealth consulting. I think there's opportunities there where you really are dealing with the entire person. And it's like you say, it's not just take the drug. It is how do I eat? How do I eat now? How do I prepare food with my family now? How do I exercise? How do I deal with the social aspects of not being the fat person in a crowd anymore. I think there's a lot to unpack there that I think creates a lot of opportunity. And then, you know, always grants, you know, it's like it's not incumbent upon the VC to come up with all the great ideas. But I do think if one has a prepared mind that this is a fairly foundational, impactful technology Now you're receptive to when entrepreneurs come and pitch you or you go to Y Combinator or go to an incubator and you're hearing about a team that is pursuing something. I think you now, we all have handholds to be like, okay, yeah, that really resonates with my framework of what the world's going to look like 10 years from now. So, I always leave for like half of the investing budget to be like just, you know, prepared mind.

Well put. Well, I think I conceptually agree with you that right now in the early stages, the value is going to be primarily captured by the therapeutics players, then captured by the service providers around the therapeutics players. And then once they become fully priced, we're going to start to see more macro-level strategies around the downstream impacts of things like Sport, fitness, et cetera. And those are going to be the opportunities and it's up to us to spot them. And the good news is we're a multi-stage, multi-sector investor with the opportunity to do that.

Yeah. No, I mean, and just an aside to wrap up, which is, you know, my, with my foot surgery, I was chatting to the surgeon about it and it's like, he was mentioning to me, you know, and this is kind of the second order, third order effects. He goes, you know, one of his classmates is a plastic surgeon. And just the, the huge uptick in people who have lost significant amount of weight now basically kind of are interested in getting a facelift because they're, you know, they're, you know, they have, they've lost a lot of weight in their face now. And it's like they actually look like their age as opposed to being puffed up because they're, you know, their face is fat. In essence. So, you know, that's a— that's an example of like, you know, who'd have thought this would have been, you know, a boon to plastic surgeons, but it seems to be. So, I mean, haven't— hadn't even thought of that. But, well, thanks for the time, Grant. Interesting conversation.

Thank you, Mike. Appreciate it.

Okay. Be well. Talk soon.

Take it easy. Bye.

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