Pandemic Pounds…

The 2021 Stress in America report by the American Psychological Association found dramatic unwanted weight gain by adults = 61% of U.S. adults said they experienced unwanted weight gain in the pandemic, averaging 29 pounds.

I’ve written before about the pandemic’s toll on mental wellness and weight – and a couple of weeks ago, we launched an all-natural approach to balance them both via the Gut-Brain-Axis.

Microbiome-Gut-Brain-Axis Involved in Mood/Weight Connection – New Study

Interesting new study showing the relationship between the Microbiome-Gut-Brain-Axis and BOTH mood and weight.

We showed a few years ago that you could CHANGE this relationship with the right combination of probiotics, prebiotics, and phytobiotics.

In those peer-reviewed and published studies, we showed that targeted supplementation improved microbiome diversity, elevated mood, and reduced body fat (the supplements included Fundamentals and the GBX Functional Foods System).

Earlier this month, we launched an even more advanced approach – the world’s first “QUAD-biotic” targeting both mood and weight (probiotic + prebiotic + phytobiotic + postbiotic).

This GBX Fit formula (from Amare Global) delivers specific strains of beneficial bacteria and other plant-derived extracts to rebalance multiple aspects of the weight/mood connection (stress, inflammation, blood sugar, appetite, etc) – so you feel good while you lose weight.

You can read more about GBX Fit at www.Amare.com and read the full scientific article at the link below.

Microbiota and Metabolite Profiling as Markers of Mood Disorders: A Cross-Sectional Study in Obese Patients
— Read on www.ncbi.nlm.nih.gov/pmc/articles/PMC8746987/

Mental Wellness Meets Metabolism (GBX Fit Science)

Here are the slides from my (January 20, 2022) deep dive into the science of the ingredients in GBX Fit – the world’s first “QuadBiotic” to combine a specific probiotic, prebiotic, phytobiotic, and postbiotic to enhance weight loss, metabolism and fitness.

The general idea behind the GBX Fit formula is to harness the power of our microbiome and Gut-Brain-Axis to help us get “unstuck” in our efforts to lose weight – and especially belly fat and inches.

The recorded presentation will be HERE on YouTube – and you can see many other presentations and subscribe to my YouTube Channel HERE (so you’ll get notified whenever I post a new video).

Please also “Follow” my blog (lower right) so you get notified whenever I post a new article.

Toxic Food is Killing Us (and Our Microbiome) – How to Fight Back

In 2008 (a long time ago), I produced a feature-length documentary film about America’s obesity epidemic. It was called “Killer at Large – Why Obesity is America’s Greatest Threat.” It was a lot of fun to make – it won numerous “best documentary” awards on the film festival circuit – and was screened at the White House for Michelle Obama (who was an advocate for healthy eating and solving childhood obesity when she was First Lady). You can watch it today for free on Netflix, Amazon Prime, and all the different streaming platforms – including the YouTube link below…

Killer at Large link = https://youtu.be/KBVm3fWPXCY

Note = This is a 20-min “educational version” that we released nationally for FREE – and which was shown at thousands of schools and community events around the country – as a way to get people talking about the problems around the obesity epidemic (e.g. processed food, stress, sleep, etc)…

Back in those days (more than a decade ago), we had little understanding of the way junk foods high-jack our brain’s reward circuits – or how ultra-processed foods damage our “2nd brain” (microbiome and gut-lining) – virtually guaranteeing food addiction, weight gain, and problems with both mental wellness and physical health.

But now we know!

Big Food is using the same playbook developed by Big Tobacco to addict consumers with foods laced with sugar, artificial sweeteners, chemical additives, pesticides, and antibiotics. These ultra-processed “foods” damage our gut (2nd brain), kill our healthy gut bacteria (microbiome), interfere with neurotransmitters (serotonin, dopamine, etc) and drive our metabolism toward “storage” so we gain weight (that is almost impossible to lose) and feel terrible (fatigue, lack of motivation, brain fog, depression, anxiety, etc).

I want to share an excellent article – written by Adam Piore and appearing in NewsWeek last month (Dec 8, 2021). My highlighted version is below with a link to the original article.

The title sets it up nicely = “Americans are addicted to ultra-processed foods, and it’s killing us.” There is a lot of great information in the article, but it is the last sentence, calling for a “national nutritional moonshot” that is our call to action.

The new science around the microbiome and the Gut-Brain-Axis is showing us quite clearly that having trouble losing weight is not necessarily your fault – and that it might be your microbiome. Damage to our microbiome and gut – caused by ultra-processed foods – leads to metabolic changes that make it nearly impossible to lose weight and keep it off. But, by restoring microbiome balance, we can finally move metabolism back in a healthy direction – to control appetite and cravings, improve mood and energy, balance blood sugar and fat storage, and ultimately help us get “unstuck” with our weight loss goals.

