When Napala Pratini and Ian Braithwaite met at Counterweight, a diabetes reversal research company, they had no idea that their coworker relationship would turn into a co-founder one. But after seeing that the life-changing diabetes reversal programmes available in research trials were not scaling quickly enough to meet market demand, they put their heads together to co-found Habitual. Habitual provides a unique combination of digital therapeutics and nutritional treatment that reverses and prevents chronic diseases like type 2 diabetes. We are thrilled to back Ian and Napala alongside MMC Ventures in their £325k pre-seed round. We backed the Habitual team because we believe in their vision of not just preventing, but also reversing, chronic disease by putting patients at the centre of the healthcare ecosystem. Recently, we had the chance to speak with Napala and Ian to learn more about Habitual’s journey to-date and the team’s vision moving forward.
Tell me a little bit more about Habitual.
Ian: Habitual is a digital diabetes prevention and reversal company, and we’re on a mission to reverse type 2 diabetes for as many patients as possible. We do it by combining two things. The first is a nutritional treatment called total diet replacement, which helps people to lose 15 kilograms safely, quickly, and reliably. This is a key number because the evidence shows that to reverse type 2 diabetes, patients need to lose about 15kg. That level of weight loss allows the pancreas to start functioning normally again—and thus reverses type 2 diabetes in 40-60% of patients. But as anyone knows, that amazing weight loss is not effective unless it’s twinned with effective behaviour change. So we built our digital therapeutic to accompany our patients throughout the entire journey, helping them to assess their relationship with health in lots of different aspects: nutritional, behavioral, and physical (including exercise).
What makes Habitual stand out among other digital therapeutics?
Ian: So many digital therapeutics have been built for a healthcare provider or an insurer. And they do a really good job of answering the questions that doctors have about their patients, like daily blood pressure measurements. But what we see is that there are real struggles with long term retention and patient engagement. To really change health behaviours, you need to deepen your thinking about product, and think much more broadly than just monitoring—you have to build a product from day one that’s designed for the patient. You really need to take a step back and ask, what am I solving for the patient here? What am I helping them with? Whether it’s a really difficult day and they need motivation or they need coping mechanisms to deal with something emotional that has gone on in their life, or perhaps they want brilliantly written, actionable information… you need to build around the problem that the user has.
How does a user interact with Habitual on a day-to-day basis.
Napala: Well, on the nutritional side first — somebody goes through three months of total diet replacement, switching away entirely from normal foods and onto our nutritionally-complete powdered shakes, soups, and porridges. That is what unlocks that 15 kilos weight loss that Ian mentioned. Then, over the following three months, they slowly reintroduce food back into their diet, during which we educate them about how to build sustainable healthy eating habits. On the digital behavior change side of things, the programme is structured as weekly themes, or modules, which are each broken down into seven bite size pieces. So it’s a daily lesson and/or an exercise. On top of daily behaviour change, patients track their progress daily using our app, which also enables us to send more tailored tips and notifications back to them.
A lot of behaviour change solutions operate on more of a ‘pull’ model, asking the user ‘What do you want to work on? Do you want to be more mindful? Do you want to do X, Y, or Z?’ And the problem with that is that most patients don’t know where to start, or what they need. Our behaviour change is delivered using more of a ‘push’ model because we’re confident that our programme works: We’ve designed all of our behavior change content in collaboration with leading behavioural scientists, and it’s been extensively tested on real people going through our habit change and weight loss journey.
Why do you think the reversal of type two diabetes has been overlooked?
Napala: A lot of it has to do with how Western medicine thinks about disease treatment and management. It’s really hard for your doctor to say, ‘I’m going to help you change your eating and exercise habits.’ Unfortunately, it’s a lot easier to prescribe a pill or a surgery. Diseases like type 2 diabetes, heart disease, knee osteoarthritis, and sleep apnoea (all of which our programme can help to reverse) are diseases caused by people’s daily habits—what they’re eating, whether they’re exercising, and their relationship with food and themselves really. It’s a mental thing as much as it is physical. And that’s virtually impossible to tackle in a 15 min GP visit.
Ian: From a more medical perspective, it’s also worth noting that it’s only recently that we understood that type 2 diabetes was reversible in the first place. Just for background, type 2 diabetes actually starts with something called pre-diabetes, which is essentially when your blood sugar starts to rise above healthy levels as you become resistant to insulin. You develop type 2 diabetes when the cells inside the pancreas, which normally secrete the hormones controlling blood sugar, cease to function correctly. Up until recently, it was believed that these cells in the pancreas actually died in type 2 diabetes—that is, that irreversible damage was caused. Now, the big breakthrough five years ago was the understanding that these cells were capable of functioning normally again—that they didn’t die in the first place, but were rather impaired by the presence of fat. By decreasing the fatty burden on the pancreas, these cells can go back to normal and control insulin and thus blood sugar levels as they’re designed to. That was really the big shift in understanding of type 2 diabetes. Even when I was at medical school 10 years ago, that understanding just wasn’t there yet. Now it is what fuels our excitement for the future of Habitual.
What results have you seen so far from Habitual patients?
Ian: Each patient’s story is super unique and what health means to them is really individual. One of our patients lost 30 kilograms, but for him, health is being able to do a 5k at the time he used to do when he was 35. Another patient, who has lost 45 kilograms, is now in pre-diabetes remission and started cooking again. It’s really easy to over medicalize these problems and say, you know, ‘she’s in pre-diabetes remission’, but actually for her, it’s about cooking. Overall our patients have done incredibly well, losing an average of 15.5kg and reporting great health outcomes across the board.
You just raised an exciting pre-seed round with Seedcamp and MMC ventures. What are your immediate goals post-raise?
Napala: Now that we’ve basically wrapped up our private beta, we’re launching a public beta, and it’s really all about acquiring our first paying users and figuring out what message resonates with people and who are our early adopters. It’s about finding the people who are going to evangelize our product in the early days and really get the word out (which we’ve already seen be incredibly powerful amongst our private beta participants). Alongside that, we will be working on the product. We currently have version two or three of our MVP which we’re going to go live with, but we are looking forward to developing a lot more on the tech side as well.
What is your vision for Habitual 5-10 years down the road?
Ian: We’re seeing a huge shift in the way that healthcare is being delivered. The co-founder of Parsley Health likes to say that health happens in the 99% of the time we are not in the doctor’s office. Health is about the decisions we take in our day to day lives. At Habitual, we want to be part of the journey of moving healthcare away from that interventional relationship in a doctor’s office to actually being in patients’ hands. We’re starting with type two diabetes reversal, but we see the opportunity to help people live healthier lives go far beyond that.
To learn more about what the Habitual team is building, visit tryhabitual.com