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Launch HN: Mighty Health (YC S19) – Health coaching for people over 50
134 points by minibronco88 on June 19, 2020 | hide | past | favorite | 77 comments
Hey HN!

We’re James, Felipe, and Bernard, founders of Mighty Health (https://mightyhealth.com/gift), a personal coach that helps people over 50 become healthier through exercise, nutrition, and wellness.

With Father’s Day coming up, we thought some of you might be in the same position as we are, worrying about our parents and loved ones, wanting to do more to help out in these uncertain times.

A few years ago, my dad was rushed to the hospital for emergency heart surgery. Though he luckily survived, this was quite the wakeup call—he had to change his lifestyle habits immediately, or else he’d have to deal with painful, worsening chronic issues for the rest of his life.

These changes—exercise, nutrition, sleep, and reducing stress—are hard as is, but even more so for folks over 50. Most wellness apps are designed for motivated millennials, making them feel less relatable to older adults. They don’t take into account evolving health needs, joint issues, or technical limitations. Personal trainers and nutritionists are expensive long-term and often inaccessible. And because our older loved ones are at higher risk of COVID complications due to their age, they won’t be able to return to gyms for the foreseeable future.

That’s why we started Mighty Health. Everything is designed intentionally for people over 50:

1. Coaching: A personal coach keeping them motivated through SMS, providing a real human relationship

2. Exercise: At home workout videos that are easy on the joints, led by top-rated certified trainers

3. Nutrition: A personalized plan and grocery list designed by cardiologists for heart health

4. Reminders: Preventative health checkup notifications (based on their age and gender) and medication reminders

5. Celebrations: Texts to family members about milestones in the program so you can celebrate together

Our app is simple to set up and use, accommodating large and high contrast text. We chose SMS (through Twilio/Front) for coaching because it’s a more familiar medium, like texting with your family. We integrate with Apple Healthkit and Google Fit, as well as a number of cellular blood pressure cuffs and scales.

Dr. Bernard Chang, our medical co-founder, is the Vice Chair of Research at Columbia University’s Department of Emergency Medicine and leads our team of physicians, trainers, and coaches who develop our plans and content.

These plans are optimized for health goals specific to people over 50, such as losing weight to prevent chronic diseases, becoming stronger/decreasing joint pain, or reducing their risk of heart disease. On average, 85% of our users stick to our plans for at least 12 weeks and lose ~10 pounds.

We’d love for you to check out our website at https://mightyhealth.com/gift and are eager to hear your feedback and ideas below. Feel free to reach out directly at james@mightyhealth.com as well!



The need for your app is overwhelming. I am 65, female, very fit, and lost 40 pounds since 2014. Daily, I do some type of class, either strength, cardio, yoga, or walking. Here are my concerns with your app as a vehicle to long-term improvement.

1. The enemy of healthy living is social interaction that is nearly always alcohol and food indulgence. Either your user has to find new friends (like an alcoholic develops a cohort of non-drinking friends,) or they have to acquire the strength of purpose to abstain while still being social. Success here is very dependent on self-esteem....a distinctly non-technical aspect not directly addressed by the app.

2. Preparing your next meal BEFORE YOU ARE HUNGRY is critical to success. This could be addressed by subscribing to a pre-packaged frozen meal service, or, by consistently doing grocery shopping and meal prep in advance. The latter takes planning, discipline, and effort. Lack of planning is frequently the reason for eating excess or unhealthy food.

3. Eating to self-soothe is prevalent. Learning other sources of pleasure or gratification is crucial to sustained success. For example, I always want second helpings even though I know I have already had enough. This because my stomach needs an extra 15 minutes to tell my brain that I am satisfied. To cope, I set a 15 minute timer and for that 15 minutes, I walk away from the food area, sit in a comfy chair and do something pleasant with my phone, such as read fashion news or text with a friend. A sine qua non of healthy eating is having a list of other pleasant things to do when you feel the urge to eat when not hungry.

4. Many overweight people will only succeed in the transition to a healthy life if they have in person contact with others that support and acknowledge their struggle. Either a 12-step meeting or a FaceTime call with their coach is vital so that your user can visualize that person's face when the user is at the moment of decision to binge or not.

5. If you take away food and drink as the emotional coping tool, you have to replace it with something that is not self-destructive. Your users have to be ready when emotional crisis comes when, then more than ever, they will feel entitled to eat or drink anything within convenient reach. For this reason, I am unable to keep ready-to-eat foods in my house.....cereal, cheese, nut butters, dessert, snacks, bread of any kind. I do keep fresh apples and oranges, but that is it. Your user must develop other methods of dealing with crisis.....journaling, phone a friend, or just giving themselves permission to withdraw, lay down and rest if possible. Since I have momentum on my side, an activity that 100% occupies the mind, like a spin class, is my helper that enables me to muddle through. Meditation is another good tool.

