RX2_podcast_ Shantanu Gaur Founder Allurion Technologies: Audio automatically transcribed by Sonix

RX2_podcast_ Shantanu Gaur Founder Allurion Technologies: this mp3 audio file was automatically transcribed by Sonix with the best speech-to-text algorithms. This transcript may contain errors.

Narrator:
ForbesBooks presents: Entrepreneur RX, with Dr. John Shufeldt. Helping health care professionals own their future.

John Shufeldt:
Welcome back to the podcast. You know, medicine is hard, but there probably isn't anything harder to solve in medicine than the obesity epidemic. The CDC considers 42 percent of Americans obese. That fact didn't scare off my guest this week. His name is Shantanu Gaur and he's the founder of Allurion Technologies, a leader in the development of innovative, scalable weight loss solutions. Shantanu, welcome to the podcast!

Shantanu Gaur:
Thank you for having me, John. I'm looking forward to chatting.

John Shufeldt:
OK, so apparently you and I have the exact same quote on the walls of our offices and I'll start it for you, but you'll know exactly where I'm going. But I want to know what it means to you. "It's not the critic who counts, not the man who points out how the strong man stumbles or where the doer of deeds could have done better." That's on your wall, I hear.

Shantanu Gaur:
Correct. That is a quote that I read every morning when I walk into the office. And it's a quote that has been near and dear to me since we started Allurion 11 years ago.

John Shufeldt:
That is so funny. I have the exact same quote and I feel the exact same way about it. I think I'm going to dare greatly so that even, so that my place will never be with those cold and timid souls and neither no victory nor defeat.

Shantanu Gaur:
That's right. That's right. And that's entrepreneurship in a nutshell. What we do every day as entrepreneurs is we take risk. Though we work on problems that are big and have the potential to have global impact. And what I admire about Teddy Roosevelt is he was able to sort of transform his own image in his own brand, as a aristocratic, very wealthy individual, and turned into a frontiersman and ended up becoming president of the United States. No matter what your background is, no matter what your ambitions are, as long as you're daring yourself to think big and do great things, you have the potential to change the world.

John Shufeldt:
I absolutely could not agree more. And actually, he was very sickly as a child. He had asthma pretty severely. And his father put a weight set up in his room and said, you know, you have the ability to remake your body. You know, the choice is yours. And he did it, which was really, really amazing at that, you know, in that era.

Shantanu Gaur:
Absolutely. He was truly a self-made man in that respect. Very sickly childhood, as you mention, was plagued by asthma. But he he built himself up, push-up by push-up, sit-up by sit-up. And again, that ties into what it means to be an entrepreneur. You make incremental improvements every day and at the end you have a lot to show for it.

John Shufeldt:
I can not agree more. OK, so let's get back to you, and this completely cracked me up. In eighth grade, you wrote an essay titled "What does a Sequencing of the Human Genome Mean to You?" So you're clearly not in the same eighth grade that I was in, how did you get to a place like that in junior high?

Shantanu Gaur:
It was a very interesting time in the world when I was an eighth-grader back then, in 2001, the world was undergoing a revolution in genomics. It was on the news every night. It was something that I heard my teachers talk about at school, and it made science feel very real to me. And I entered this essay contest sponsored by a nonprofit called The Genetic Alliance. And that blossomed into a fantastic development experience for me while I was at this conference where I got my award for writing this essay, I met Francis Collins, who is now the director of the NIH and who at that time was leading the government's efforts to sequence the human genome. And that's when I got my first taste of how science can actually change the world and how a simple concept like the DNA that we're all walking around with in our bodies has the potential to transform the way we do medicine and do science for generations to come. And after that, I was hooked on big problems and how science can actually be used to solve them.

John Shufeldt:
All right. And you're on your way. OK, so you went to Harvard undergrad and then Harvard Medical School. And while you're in medical school, what prompted you to come up with Allurion and the devices so well known for?

