Kevin Appelbaum

We recently announced that Better Therapeutics will go public via a merger with a special purpose acquisition company, or SPAC, and has raised a significant amount of money from a group of exceptional institutional investors. We are thrilled to have reached this milestone in our journey to change the way some of the most common and costly diseases are treated. We took a moment to celebrate this accomplishment as a team (on Zoom, of course), and then quickly got back to work. What else were we to do?

But as Better’s founding CEO, I do want to take time to reflect on our journey of how we got here. From the initial kernel of an idea developed with co-founders David Perry and Georgi Maule-Ffinch (now Perry), to beginning work on a whiteboard with stacks of stickies and dry erase markers in a small team room at Carbon Five (the best software and design consultancy any startup could work with), the messy process of innovation began five-and-a-half years ago.

In those early days, Nicole Landberg , my partner at the time (the impact of a startup work environment on relationships is a topic for another time), Nicole Rosendin , our first full-time employee, and a developer+designer team from C5 got to work. We had a good grasp of the problem at hand: the diseases affecting the most people and accounting for the vast majority of healthcare costs are ones caused by the choices we each make every day that drive our behavior. We also knew that software has been used to change behaviors for decades. So, we set out to create software that could be prescribed by doctors, used by patients and reimbursed by insurance to help people change the behaviors that were making them sick.

A breakthrough moment occurred early in our journey when we were introduced to a brilliant (yet humble), creative, Yale- and Harvard-educated physician, Mark Berman . Mark is atypical in many wonderful ways, and he had an entirely different view on how we could tackle this epidemic of behavior-driven disease. This new approach would become what we now call nutritional cognitive behavioral therapy , and it has demonstrated promising results in multiple clinical studies.

Our good fortune in finding Mark early-on and convincing him to become our Chief Medical Officer was followed quickly by the hiring of Andres Camacho , a supremely talented Head of Engineering and mentor to our developers. And little did we know that one of the Carbon Five designers that was most formative in our product creation, Kristin Wynholds , would join us several years later as Chief Product Officer. With that core team in place, we are able to integrate clinical intent and design thinking, with the building of great software.

We’ve made a lot of progress since those early days. We have developed our therapeutics platform and created a highly polished first prescription digital therapeutic (PDT) for treating diabetes. Data from our early clinical studies have been peer-reviewed and published in medical journals, and our first pivotal trial is underway. Our team has grown and now includes the beginnings of a commercial organization that will launch our PDTs in primary care once authorized or cleared.

Personally, I’ve learned about agile software development, been introduced to concepts like radical acceptance and reframing shame - and honed my ability to communicate complex ideas through emojis on Slack. I’ve been awestruck by the cohesiveness and commitment of the Better team, and especially their resilience as we prepared for and started our first pivotal trial in the midst of the COVID-19 pandemic.

We’ve made our share of mistakes, but thankfully, none were fatal. The Better team practices the same growth mindset we help unlock in patients, and with every setback we learn something and take the next step forward.

We have much work ahead of us. There will inevitably be additional setbacks. But if we are successful in our journey, we may just change the way diabetes, heart disease and a whole range of cardiometabolic conditions are treated. We could play an important role in reducing the health and cost burden of disease.

On the other hand, our team still struggles with the same deep, existential questions we’ve been asking ourselves for years:

● Is a fork a superior eating instrument to chopsticks?

● What is the origin of “cool beans” and is it one word or two?

● What exactly is mezcal?

● Is the “best sandwich ever” really made of hummus, carrots and broccoli?

● While we learned how to eat on $5 a day, do we want to repeat that experiment?

Kevin Appelbaum

Bend, Oregon, United States 2K followers 500+ connections

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Back Bend Labs

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University of Pennsylvania

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