My own personal “nutritional moonshot” has been to write books, and develop products (including the new “PotentPurplePill”), and build companies and research centers to help bring this new science to people in a way that they can actually USE and APPLY in their everyday lives.

I hope that you’ll check out some of my work – and consider giving it a try to improve your own mental wellness and physical health?

 

Americans Are Addicted to ‘Ultra-Processed’ Foods, and It’s Killing Us

By Adam Piore

December 08, 2021

https://www.newsweek.com/2021/12/17/americans-are-addicted-ultra-processed-foods-its-killing-us-1656977.html

Being severely overweight has never been so dangerous. During the COVID-19 epidemic, Americans who are obese, without any other risk factors, were hospitalized at three times the rate of those who weren’t, by some estimates. When combined with other diet-related health conditions such as cardiovascular disease and diabetes, obesity raises the risk of hospitalization sixfold and the risk of death twelvefold.

 

Those numbers have raised the stakes in the nation’s epidemic of diet-related disease and added to the growing alarm of politicians and nutrition experts, some of whom are starting to call upon regulators to rein in food companies. They’re pushing measures similar to those used to curb the influence of tobacco companies in the 1990s, such as limiting the marketing of certain kinds of food to children and actively discouraging the consumption of key ingredients—chief among them, sugar.

 

At issue is the explosive growth in a broad class of food products that are not merely processed in the conventional sense to lengthen shelf life, but are also often modified to maximize flavor, visual appeal, texture, odor and the speed with which they are digested. These foods are made by deconstructing natural food into its chemical constituents, modifying them and recombining them into new forms that bear little resemblance to anything found in nature. So radically are they altered that nutrition scientists have given them a new name: ultra-processed.

 

Ultra-processed foods are often designed to directly target the vulnerabilities of the human brain—in particular, to exploit the way the brain processes pleasurable sensations. They often deliver a signal to the brain’s reward centers so quick and potent, some neuroscientists believe, that many people find it as addictive as opioids or nicotine.

 

Lab-made creations such as chips, hot dogs, enriched bagels and American cheese have been a staple of the American diet since the 1980s. In recent years, however, the varieties of these foods have multiplied on store shelves and in fast-food restaurants. In 2017 and 2018, they accounted for 57 percent of the calories consumed by the average American—up from 54 percent in 2001 and 2002, according to one study.

 

“We’ve gotten really good at stripping out and refining and processing sugars and fats into these really potent vehicles, and they’ve gotten cheaper to make,” says Ashley Gearhardt, a psychology professor at the University of Michigan who studies food and addiction. “Then we combine them into totally novel food products that are so much more rewarding than anything our brains ever evolved to handle. That’s why so many of us can’t stop eating them.”

 

The implications are worrisome. Half of American adults now have diabetes or pre-diabetes, three quarters of adults are overweight and about 100 million, or 42 percent, are obese, by the standards of the Centers for Disease Control and Prevention (CDC). Among children between 2 and 5 years old, one in 10 are already obese. Among teens, that number is one in five.

 

Our food, in other words, is literally killing us. Food companies have tricked our brains into making us complicit, and our elected officials are complicit, too. What’s needed is a better understanding of exactly how processed foods make us sick and a public reckoning with Big Food’s role in the nation’s health crisis. So far, policymakers have shown little appetite for scrutinizing the tactics of the powerful food lobby, but the pressure to curb consumption of ultra-processed foods is growing.

 

The nation’s food crisis seems to be playing out in ways eerily reminiscent of the early days of tobacco smoking more than half a century ago, before regulators caught up with Big Tobacco. (It’s no coincidence that many tobacco companies later acquired food companies.) This time, it’s Big Food peddling harmful and possibly addictive products.

 

“We have now the accumulated evidence, particularly in the last five years, that people who eat more ultra-processed foods have higher risk of obesity, diabetes, cardiovascular diseases, depression, cancer, renal and liver diseases,” says Marion Nestle, a professor emerita of nutrition, food studies and public health at New York University. “The studies have been overwhelming. There’ve been hundreds and hundreds of them. There’s no doubt that this is not a good thing. It is a problem.”

 

Proof of Harm

A few years ago, Kevin Hall set out to debunk the theory, espoused by a growing number of nutritionists, that Americans were getting fatter and sicker because of the complex industrial and chemical processing that food companies were using to make their products appealing. Hall believed the explanation had more to do with Americans simply eating too many calories, fats and sugars. The notion that extra processing might be causing the problem struck him as “ridiculous.”