Shantanu Gaur:
When we were medical students, we got exposed to all sorts of issues that are plaguing our health care system. And we were very lucky at Harvard Medical School in that the faculty who came to lecture us every day were lecturing us not on just the nuts and bolts of medicine, but also on the problems that they were facing in their practice across all disciplines. And my classmate Samuel and I would sit together in the lecture halls of Harvard Medical School and keep a running list of the problems that our faculty members were telling us about. And what we noticed in that list was that obesity kept on coming up time and again, whether it was a lecture on cancer and the risks that obesity poses to raise your risk for cancer, whether it was cardiovascular disease, type two diabetes, something called fatty liver disease or nash infertility, no matter where you looked, obesity was the central theme. And at the same time, Sammy and I had access to the patients in the hospital that we were helping to treat and take care of. And when you actually sat down and talk to them about how they were dealing with their weight, how they were managing the obesity, we heard the same thing over and over again. I've tried everything. I've tried dieting, I've tried exercise, and it hasn't worked. And I do not want surgery or in the cases where someone did undergo surgery and it didn't go well, we were exposed firsthand to how deadly the outcomes could be. So that was enough for Sammy and I to put the pieces of the puzzle together and say this is a massive problem. It is a global pandemic. This was a decade before covid would spread across the world. This was a global pandemic. And the therapies that were out there were fairly limited. And that gave rise to Allurion, that was really the genesis of our business.

John Shufeldt:
Right, just before Allurion, I mean, it's really and I still see that as, I'm an emergency medicine physician, and, you know, I was saying earlier that I will bet 50 percent of the people I see and I'm working in the city ED's, I will easily about 50 percent of the people that I see at least on BMI qualified for being considered obese or morbidly obese. In, you know, the treatment, as I understand it, with a mutual friend, and Dr. Blackstone, is really diving, the old dieting exercise and then the surgical treatments, which are of the band and I'm not sure what else they do anymore. But there's not a lot else. And literally, that's why I learned about your product.

Shantanu Gaur:
That's right. And that's the massive gap that we are really filling. Our weight loss experience that we've developed is designed to deliver more weight loss than diet and exercise, significantly more. But without any of the procedures and without any of the invasiveness. At the same time that Sammy and I were starting Allurion, there was another revolution going on in the health care system and that was around data. There was a desire both amongst patients and providers to have access to data, both on outcomes and also just day to day progress. And so when you think about it, what we've developed at Allurion is really a program that leverages what we've learned about how obesity can be treated without procedures and also leverages what we have learned has the power of data. And so our program at Allurion really has three components. The first component is what we call the Elipse balloon. It's something that can be delivered, you know, 15-minute office visit, start to finish, it's a balloon that's swallowed in a capsule that goes down into the stomach, gets filled with half a liter of liquid, and that balloon remains in your stomach for four months, prevents you from overeating, helps suppress your appetite. And after four months, our balloon opens up on its own, empties, and passes. We have over forty-five patents issued on that technology around the world. And what that enables us to do is deliver a device to someone's stomach without a procedure, simply by swallowing a capsule attached to a thin tube, and four months later, that device disappears. It gets rid of itself. And so you don't have to come back to the doctor's office and have a procedure. You don't have to go under anesthesia. And certainly there's no surgery involved. And that is really one of the central pieces of our weight loss program. But then that balloon works hand in hand with our digital platform. Every one of our patients gets the Bluetooth scale. It measures all aspects of body composition, not just weight. We also get our health tracker watch, which measures their heart rate, exercise, activity, steps, and all of that data syncs with our mobile app, and all of that data also syncs to our cloud. And so when you combine those two forces together, you really start to get a picture for what the next generation of weight loss therapies are going to look like. They're going to be devices or therapeutics linked to this digital piece to really round out the consumer experience and get providers and consumers all of the data they need to see their progress.

John Shufeldt:
So when I look at the Elipse balloon, you look at and go, duh, this was such a genius. And I say simple, but that's nothing simple. You have forty-five patents on it, but such kind of a no-brainer on how to treat obesity. I think of Peter Thiel with the zero to one, you literally created something out of whole cloth that had yet to be ever thought of. But then someone like me goes, well, God, that seems so obvious now in retrospect, how did you come up with that? Because I mean, literally, I'm, I'm in awe. It's a genius solution.