I have come to believe that lack of self-care has much more to do with emotional self-regulation and self esteem than it does with lack of knowledge on sleep, exercise, and nutrition.

However, for those who suddenly get motivated by a health scare, the knowledge and guidance in your app is like a welcome breath of life.


Wow, thank you for sharing your personal experience and such a thoughtful response. We'll definitely take your concerns into account as we continue to improve the product.

100% agreed that the underlying issue is not knowing what to do, but rather more psychological aspects such as who you spend time with, environmental factors, self-esteem, and discipline. Our medical co-founder Dr. Chang is a psychologist by training and constantly emphasizes this. One direction I'd personally like to see our product go in is increasing our sense of community and what it means to be "Mighty." Much like the strong online community you see from apps like Peloton and Strava, but with more of an angle of shared physical and emotional self-care. As you mentioned, this is not necessarily a technological solution, but rather one of how we create the right culture and environment for our members to succeed.


Hey this is awesome. One question, can the coach(es) cater to preexisting conditions/diets? My pops has Parkinson’s and is on a pretty tight diet that my mom has put him on for weight loss, so in order to try to get him to try it, Mighty Health would probably need to work within those confines to start. Would something like that be possible? If so, I’d love to gift a subscription to see how it helps him.

Cheers and congrats on the launch! v exciting stuff.


Yes, absolutely! At the start of the program, we ask about nutritional preferences / restrictions, and the coach can also hop on a call to clarify anything.


Have you considered expanding into ADHD coaching? I feel like it's something I could use. Since I haven't yet tried it, I don't really know how it works. It seems like something that's useful but is in its early stages, with a lot of people just relying on frequent counseling, which can be expensive. I also feel like it's something that could be mostly automated which would be ideal for a tech company.


Thanks for the idea! Definitely something to consider for the future, though we'll need to bring on a few experts to develop the content and pathways first. We've seen online solutions like https://donefirst.com/ but that seems like a more pharmaceutical approach.


I’m pleasantly surprised you went with 50, as opposed to Medicare age. It just shows you aren’t going after only the easy Medicare dollars. Of course you can still capture that too (see the Silversneakers program as an example).

Just like economic gap that is growing in the US there is a major health gap growing too. For those with resources 50 is like the new 20 as many of men are now “juiced to the gils“ with testosterone provided by their doctors (I see it a lot in Miami, and I’m sure it’s proliferated in tech companies/cities too, just something about money and ego I think), then for the have nots it’s this age where many are just holding out to become Medicare eligible to begin treating their chronic conditions and they are only suffering and getting worse in the meantime.

One day, if I am ever financially independent (unlikely), I have resolved to dedicate my life to health/wellness for children, with a very specific goal of type 2 diabetes prevention. I really have no idea why, I never got T2D, but it breaks my heart especially in children. If you ever expand in this direction, I’d be the first to apply in any capacity.

Good luck!


Thanks for sharing! We've definitely seen a bit of the same. The economic gap leads to an access to care gap, especially in more rural areas. That's before even factoring in lack of access to fresh, non-processed foods, which is a key part of nutrition especially at an older age. We hope that services like ours (and your much-needed T2D concept) can help close that gap!


This is fantastic and could be so helpful so many people. A piece of feedback on the sales page: it does a good job of describing the person who would be /gifting/ the service and they (we) need some guidance on how to gently bring it up to the recipients and sell them on investing the time and energy into it.


That's a fantastic idea - we'll work on adding that!


Do you ever plan on adding live video for the coaching or trainers?

Additionally, would preventative health reminders be coordinated with the patient’s PCP in some way? For example, you wouldn’t want to tell a user to go get blood work for checking lipids when they just had it done the other day.


Yes, that's a great idea. Live video would have even more of a community feel--plus, we could probably capture and edit the streams into re-usable workouts for the future.

We'd love to integrate with provider medical records in the future, but sadly there are very few incentives in a fee-for-service environment. For now, members can just check things off or "postpone" if our cadence is off.


I'm glad to see people building for this audience. I have to say I'd be a little reluctant to gift this to someone for fear of offending them. That said, it seems like it would be a great addition to a doctor's available interventions or a workplace wellness program.


Thanks for the feedback! We’ve been surprised by the number of users who have told us they couldn’t relate to other exercise programs. You bring up a great point about potentially offending -- we feel it comes down to how close you are with the person and if they know you’re coming from a good place. We just added a 30-day guarantee to the site as well in case they don't end up liking it!


This is an excellent idea! In the US, there's a culture/mind-set within this age group that going to the doctor is a waste of time or that they're "stronger" for not having to see a doctor, which only allows pain/injuries to linger or grow before they get too far out of hand that a doctor MUST be consulted.