 

To prove it, Hall, who runs a research laboratory that studies the regulation of metabolism and body weight at the U.S. National Institutes of Health (NIH), ran a controlled experiment that he thought would show beyond a doubt that processing wasn’t as important as nutrients. He paid 20 volunteers $5,000 apiece to move into an NIH facility in Bethesda, Maryland, for one month. He divided the volunteers into two groups. One ate mainly healthy food derived from simple ingredients with minimal processing, such as Greek yogurt, beef tender roast and shrimp scampi with spaghetti. The other group ate Honey Nut Cheerios, Chef Boyardee beef ravioli, Eggo pancakes and other processed foods—the kind most overweight people in America eat.

 

Hall and his colleagues did their best to ensure that the only significant difference between the two groups was in how much processed food they consumed. Each group ate diets that were nutritionally identical in every way Hall and his team could think of, containing the same amounts of sugar, salt, fat, fiber, macronutrients, carbohydrates and calories. Both groups of volunteers were allowed to eat as much as they wanted. After they finished a meal, their leftovers were carried down a couple floors and delivered to a team of nutritionists in a laboratory, who precisely weighed and characterized everything left on the plate.

 

Hall, it turns out, had it all wrong—processing, in fact, made all the difference. The subjects in Hall’s study who subsisted on Cheerios and Chef Boyardee gained one pound per week on average and consumed in excess of 500 calories a day more than the group with the healthier diet. What’s more, when they later switched to a natural diet, they dropped the extra weight. The conclusion: whatever food company chemists are doing to food, it makes people fatter.

 

The results opened up a new avenue of inquiry for Hall and his colleagues. What was it about the ultra-processed food that prompted this overindulgence and weight gain? The question is a matter of intense speculation and debate in the world of nutrition science—a debate that can only be solved with more research. What’s clear, however, is that the ultra-processed foods favored by a vast proportion of Americans are causing harm.

 

The Two-Year Cupcake

Humans have been modifying food since hunter-gathers discovered fire and figured out how to barbeque stone-age animals. Ten thousand years ago, ancient Mesopotamians and Egyptians learned how to smoke, salt and dry their food to preserve it. In the 19th century, pasteurization and canning techniques vastly expanded the capacity for long-term storage and transport of food.

 

Processed food, as we know it today, arrived in the first half of the 20th century. That’s when food engineers figured out how to use modified potato starch to form pork, ham, sugar, water and sodium nitrate into a pliable gelatinous blob that would fit into a rectangular tin emblazoned with the word “Spam.” Two World Wars, the Space Race and increasing consumer demand for fast meals with a long shelf life that could support the lifestyle of the expanding middle class financed the scientific efforts necessary to give us spray drying, evaporation, freeze-drying and a sophisticated understanding of how to make a decent tasting cupcake you can put on a shelf and still eat two years later. By the early 2000s, Americans were getting more than half of their calories from chicken nuggets, artificially sweetened canned food, potato chips and other man-made concoctions.

 

Nutritionists didn’t create a language to describe this trend until 2009. That year, Carlos A. Monteiro, a lanky, curly-haired professor of nutrition at the University of Sao Paulo, introduced the “NOVA Food Classification system,” a novel grouping of foods based not on their nutritional content but according to the extent and purpose of the physical, biological and chemical processes applied to them after they were separated from nature.

 

He coined the term “ultra-processed,” (as opposed to “minimally processed” or simply “processed”) to refer to “industrial formulations made entirely or mostly from substances extracted from foods (oils, fats, sugar, starch and proteins), derived from food constituents (hydrogenated fats and modified starch), or synthesized in laboratories from food substrates or other organic sources (such as flavor enhancers, colors and food additives used to make the product hyper-palatable). Monteira excluded foods that had been exposed to simple processes like drying, fermentation, pasteurization or other processes that might subtract part of the food (frozen vegetables, dried pasta or eggs). He also carved out exceptions for products manufactured by industry with the use of salt, sugar, oil or other substances added to natural or minimally processed foods to preserve or to make them more palatable, but that could still be recognized as versions of the original foods—usually foods that had just two or three ingredients (such as beef jerky, or freshly made bread).

 

Ultra-processed food, by contrast, was meant to include Frankenstein-like creations that were often made up of added sugar, salt, fat and starches extracted from natural occurring foods and then blended with artificial colors, flavors and stabilizers to hold it all together. Soft drinks, hot dogs, cold cuts, packaged cookies and salty snacks like pretzel rods all qualified, as did many frozen dinners and canned entrees.

 

“They are not food,” Monteiro says. “They are formulations. They contain chemical compounds that do not belong to food—that should not belong to foods.”