Shantanu Gaur:
My dad's a mathematician, and so he loves elegant solutions that are simple, and often in mathematics, when you prove a theorem or when you solve a really tough problem, most people look back on it and say, gosh, why didn't I think of that? It's so simple, it was staring us in our face. And that was very similar to what we experienced in the early days of Allurion. For generations, people have been trying to either surgically reduce the size of the stomach, put things inside the stomach to fill, fill it up and suppress appetite. But no one, I think, had the audacity to ask the question, can we do all of this without a surgical procedure? Can we do all of this without an endoscopic procedure? Can we do all of this without anesthesia? And the reason we ask that question from the beginning is that was the question that was being posed to us by the patients and providers that we were speaking to. And we actually sat down with patients in the hospital who had undergone surgery. Their request to us is, can you actually deliver this weight loss without the surgery? When we talked to providers, other physicians, they told us, can you actually give us a weight loss solution that we can use in our office and not in our operating room? And so that was the key design input from the beginning. And we weren't going to advance Allurion unless we could come up with a solution that was truly procedure-less. And when we started diving deeper and deeper into the prior art, what types of devices had been tried before we learned about this concept of putting a balloon inside someone's stomach, but it was being done endoscopically or with some other type of medical intervention. And that's where the sort of aha moment came. Could we deliver a balloon to someone's stomach without a procedure and then have it get rid of itself? And that's where the idea came from to actually create a swallowable pill and have the balloon degrade after four months and pass out of the body. Coincidentally, the reason that we started going down the path of the degradable balloon is because I had taken one course as a Harvard undergrad in polymer chemistry, and I learned about this whole family of polymers and materials out there that were degradable, that just naturally resorbed over time. And that was enough rope, quote-unquote, to hang ourselves with because that gave us a window into, hey, this is a possible, this is a possibility. This is within the realm of possibility to create something that can be great on its own and get rid of the requirement for a procedure.

John Shufeldt:
So, yeah, and then I've said it's just remarkable because when you think about it, the easy path, it would have been OK to just put it in endoscopically with some Propofol and you inflate it that way. Do people struggle with, I'd assume it's kind of like an NG-tube, do people struggling with swallowing a capsule attached to an NG-tube or something like it?

Shantanu Gaur:
The capsule is about the size of a fish oil capsule, a little bit larger. And the tube itself is, that you can think of it as a thin piece of cooked spaghetti. It's very thin. And when you swallow the capsule, it goes down into the stomach and it pulls that tube with it. And the tube is actually made from a material that is very soft and very slippery, especially when it's at body temperature and it's exposed to a little bit of moisture. And so actually, it's a very quick and easy, and in most respects, very comfortable experience for the patient. And that's partly why we're able to deliver our balloon without anesthesia or sedation. It's because of the size of the capsule and the flexibility of our tube. If it were rigid or if it were wider in diameter, like an oral gastric or nasogastric tube, it would be much more uncomfortable for the patient.

John Shufeldt:
Right, wow. That makes a tremendous amount of sense. OK, going back to the Theodore Roosevelt quote, I mean, you went to Harvard undergrad, Harvard Medical School. You came up with this idea that's brilliant. And I don't say that often or easily. Where have you failed? I mean, it seems like you've and it gets easier for me to say, but it seems like you knocked it out of the park from about eighth grade on.

Shantanu Gaur:
I'd say if we had several more hours, we could go through all the places that I've failed in my life. I think that whenever you go down this entrepreneurial journey. If you are not failing fast and failing quickly and failing often, you're just not moving fast enough and you're not taking enough risk and you're not pushing the envelope as hard as you should. There are several examples, especially in the early days of Allurion, where we struggled for years to find the right polymer that would actually remain inside the stomach and degrade over a four-month period. We did benchtop test after benchtop test and had failure after failure. Our first laboratory was in our apartments. We had a table set up where we would actually build by hand our first balloon prototypes. We had just taken our surgical rotations and so had learned how to suture and stitch, which actually came in very handy when we were building our first prototypes. But I can't tell you, John, how many prototypes failed, how many experiments failed, and how many studies failed. But that's how we learned. And I'd say that our background as scientists and our background in clinical medicine prepared us for this, because everyone who's done science knows that the first time around it really works. And you learn as you go and you fail as well. And I try to make sure that that part of our DNA as a business stays true. I want our staff, our employees, our team to be very comfortable with failure and to push the envelope, because that's really where the breakthrough discoveries happen.