I think there's an interesting angle to attract a wider audience here too – if your claim of losing ~10 pounds in 12 weeks is true, maybe there's an opportunity to be a "weight loss service" masquerading as a "wellness service." The difference being that well-being is a lifelong goal and weight loss is not.


Agreed! It's such a struggle encouraging people to take preventative health seriously, even as chronic issues start creeping in. Rising insurance deductibles in the US certainly don't help as well. We've found that the members who are must successful are those who have received some kind of "warning" from their doctor -- "if you don't lose the weight, you're going to need back surgery" -- or worse yet, people like my dad who had a near brush with death before realizing he needed to take his health into his own hands.


This is such a great solution in a country where healthcare is so expensive. It helps kids of aging parents, and aging parents themselves take care of their health. I bought this app for my mum on mothers day, and she's been using it!


This sounds great. I'm 47, but have physical limitations due to truamas earlier in life. I love the idea of a service tailored to older folk, and may participate.

The one thing from your description that threw me off was " it’s a more familiar medium, like texting with your family."

I don't text with my family. Or with anyone, really. It is a running joke that the last way you'd want to get in touch with me is by text. My kids text me just to take bets on how many days will go by before I see it. Maybe I'm the exception... but I'd encourage you to re-visit whether that really is how people who are 50+ would prefer to communicate.


Thanks for the great feedback. We started with text as it seems more integrated with daily life than in-app chat, but we'd love to expand out channels in the near future. Would love to hear what method you'd prefer instead so I can pass it along to the team!


I like emails and video calls. If I need to communicate in real-time, I prefer to just have a call and do it. If not in real-time, email feels the least invasive to me, and is my preference.


Isn't part of the idea here to _be invasive_ though? If part of the intent of the service is change behavior then the coach must interject themselves into the clients' lives in order to create action.

How would you see the minimal invasiveness of email aligning with such a call to action?

(hope this doesn't come across as an attack as it is not intended to. Just trying to understand how you see these two ideas as compatible since I see them as opposing and so wanting to know what angle I'm missing)


I see your point, but I believe your goal is to be visible, not invasive. You are trying to help people along a path that they want to be on, not force people on a path that doesn't feel right to them.

For me, texting is a path I won't walk. Email is a path I walk multiples time a day. Talk to me there, I'll see it, it will be injected into my life.


That makes sense - thank you for your reply!


Really great idea and well executed from what I can see. Just wondering about the business model: how often do your coaches interact with your customers? It seems that at a ~$10/month fee you wouldn't be able to afford too much of their time per customer.. Maybe 5 minutes per month at most (assuming $75/hr and deducting payment fees etc) ? Or am I missing something?


Coaches interact with the members every day. The vast majority of our coaching touchpoints are asynchronous -- either checking in or replying to members via SMS, or configuring member's daily plan (step goals, exercise videos, lessons, etc.). As you can imagine, we've spent quite a bit of time building out tooling on our back end to scale the coach to member ratio while still being able to provide personalized, human service.


This looks very good! congratulations.

Curious to know - does the Western market adopt solutions like this very easily ? Because atleast in India (or Asia), i see my parents and lot of older folk being highly resistant to adopting management solutions.

And we are a market that's almost entirely mobile-based. I would have guessed this is something one would need to push via doctors ... rather than directly.


That's a great question. We're definitely seeing a large shift toward the consumerization of healthcare in the US -- especially starting with product/services that folks are already accustomed to paying out of pocket for (i.e. therapy, home testing kits, meditation, certain drugs). Similarly, Mighty Health is meant to be aligned with services like personal trainers, nutritionists, and gyms.


Excited for your launch! How do your coaches get parents to become motivated? Been a challenge for me to get them to exercise and eat better


Thanks! Great question. Our coaches are trained to help members develop habits (using a framework similar to Atomic Habits or The Power of Habit) -- to successfully create or replace a habit, you need a trigger, the routine (in our case, the workout or eating well), and a reward. At first, the coach's SMS prompts serve as the trigger, but over time we help members establish their own triggers in their environment (post it notes around the house, associating a workout with finishing a specific meal). Similarly, the coach is at first the reward (insight on your meals, shoutouts in your support group) but members learn to embrace other intrinsic rewards like the great feeling of accomplishment you have at the end of a well balanced day.


Congrats on the launch.

To clarify: Are you guys specifically focused on people over 50? The website makes no mention of the 50+ age focus. I just got a gift for my mom, but the only reason is for an exercise coach who can create a specific routine for someone who is 65 years old. We don't need the nutrition coaching.


Yes, we only focus on people over 50! It's in the sub-headline of our site, but we could make it a lot more prominent / repeated throughout -- thanks for the feedback. All of the exercises in our app are specifically designed for that age range. Looking forward to hearing what your mom thinks of our program!


Love the idea! Honestly health is often taken for granted and we need more things in tech pushing health forward


Agreed! Unfortunately, most people don't think of it as an acute problem until it's too late.