 

Many researchers dismiss Monteiro’s classification system as overly broad. The category of “ultra-processed foods,” after all, encompasses a wide variety of different products with endlessly varied nutritional profiles. It lumps Twinkies, Doritos and diet soda together with protein-rich entrees like Perdue Chicken tenders, which are made from the rib meat of an actual chicken and then combined with dextrose, sugar, guar gum, yellow corn flour and other ingredients, and Hormel Beef and bean chili, made from actual beef, beans and crushed tomatoes and combined with less than 2 percent modified cornstarch, soy flour and caramel color.

 

Nonetheless, by defining a new category that represents levels of processing, he gave public health experts and epidemiologists the language to discuss how industrial chemists had changed food—and how to measure their inventions against a wide array of health problems. The strength of those associations soon began to generate attention.

 

Toxic Sugar

Although scientists haven’t figured out how ultra-processed foods cause people to gain weight—which of the thousands of chemicals, additives, nutrients actually lead to worse health outcomes—the market forces that have guided food manufacturers are clear enough. Between 1980 and 2000, the period in which obesity and metabolic diseases began to rocket upwards, the number of calories available for purchase in the U.S. food supply increased 20 percent, from about 3,200 per person per day to 4,000, which dramatically increased competition for the limited attention and stomach capacity of the American consumer.

 

Nestle, the author of many books on the politics of food policy, suggests that federal farm subsidies that ensured surplus crops, such as corn, made it to market, along with the widespread adoption of cheap additives in the 1970s like high fructose corn syrup, were among the factors that drove this overproduction. Meanwhile in the 1980s, activist stockholders stepped up pressure on food companies to grow their quarterly growth profits to keep the stock prices rising. All of this fueled a high-stakes arms race in the food industry between competing product development and marketing teams.

 

To sell more, food companies made their products ubiquitous. They sold them in bookstores and libraries. They set up in clothing stores, drugstores and gas stations. They offered up bigger portions and created more cartoon characters to sell cereal, using tactics pioneered and perfected by Big Tobacco, which by then had begun to diversify from cigarettes into food. They also called in scientists, who helped devise ingenious marketing techniques and scientific innovations to sell more food.

 

Michael Moss devotes a chapter of his 2013 book Salt Sugar Fat to the exploits of Howard Moskowitz, an industry star who pioneered the use of advanced mathematics and computational science to “optimize” food products so that they created the most powerful cravings. Over the years, Moskowitz reengineered a wide array of products, ranging from General Mills breakfast cereals to Prego Spaghetti sauce, by testing out modifications in color, smell, packaging, taste and texture on human guinea pigs, and then feeding the data into a sophisticated mathematical model that “maps out the ingredients to the sensory perceptions these ingredients create, so that I can just dial up the product,” Moskowitz explained to Moss.

 

The most important weapon in Big Food’s arsenal turns out to be sugar. Moskowitz coined the term “bliss point” to describe the “perfect amount” of the sweetness in a product to maximize consumption. By focusing on the bliss point, Moss argues, food companies have changed the American palate in ways that predispose us to overeating the bad stuff (potato chips and ice cream) and pushing the good stuff (broccoli and asparagus) to the side. Recent studies, he says, show that 66 percent of the food in grocery stores now contain added sweeteners.

 

“These companies have learned how to find and exploit our basic instincts that attract us to food,” says Moss, whose latest book, Hooked, examines the addictiveness of the food. “The problem isn’t that these companies have engineered the perfect amount of sweetness for things like soda, cookies or ice cream. It’s that they’ve marched around the grocery store, adding sugar to stuff that didn’t used to be sweet, like bread and yogurts and spaghetti sauce. This has created this expectancy that everything should be sweet.”

 

Fructose, one of the most commonly used sweeteners, is now present in many foods at concentrations unheard of in nature, according Robert Lustig, a pediatric endocrinologist affiliated with UC San Francisco and author of Metabolical, about the dangers of processed food. In recent years, studies have shown that fructose destroys or inactivates several key enzymes needed for the healthy functioning of mitochondria, the power plants in human cells that convert simple sugars into ATP, the form of energy we use to carry out the functions of the human body and brain.

 

This disruption in energy conversion causes a backlog of unprocessed glucose to circulate in the bloodstream. Sensing the excess glucose, the pancreas floods the system with the hormone insulin, which tells the body to remove the glucose from the bloodstream and store it as fat. Some of this fat tends to build up on the liver, which the body relies upon to filter, process and balance the blood leaving the stomach. The liver becomes sick and the problem worsens. Starved of the energy our mitochondria would normally provide, we eat more.