John Shufeldt:
Yeah. That's the Thomas Edison quote, you know, ten thousand ways not to make a light bulb. Was there ever a point when you either did it yourself or thought about doing it yourself, where you swallowed, swallowed the balloon, even though you're not obese?

Shantanu Gaur:
You, we did all sorts of experimentation on one another with bits and pieces of the balloon, especially Sammy and I in the early days, we swallowed capsules of different sizes to understand how large a volume we could actually accommodate. We swallowed different types of tubes. We had this harebrained idea in the early days that instead of having a resolvable polymer that would degrade over a period of four months, that we could actually swallow some type of solution that would dissolve the balloon, quote-unquote, on-demand. And I had the crazy idea of swallowing a temperature probe that was actually in the form of a swallowable capsule, attaching it to a very thin string. And I taped the string to the, to my cheek and had this capsule suspended in my stomach for twenty-four hours and drank all sorts of different types of solution to see how high of a temperature I could get into my stomach so that we could feasibly even melt our balloon on demand if needed. We did all sorts of things in the early days because back then we had an idea, we had a clear unmet need that we needed to solve, but we didn't know how to solve it. We were agnostic to the solution. We just spent a lot of time crystallizing the problem and the unmet need and then we went about solving it.

John Shufeldt:
I could just imagine you coming into the emergency department and me asking you, so wait, what are you doing? What's, what's the thing taped to your cheek? And why did you? On that ... monitor?

Shantanu Gaur:
There were times when I probably should have sought medical attention when I did it!

John Shufeldt:
Or psychiatric attention at least!

Shantanu Gaur:
That's right.

John Shufeldt:
It seems like, what you developed here would completely take the place of any surgical intervention that anyone is doing now, you know, the banding procedures that are done. Why then, if you can do it this easy with the Elipse balloon, would anybody get surgery and have that risk? It seems like you're going to put a lot of bariatric surgeons out of business, candidly.

Shantanu Gaur:
In actuality, John, we have seen the opposite effect so far commercially. We've treated over 40 thousand people around the globe. We have several hundred accounts now around the world who are using our technology. And the majority of our accounts are actually run by bariatric surgeons. And what we have found is that first, there's two billion people around the world who are overweight and every single person has a different risk profile. They have a different desire in terms of ideal weight. And so for some individuals, surgery is absolutely the right approach. If you have severe obesity, class two, class three obesity with a lot of comorbidities, surgery may very well be the best approach. And that's the conversation that every patient needs to have with their physician. What we have found is that for people who are moderately obese or simply overweight, we are certainly one of the first solutions that they may very well try after diet and exercise. And some of our higher BMI patients may start with our balloon and then move on and get a surgery. Actually, one of the applications of our balloon in the higher BMI population is to prepare them for a safer and more effective surgery. So if anything, what we have found is that by introducing this type of revolutionary weight loss program to a bariatric surgery practice, they not only attract new patients who want to lose weight through non-surgical approaches, they're actually able to improve the efficacy and safety of their surgical patients and also increase the number of patients who have the confidence and feel ready for the surgery after they use our balloon. So it's actually been synergistic, not antagonistic.

John Shufeldt:
It's interesting, it's probably like coolsculpting and plastic surgery for as opposed to liposuction. You know, the coolsculpting gets them in the door and they can see the different opportunities and different ways to treat whatever, whatever surgical need they feel like they have at least three hours of plastic surgery. I want to go back to medical school. So you did something that I think is really unusual and rare and requires a lot of guts. You went from Harvard Medical School right into this. You didn't do a residency, did you?

Shantanu Gaur:
No, I did not.

John Shufeldt:
So were your, what was your peer group? What were your parents saying to you? Like, you've, you've killed yourself for four years in Harvard, you've killed over four years in Harvard Medical School. And then you don't do the one thing you have to do that allows you to practice medicine or what have given you a hedge on your back, you know, you could have done, whatever, three years of internal medicine and run this program on the side and still, and still have something to fall back on. What were you thinking after spending all that money and all that time?

