BHAG

Right now, the US is facing a terrible, relatively new problem: a surge in chronic disease.

One in two Americans suffers from chronic disease (more than half of those from multiple chronic conditions), which is responsible for more than seven out of every ten deaths annually. We spend more than $2.3 Trillion each year (about 12 percent of our GDP) treating chronic disease, and it’s likely only going to get worse going forward, as the rate of chronic disease in kids has more than doubled in the last twenty years.

Our healthcare system wasn’t built to deal with these kinds of chronic conditions. A century ago, our leading causes of death were acute, infectious disease (the top three: tuberculosis, typhoid, and pneumonia), and most other doctor visits were also for acute problems like appendicitis, gall bladder attacks, etc. For those kinds of issues, the medical system is incredibly effective: go see a doctor, get an antibiotic / have surgery, recover. And with new treatments and technologies coming online, we get better and better at acute treatment every year.

But that same system isn’t well-equipped to deal with chronic disease, where doctors’ current tools are largely focused on suppressing symptoms rather than dealing with underlying causes. If you have high cholesterol or high blood pressure, you can get a drug to take (for the rest of your life) to lower them, but rarely a serious look at why either is high in the first place.

Recent research suggests that more than 85% of chronic disease is caused by environmental factors, like diet, behavior (including movement / exercise), and lifestyle. Dealing with the root causes of those chronic diseases, then, involves helping patients build and sustain new patterns and habits over the long-haul.

Given the heavy load we already place on physicians, it’s not reasonable to expect them to accept responsibility for driving that kind of behavioral change, too. The average primary care provider has about 2500 patients on their roster, and sees each for visits lasting on average just 10-12 minutes. That’s enough time to diagnose symptoms, prescribe medication, and then follow up a few weeks later. But while most people will take a course of antibiotics their doctors prescribe, drastically fewer will make wholesale changes to their lifestyle, without substantial ongoing support.

Currently, the fitness industry is failing equally when it comes to providing that kind of support. Indeed, the vast majority of people who start a diet or join a gym today will be no better off (and often worse) a year from now, having seen little results, given up, and returned to their prior behavior. Roughly, the fitness world today is akin to where medicine was in 1850: a lot of new science is emerging, and a slew of potentially helpful tools and technologies are being developed, but it’s yet to coalesce into an effective standard of care.

Which, in short, is what Composite is really about. Our big, hairy, audacious goal is to bring the rigor of medicine into the world of fitness, to try and develop clinically-demonstrable effectiveness in treating the underlying causes of the majority of today’s chronic disease.

There are a number of other companies, too, living at the intersection of fitness, technology, and medicine, developing new best practices, to whom we look for ideas and inspiration. I strongly believe that, over the next twenty years, we’ll see a whole new fitness industry emerge from those kinds of companies, one that can work hand-in-hand with the existing medical system, to help the US address the problem of chronic disease. And I’m hoping that, with the right team, a bit of luck, and a lot hard work, Composite can help drive that change, can become a leader of that pack.

July 6, 2017