 

“It shouldn’t be surprising that kids are getting type-two diabetes and fatty-liver disease that used to be the diseases of alcohol,” he says. “We now know that fructose is a mitochondrial toxin, which turns into fat in the liver and is metabolized by the liver in ways virtually identical to how alcohol is metabolized.”

 

Sugar isn’t even the worst problem in the American diet. More damaging still is the consumption of processed grains, used in corn flakes, white bread and many other products. These grains are stripped of their outer shell, known as the “bran,” and their inner germ, which contains fiber, fatty acids and nutrients, leaving only the carbohydrates. The human body digests these liberated carbohydrates much faster than when they’re locked inside the grains.

 

“Instead of sitting in the stomach and gradually being broken down into glucose, it begins to break down as soon as it gets to your mouth and is almost fully digested by the time it has moved through the stomach, and all absorbed by the time it gets to your small bowel,” says Dr. Dariush Mozaffarian, a cardiologist and dean of the nutrition department at Tufts University.

 

This rapid digestion starves the gut bacteria, which we rely on for healthy functioning of the digestive system, leading to increased gut permeability that in turn may allow bacteria and toxins to enter the bloodstream and cause widespread inflammation, a factor in a wide variety of diseases such as celiac disease, diabetes, asthma, Alzheimer’s and cancer.

 

It also floods the bloodstream with glucose, causing insulin levels to spike. This high “glycemic load,” a measure of how quickly blood sugar rises, can have long-term consequences for the way the body processes food, leading to a long-term dysregulation of the hormonal systems. These hormones tell the body to store more fat at the expense of providing calories to keep things running. The body, starved of energy, craves food—meaning we are forever hungry, even when we overeat.

 

“Having seen thousands of patients with obesity, I think people can show a lot of discipline around food choice and selection if they experience benefits,” says David Ludwig, a pediatric endocrinologist at Boston Children’s Hospital and a professor of Pediatrics at Harvard Medical School and of Nutrition at Harvard School of Public Health. “I think what we have trouble with consistently is resisting extreme hunger.”

 

As Addictive as Heroin

Some researchers suggest the change in our diet may also be changing our brains, rewiring them with aberrant patterns that lead to compulsive eating, and possibly even addiction.

 

Nora Volkow, a neuroscientist who is now Director of the National Institute on Drug Abuse (NIDA) at the NIH, was one of the first to begin researching food addiction in 1980s. She was struck by similarities between the compulsive behaviors and experiences reported by drug addicts and alcoholics and those reported by obese patients who claimed to be unable to control their eating. In recent years, she says, evidence has emerged from her lab and others linking the pathological brain activation patterns seen in drug addicts to those seen in many obese research subjects and compulsive overeaters.

 

“When I first started to speak about it, there was a complete and absolute rejection, almost anger, from people who insisted it was an endocrinological disease, not a disease of addiction,” she says. “But that’s an artificial distinction. If you look at it from the outside, what is the difference between nicotine and an ultra-processed food if both have been designed optimally to generate that compulsive response—a response that manipulates the dopaminergic system in a way that you don’t find in natural foods?

 

Nicole Avena began studying whether or not sugar could actually meet the scientific criteria for other addictive substances in the early 2000s after hearing from recovering drug addicts that they found it more difficult to quit sugar than heroin. Avena, an associate professor of neuroscience at Mount Sinai School of Medicine, found that sugar, in both animals and humans, led to binging, withdrawal and craving—all components of addiction typically seen in drugs of abuse. She also saw neurochemical and neuroimaging changes in the brain virtually identical to those found in drug addicts. Sugar, when combined with other ingredients present in ultra-processed food, was more addictive still. In rats, sugar was found to be as addictive as cocaine.

 

“Our brains just aren’t designed to be able to process these different types of ingredients in the quantities that we’re being exposed to,” says Avena.

 

Ultra-processed foods have something else in common with nicotine: Some of the biggest producers of processed foods were, from the 1980s to the end of the 2000s, known as Big Tobacco. In 1985, RJ Reynolds acquired Nabisco for $4.9 billion, and Phillip Morris acquired General Foods in a $5.75 billion deal that was then the largest takeover in U.S. history outside of the oil industry. Phillip Morris added Kraft to its portfolio in 1988 and rebranded itself as Altria in 2003. (RJR flipped Nabisco to Phillip Morris in 2000, which in turn spun off Kraft from its international tobacco business in 2007.)

 

 

UM’s Gearhardt has been studying the events that led up the groundbreaking 1988 Surgeon General’s report that deemed nicotine addictive, and the benchmarks used to do so, despite a concerted effort by one of the most powerful lobbies in the nation to prevent it.