Shantanu Gaur:
It was one of the most difficult decisions that I've had to make in this journey of becoming an entrepreneur and starting over on. And I think back to a conversation that I had with my father, who I mentioned earlier in the conversation is a mathematician, very analytical. He's one of the most brilliant people I've ever had the opportunity to get to know. And my father put it very simply to me. He said, look, you're at Harvard Medical School. You will be a wonderful physician and you will have a very fulfilling career as a physician. And you may very well end up impacting the lives of tens of thousands of people, maybe over one hundred thousand people in your career, directly and indirectly, just with your own two hands as a physician. Now, that's very fulfilling and that could be a very long-lasting career for you, if you don't start a business like Allurion that has the potential to serve millions, if not billions of people around the world, you may really change the world and change the way we think about weight loss. You may also not change anyone's life because balloons are a new technology and Allurion is a startup and startups can fail and before they even get off the ground. So the question for you, young man, is the following. Do you want to build a career that maximizes your impact in the world or do you want to build a career that's a little bit lower risk and still fulfilling but has lower impact? And when he asked that question, the answer was pretty obvious in my mind, the way he had framed it. But then he added one more thing and he said, I don't want you to say no to entrepreneurship and I don't want you to say no to taking a risk because you're worried about failing, because you're worried about not being able to get back up on your feet in case your company doesn't survive or succeed because you have two Harvard diplomas to your name. If you can't find a job, if your company fails, shame on you. And he cited one example, which was when he came to the United States after finishing his Ph.D. in Canada, he was earning a salary of probably twenty thousand dollars a year and had a wife and two kids and was living the immigrant experience. That was risk. You know, he picked his family up out of India and came to Canada and then the United States. He took a big risk. My mom took a big risk in starting a family here in the United States. That's risk. His safety net was minimal. Mine, fortunately, was pretty extensive. And so when you put all of those things together, it was a no-brainer to go and start Allurion and take the risk to potentially have a huge impact in the world.

John Shufeldt:
It's funny when you framed it, when you repeated how your father framed it, I thought the exact same thing. That's obvious. I mean, impacting millions of people, if not billions of people. But it was a no-brainer the second you said that to me. But I think most people, myself included, would have hedged our bet and got it out a couple of years just to have that fallback position. I have to give you a tremendous amount of credit. I've done a lot of startups over the years, many of which would fail. But I've laughed and you said, you know, how many hours do you have to talk about my failures? I say the same thing, but I'd probably put it in days. But I think the risk you took, even though framed in such a black and white, like okay this is a no-brainer, it still took tremendous guts to do that as a medical student, were there any other medical students at Harvard and maybe other than Sammy, did he do it as well? No residency?

Shantanu Gaur:
Correct.

John Shufeldt:
Wow. So were you guys the only two at Harvard to do that?

Shantanu Gaur:
We were the only two to do that, to start a business. There were maybe a handful of classmates who went on and had careers in consulting or even investment banking out of medical school. But we were clearly the minority by a long shot, especially at a place like Harvard Medical School, which has this incredible reputation of really being a breeding ground for academic physicians and research scientists who have really long successful careers in academic medicine. And I have to really credit my dean at the time, dean Jeffrey Flier, for giving me the encouragement and giving Sammy and me the encouragement to take this risk. He was a very forward-looking dean. I had a lot of mentors or a plat who was my, one of my society mentors, was very forward-looking. And they said we are entering a new era of medicine. We are entering an era where these types of innovations, these types of inventions have the ability to impact millions of people around the globe. And I'll never forget, I had a conversation with dean Flier after I graduated. He actually started a group of entrepreneurs that have come out of H.M.S., Harvard Medical School, and gotten the entrepreneurial route because he was creating several initiatives inside Harvard Medical School to support more and more entrepreneurship. And I told him that I want Harvard to get to a point where if you have one hundred nature and science articles on your resume, that's one thing. But if you have one hundred patents as a professor or as a resident physician, that's another thing. And that's equally valued, if not valued even greater than academic accomplishments. And I think that balance now at Harvard Medical School is starting to come to fruition. There is a new center for entrepreneurship. I get emails periodically from medical students who are asking about becoming an entrepreneur and starting a company that sort of dialogue at Harvard ten years ago was few and far between. But now it's quite more ubiquitous.