My first thought was "the clothing brand is doing coaching"? https://hypebeast.com/tags/mighty-healthy


Haha we haven't seen that! Maybe drop a collaboration in the future...


Just gifted it for my mom. Hoping it kick-starts some better habits for her.


Awesome, excited to hear what she thinks about it.


I was just thinking about how great it would be to have something like this for my mom! Especially the low-impact exercises. Do you have coaches in any other languages outside of English?


Currently, we offer coaching in English and Portuguese -- we'd love to add more in the future though! What language would your mom prefer?


Vietnamese, although Spanish might be helpful if you had to prioritize. Lots of kids of immigrants in the US where our parents don’t read English well enough to participate in things like this.


I agree, I would love to get a subscription por my parents but I’m sure they will not stick to it unless Spanish is supported.


Got it, we'll be sure to add Spanish and let you know. Thanks!


This is such a great idea in a country where healthcare is so expensive, giving peace of mind for kids of aging parents, and for hopefully parents themselves. Good luck with this app!


So true -- deductibles are getting higher every year, and my parents are always facing hard decisions on whether or not they should go in for elective visits. Excited to hear your mom's feedback!


Love this idea and I can totally see my parents using something like this! What's been the most interesting insight you guys have learned so far while building Mighty Health?


Our older users have been much more tech-savvy than we anticipated when we first started working on this. Roughly 10k people turn 65 each day, and many of them are in the generation that is used to relying on an iPad every day. That said, we've tried to incorporate tiny UX considerations wherever we can, such as adapting with the phone's text size settings and increasing the size of touch targets.

We've also found that folks are generally overconfident but misinformed about nutrition (probably due to the overwhelming amount of information online and in the media) but anxious and risk-averse when it comes to trying new forms of exercise.


This sounds great! I am on my 30s. Maybe I can't join your program right now but I can definitely share this idea with my parents. Is your app running global?


Yes, it's available on both iOS and Android in most countries. We'll refund your gift in full if we can't get it to work!


What did you guys use to build the landing page? Looks nice.


Hey! CTO here. First, thanks.

We used a custom design by our great designer, meaning the rest of the landing page is CSS and HTML.

We used a few css libs, for the sake of helping us making it responsive, but that is all.


The overall design is nice, but you may want to reconsider the combination of Visuelt and Helvetica Neue. Not only are they just different enough to noticeably clash; what's worse, I thought the Helvetica was (unstyled, fallback-stack) Arial at first, which looked like carelessness. For Helvetica to look sharp, you need to really commit to the Swiss look, headings and all.


Got it. Appreciate the feedback and will incorporate into our future iterations.


Sounds like sth http://www.lab4.life/ has been working for a while.


I’m not the target audience right now, but someday I might very well be. This is one of those ventures that I’m glad exists.

Thank you for doing this.


Appreciate the support. For Father's Day, we've added the ability to gift a membership, in case there's anyone that comes to mind that could benefit!


I hope you succeed. But the people who most need this coaching are also the same ones least likely to engage.


Congrats James! This would indeed make a great last-minute father’s Day gift. Good timing on the launch!


Thanks Jay - always appreciate your support!


My mom is one of the first members of the program; it helps her a lot already!


Wow, glad she's liking it! Let us know if she has any other feedback for how we can improve.


Why does your "Contact Us" link just go to the FAQ page?


Hmm... I'm seeing that it links to mailto:support@mightyhealth.com - are you referring to the "Contact Us" at the very bottom of www.mightyhealth.com/gift, or somewhere else?



Got it - fixing it now. Thanks!


Is this worldwide ? Can I gift it to my dad in india ?


Yes, available internationally! You can use the country selection dropdown to input an Indian phone number while completing your gift.


Do your trainers specialize in training older clients?


We have a couple of trainers that have focused on older clients exclusively (for example, one of our lead trainers Julie Diamond: https://www.instagram.com/juliediamondfitness/), and all of the rest have had extensive experience training clients up to their 70s. In addition to making sure the workouts are tailored to health goals and easy on the joints, we ask that our trainers offer lots of modifications in the workout videos for those who can't do specific exercises due to joint/back pain.


Congratulations to you and the team for the launch!


That's amazing, congrats for the launch.


Awesome idea!


Very cool idea, best of luck!


Good luck!


Congrats on the Launch! My mom has been using Mighty Health for about a month now, and is very happy with it. She particularly likes the accountability via text message, and nutrition coaching.


So glad to hear your mom has been finding it valuable! Will pass that along to the team.


I got Mighty Health for my mom as a Mother’s Day gift and she loves it! Absolutely worth it and the content the team publishes is especially helpful.


Thanks! We've been working hard on developing our new workout videos, especially since everyone's been stuck at home with little to no equipment recently. Soup can curls look a little funky, but are still effective!




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