 

One of the most important factors producing an addiction is the speed with which a drug hits the body and lights up the reward centers of the brain. By the time Big Tobacco began acquiring food companies, they had decades of experience studying and optimizing the speed with which their products delivered nicotine to the brain. They continued to harness that science in their food products.

 

“Many of these ultra-processed foods are almost pre-chewed for us,” she says. “They melt in your mouth immediately. There’s no protein, there’s no water, there’s no fiber slowing them down. It’s going to hit your taste buds and light up your reward and motivation centers of the brain immediately. Then there’s a secondary hit of dopamine when it gets absorbed into the body.”

 

Taking on Big Food

The threat is so grave that policymakers have recently shown glimmers of a newfound willingness to take on the food industry. A report by the General Accounting Office in August, commissioned by members of Congress on the powerful House appropriations committee to review diet-related chronic health conditions and federal efforts to address them, painted a grim picture.

 

More than 30 percent of young people aged 17 to 24 no longer qualify for U.S. military service because of their weight. Diet-related ailments such as cardiovascular disease, cancer and diabetes soaked up 54 percent of the U.S. government’s $383.6 billion in health care spending, which includes Medicare and Medicaid, in 2018. They accounted for about one-quarter of the nation’s total $1.5 trillion in health care spending in 2018 and were associated with 1,487,411 deaths—more than half of deaths from all causes.

 

Recently policymakers on both sides of the aisle called for a White House conference along the lines of the 1969 conference on food, nutrition and health. That meeting, called by then-President Richard Nixon to address the hunger crisis, resulted in the creation of the special supplemental nutrition program for Woman, Infants and children (SNAP) and the school lunch program, among other things.

 

“Now we face a second food crisis,” said Senator Cory Booker, who chaired a farm subcommittee earlier this month that focused on the GAO report. “Despite being the wealthiest nation in the world, we have created a food system that relentlessly encourages the overeating of empty calories that are literally making us sick and causing us to spend an ever-increasing amount of taxpayer dollars—literally, trillions of dollars a year—on health care costs to treat diet related diseases.”

 

Nobody is under any illusions that solutions will come easy. In recent years, public health officials have launched major campaigns to deal with what many consider to be the lowest hanging fruit: regulations to reduce soda consumption through taxes and limitations on how federal and state food assistance can be spent, among other measures. The food industry, which has poured tens of millions of dollars into lobbying, campaign contributions and influencing public opinion, has fought back ferociously.

 

In California, where four cities have passed soda taxes, the beverage industry spent $7 million promoting a 2018 ballot initiative that would have made it harder for cities to raise taxes of any kind. The industry dropped the initiative after lawmakers agreed to implement a 12-year moratorium on local taxes on sugar-sweetened drinks. The word “ultra-processed foods” appears in U.S. dietary guidelines only in the references, says NYU’s Nestle, because if it appeared more prominently “the food industry would go berserk.” She notes that in 2015, when a scientific committee recommended changing guidelines to encourage Americans to eat less meat for reasons of “health and sustainability,” industry lobbyists convinced Congress to insert language into a spending bill ordering the Department of Agriculture to change it.

 

“We could put restrictions on portion size, put restrictions on advertising and marketing, change federal subsidy policies to subsidize healthier foods and make them more available,” Nestle says. “There’s a whole lot of things we could do. But you can’t do anything without taking on the food industry. And nobody wants to do that because they’re very powerful—everybody eats and loves their products. Anytime anybody talks about taking on the food industry, all of a sudden we have charges of ‘nanny statism.'”

 

Congress has been slow to address the obesity crisis. Dr. Fatima Cody Stanford, an obesity medicine physician at Massachusetts General Hospital and Harvard Medical School, has been among those advocating for the passage of a bipartisan bill that would require Medicare to cover medications, behavioral therapy, dietician visits and other approved therapies to treat obesity. The bill has been introduced in both the House and Senate every year since 2013, but Congress has not passed it.

 

It will take time, research and public pressure to change minds in Washington, advocates say. For now, the best hope for a solution is to catalyze a groundswell of consumer demand for products that are healthier.  

 

To change minds, scientists—and the food industry itself—will need a better understanding of precisely what it is about the nation’s diet that is feeding the public health crisis. “We need to better understand what the mechanisms are that are driving the deleterious effects of ultra-processed food so we can target policies and potential reformulations to improve the health of the nation.”

 

We need a national nutrition moonshot,” says Tufts Mozaffarian. “We’re drowning under an epidemic of diet-related disease.”

Why is Noom Missing the Mark?

Welcome to 2022!