John Shufeldt:
Yeah, it was limited. When I went to medical school, it was probably unheard of. There was a gal I went to medical school with, her boyfriend at the time, went to U of I, the University of Illinois and didn't do a residency, didn't do an internship, and went to do investment banking. And we all thought he was crazy. Like, you really worked this hard to do what you're doing. And I think he was one of those who didn't really want to practice medicine. We all kind of rationalize it that way. But they said what you did, I thought was really remarkable. Would you give that advice to the second-year, third-year medical student who calls you up and says, hey, I've got this idea that's kind of out of the box and I'm not sure it's going to work, what advice would you give them?

Shantanu Gaur:
My advice is very similar in all of those conversations, I always ask one question to those students, and that is if you never see a patient again in your entire career, will you miss it? And will you have a lack of fulfillment as a result? And if the attraction to the idea that you were solving as an entrepreneur is something that overtakes everything else in your life that you've had and had the ability to enjoy, including seeing patients and training as a physician, then go and do it, start the business, start the company. But if you're in a state of mind where you want to continue seeing patients, you want to quote-unquote, stay connected to medicine. My advice is to go full-fledged and spend one hundred percent of your time as a physician, at least initially in your career, because that is really where you're going to get the most fulfillment, and later on, there might be an opportunity for you to go off the beaten path, so to speak. But I'm a believer in going into things, quote-unquote, whole-hog, you know, putting the one hundred percent of your efforts behind a single initiative, because that is how I believe great companies are built and that's how great careers in academic medicine are built. It needs one hundred percent of your attention.

John Shufeldt:
Yeah, it's so true. And the funny part is I say that you and I, not followed that advice at all. I've always continued to practice medicine while starting companies while we're going back to school. But I have to agree with you. If you want to do it right, you've got to be all in, and you can do it. I mean, you can be successful and do it other ways, but if you want to not, if you want to really hedge your bet being all in is the best way to hedge it because it has your full time and attention and you're not dabbling. You're in it to win it, which is, if I have to say, as a medical student took incredible guts. So hats off to you. Certainly. Hey, let's switch subjects a little bit. So I've treated a lot of folks over this last year, of course, with covid and to a person maybe except one, but to a person they were obese. Has coronavirus even made obesity, has it put them more on the radar than what was previously?

Shantanu Gaur:
Almost certainly. When I look at where we were a year ago, before covid really started to spread around the world, obesity was really viewed as a chronic illness that most people actually don't believe it should even be classified as a disease with not much of an urgency in terms of its acute issues that it can cause in a patient. And then all of a sudden covid came and these two pandemics, covid and obesity, collided head-on. And from the earliest days in Italy when physicians were on the ground treating patients day in and day out in the ICU, I was on Twitter following a lot of these physicians, translating their tweets out of Italian, looking at the working group presentations that they were putting together and making public on websites. And the one thing that kept on coming up over and over again was just how many patients, and in alignment with your experience, John, were obese or overweight. And that was really the tip of the iceberg. Just yesterday, I believe a study was published looking at all of the mortality associated with covid-19 and countries where the rates of obesity and overweight were the highest, had mortality rates due to covid that were 10 times higher than countries without widespread obesity and overweight. So the links now are well-established. There are increased risks of mortality, increased risk of ICU admission, increased risk of prolonged infection with covid, if you have obesity or if you are overweight. This is done two things to the world. One, it has made obesity an acute issue. It is something that is front and center on people's mind because it has an immediate impact on their day-to-day health, not just their chronic health. And second, I think what happened during the quarantine was a lot of weight gain. I think a lot of people had to reset their lifestyle and it became much more sedentary and emerging out of quarantine, we have people who have gained weight and are eager to lose it, and you also have on the front of the minds of providers and patients this desire to be fit and be healthy as a way to protect against covid or covid outcomes. And so it has transformed the weight loss world, it's transformed the obesity world, and it's transformed our business. We had unprecedented growth in the second half of 2020. We saw unprecedented levels of traffic on our website, twentyfold higher website traffic after quarantine's began to lift. And I believe that these tailwinds are here to stay.