If you’re like millions of other Americans, you’re just a few days into your New Year’s Resolutions – and since SO many people have gained weight during the pandemic, it’s a good chance that your goals for 2022 might involve losing some of those pandemic pounds?

When it comes to weight loss, it’s important to note that the “problem” isn’t really what you think it is – and this is one of the reasons why so many people have trouble not only losing weight, but keeping it off. Weight gain, weight loss, and weight regain are not simply “math problems” as many in the processed food industry would have you believe. The old “calories in – calories out” (CICO) is a manufactured narrative concocted in the 1950s when processed foods started hitting the market. Processed food companies needed customers to consume more and more junk, but they didn’t want to be seen as villains in the obesity epidemic – so the CICO myth was born to shift responsibility away from the junk foods and onto the consumer with a message of “just exercise more.”

I’ve been studying weight loss, energy metabolism, and mental fitness for more than 3 decades – it was part of my PhD dissertation at Rutgers – I had a private practice helping people lose weight using “nutritional psychology” in the 90s (before that was even a thing like it is today) – and I’ve developed weight loss supplements/foods and written numerous books to help people balance the biochemistry surrounding mood and weight (cortisol, glucose, inflammation, etc). We covered a lot of these topics in the award-winning documentary film, “Killer at Large – Why Obesity in America’s Greatest Threat” (that I produced in 2008) – but yet the CICO myth still persists.

Nowadays, cutting-edge science around the microbiome and the Gut-Brain-Axis is showing us that having trouble losing weight might actually reside in your microbiome (the collection of trillions of bacteria that inhabit our gut). These bacteria have broad influence over our appetite, our ability to harvest calories from our food, and our tendency to be in “fat storage” mode (gaining or holding weight) versus “fat release” mode (losing weight and giving “traction” to our healthy eating and movement regimens).

Some of the most interesting data in all of life sciences is showing us that the microbiome determines (in large part) our mood, motivation, and metabolism. Particularly exciting is the fact that we can (easily) modulate our microbiome’s signals with nutrition – the right nutrients, phytonutrients, probiotic strains, prebiotic fibers, and other components of our diet can help us feel better (better mood, sharper focus, higher energy, stronger resilience, etc) and lose fat.

How can you tell if your microbiome might need some management? If you’re tired during the day, have trouble relaxing or sleeping in the evening, and have a few pounds “stuck” (especially around your midsection), then you’re probably a good candidate for nourishing your microbiome to help you get “unstuck.” People who do this end up feeling better with more energy, better mood, controlled appetite, reduced stress, and less pounds and inches.

Don’t make the mistake that this is any kind of “magic pill” type of approach – rather think of it as a way to accelerate or amplify the benefits of your healthy eating and exercise regimen. People who have followed my “Mental Fitness Diet” plan tend to say that it “flips the switch” to finally get them unstuck and their weight going in the right direction – and that they feel great. Both of these (mental and physical benefits) are due to properly nourishing your microbiome and getting your entire Gut-Brain-Axis back in rhythm.

Which brings me to the article that I want to share with you – an excellent one by Tom Foster in INC. Magazine – that covers the astonishing rise of Noom, which you might know as, “that internet weight loss company” that you saw advertised everywhere during pandemic lockdowns. As you’ll see in the article, Noom bills itself as different because it uses “psychology” to help you lose weight – which is definitely a good idea because how we think about food and our relationship with it is an important part of the weight loss puzzle – but it’s not exactly new or different (I was doing it in the 90s, and thousands of properly-trained dietitians and nutritionists have been as well. Don’t forget that dozens of commercial WeightWatchers-style companies have also been doing it all along, albeit many of them with too much focus on the now-discredited CICO approach).

Lots of people have bought in to the Noom approach – their revenues exceeded $400-million last year and the company has raised over $600-million in multiple rounds of funding – so lots of people think this is a good approach? But not me.

Noom is a champion of the “top-down” approach to behavior change – based on using psychological approaches “in the head” (thinking, talking, education, etc) to help people make better choices. This is undoubtedly an important part of the puzzle (the brain) – but it is not the most important part – that would be the second brain (the gut, which includes the microbiome). As a nutritional biochemist and psycho-nutritionist, I prefer more of a “bottom-up” approach by focusing on nourishing the microbiome – because this improves both our mental wellness (we feel better) and our physical health (we perform better) – and we lose weight almost as a side benefit because we’re making better choices naturally – at a subconscious level – without having to “force” ourselves to make the right choices.