John Shufeldt:
Yeah. I own a telemedicine company and have the same experience that we're just, you know, for nine years it was like, okay so telemedicine. First it was like, what is it then OK, that's pretty cool but he's going to use it. And then it's last year, it is just absolutely gone through the roof. One thing that's always frustrated me about obesity and mental health, I hear a lot of people say, well, can I just quit eating, start and start working out what's wrong with you? And it's the same with mental health. It's like, you know, just buck up, you know, whatever and look at, no, it is a disease. I mean, it's not a choice people have. That has to get frustrating from someone who's as knowledgeable as you to hear, and I think it's a very common thought process in many people, it's like, you know quit ordering three Big Macs. I mean, just to start working out. How do you answer that? I mean, how do you respond to that without getting overly frustrated?

Shantanu Gaur:
Well, every frustration's an opportunity and we're actually talking here today on World Obesity Day, which really celebrates all of the stakeholders who are in the weight loss ecosystem, from patients to providers to entrepreneurs to investors, the whole nine yards. And one of the themes this year for World Obesity Day is to reduce stigma and reduce bias against those who have obesity. And certainly the same is true for those who are struggling with mental health issues. Obesity is a complex disease. It is something that has genetic underpinnings. It has environmental underpinnings. It has deep-rooted socio-economic underpinnings. At the molecular level, obesity is just as complex as any type of cancer that I studied as a medical student. It's just as complex as diabetes. It's just as complex as cardiovascular disease. In fact, some may argue it's more complex. One of the responsibilities of providers like you and me, of entrepreneurs like you and me, is to educate the world about the disease of obesity and to open people's eyes to the fact that if it were just that easy to eat less and move more, why do we have an obesity epidemic? There must be something more to the story and simultaneously our responsibility is to push for more and more solutions for people who are struggling to lose weight so that they have the options available to them when diet and exercise don't do the trick, as that is the case for most people. So the responsibility that we have, John, is very important. And as a business, we will always remain committed to not just providing solutions for people who need to lose weight, but educating those around them that what they are dealing with is not just a, an issue of lifestyle, it's a real disease.

John Shufeldt:
Incredibly well said. So I'm going to switch topics again just for a second. So I've been out raising money over my last twenty-five years or so, but it seems that raising money for the Elipse balloon would be easy and essentially you show it to people, you explain to them. And I would think that if a light bulb go off, was it easier to raise capital when you were starting out?

Shantanu Gaur:
It was very difficult. In fact, I have this memory, one day of going to four meetings with Sammy and each meeting finished early and each meeting finished early because the answer was no. And those early days were very difficult because for a variety of reasons, we were not a great investment opportunity. Here we were as two medical students who were simultaneously studying at Harvard and also starting to launch this business, here we were going into a space where there is not, there has not been a clear winner. No company has really, quote-unquote, cracked the code in obesity or weight loss. The problem just keeps getting worse. And there's a reason, the problem is really difficult to solve. And sometimes problems that are difficult to solve are very difficult from an investment standpoint. And I remember coming home or back to my dorm, rather, after those meetings, and I was scrolling through my Facebook feed, back when people used Facebook still. And I saw this quote from Michael Jordan. It's his quote about how time and again he has missed the game-winning shot and he's made so many shots in his career, but he's missed so many big ones. But what makes Michael Jordan the greatest athlete of all time is that he kept on taking those shots. He never lost confidence. And eventually, we got to a point where we had a prototype. We had a better story around what the total addressable market really is. We brought in advisors, we started building our team, and that really put a lot more confidence around our story. So no matter what, I think when you're starting a company, even in today's day and age where there is capital, it seems like everywhere in the world, it's very difficult to start when you just have an idea. People really need to believe in you and believe in the team that's around.

John Shufeldt:
Now, I totally agree with you. This has been incredible. I can say unequivocally that your place will never be with those cold, timid souls, that neither no victory nor defeat. You, in fact, are changing the world. And I could literally not be more impressed by your journey and what you're trying to accomplish. Thank you so much for being on the podcast.

Shantanu Gaur:
Thank you, John. It was a pleasure and honor, and I look forward to keeping you in the loop on how things progress.

John Shufeldt:
To find out more about Shantanu's remarkable work, look at our show notes or go to Allurioncom. That's it for this episode. I'll see you next time and please stay safe!

Narrator:
Thanks for listening to Entrepreneur RX with Dr. John Shufeldt. To find out how to start a business and help secure your future, go to JohnShufeldtMD.com. This has been a presentation of ForbesBooks.

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