Noom plans to use some of its $600-million war chest to branch out from weight loss to grow a new division called Noom Mood. Without addressing the entire Gut-Brain-Axis, they’ll be missing the mark and their customers will be paying for only a partial solution. A better approach would be to harness the entire microbiome-Gut-Brain-Axis simultaneously – which is what we’re doing at Amare Global and what I write about in “Mental Fitness – Maximizing Mood, Motivation and Mental Wellness by Harnessing the Body-Brain-Biome.”

If you want to lose weight in 2022 – and feel good doing it – you might want to check out our truly new approach and finally get the results that you’ve been looking for.

Here’s the article with my highlights and a link to the original on the INC. website

 

How Noom’s Founders Shook Up a $250 Billion Industry With a Pandemic Hit That Took 10 Years to Build

 

The secret ingredients: failure, heavy metal, and a refusal to slim down their ambition

 

BY TOM FOSTER, EDITOR-AT-LARGE, INC.

 

@TOMFOSTER2

 

 

NOOM CO-FOUNDER and CEO Saeju Jeong gets up in the morning in his Manhattan apartment near Central Park and blasts the kind of hard-driving heavy metal music that you might associate with mosh pits and death shrieks, not the perky weight-loss app his company is famous for. “It’s my routine of meditation,” he says matter-of-factly. “I take a heavy metal bath, let it wash over me. It’s the way I channel my mood, and then I am in the game, giving my every spiritual and physical energy to Noom. And then at night I listen to help me detox any unnecessary doubts. I just nail them with heavy metal music.”

 

This is not a put-on, some entrepreneurial personality quirk cultivated for the benefit of media and investor types. Sean Foster, Noom’s chief marketing officer, a ponytailed veteran of several innovative fashion, beauty, and wellness firms, marvels at the time when his son was learning electric guitar and made some videos of himself playing various metal riffs, which Foster shared with Jeong as a kind of name-that-tune game. “Saeju got it right every single time. I mean, this is a guy who took his mother to see a Megadeth concert.”

 

Put another way: Saeju Jeong is hardcore.

 

And he’d better be. Along with co-founder Artem Petakov, Jeong has led New York City-based Noom as it has become one of the breakout hits of the past two years. The company, which makes an app that employs psychological principles to nudge its users into making healthier lifestyle choices, increased its annual revenue from $237 million to $400 million in 2020 and says it has continued its fast growth in 2021; at presstime, the company was expecting more than $600 million in revenue for the year. It raised $540 million in a Series F investment round in May 2021, from such heavy hitters as Silver Lake and Sequoia Capital, and it’s been rumored to be eyeing an IPO in the coming year at a $10 billion valuation.

 

Noom also operates in an extremely hot market–or several hot markets, to be precise. Its signature product, Noom Weight, is a diet alternative that competes with incumbent giants such as Weight Watchers as well as a bundle of well-funded, tech-enabled newer entrants that offer everything from meal delivery to calorie-counting systems–many of which have boomed during the pandemic. Weight loss is a $250 billion global business, according to BCC Research, but to Jeong that’s just a starter market. Where Noom’s real potential lies, he believes, is in becoming a “habit-change platform.”

 

The company’s first foray beyond weight loss, Noom Mood, launched in October and aims to tackle another hot topic in the time of Covid: stress and anxiety. Jeong and his team think they can tackle myriad aspects of wellness and human behavior–and take on one market after another in the process. As Foster puts it, “Weight is an important starting point, but we have this incredible opportunity to take that platform and reapply it in so many different ways.”

 

It’s an ambitious plan, and not without risk: There is, after all, no guarantee that a product built to stoke one kind of behavioral change will naturally work for another. But aside from a faith in psychology, the Noom team has another advantage: failure. Before Noom was a pandemic hit, it was, for nearly 10 years, a series of ideas that never quite worked out.

 

Ten years. That’s an eon in startup time, and yet Jeong and Petakov, both immigrants, resisted the urge that might have overcome other founders to scrap the whole thing and build a different company some other day. Instead, they relentlessly kept evolving their product. In the process of finding their place in the market, that is, Jeong and Petakov also perfected the art of iteration–and perseverance. “And the way I was able to overcome the difficulties was I applied my heavy metal,” says Jeong. “My little joy.” And while that and a truckload of venture capital are no guarantee Noom can make its next big pivot, they’re going to be necessary.

 

THE STORY OF NOOM begins back in 2002 in the seaside town of Yeosu, South Korea. And it begins with Jeong’s father, WooGil, on his deathbed. WooGil was a prominent obstetrician-gynecologist who had built a local hospital but, a year after its opening, succumbed to lung cancer at age 51. It was an experience that shocked the then-21-year-old Saeju.

 

Before his father died, Saeju had been running a heavy metal music label he founded at 19 called BuyHard Productions. “I imported all the music I couldn’t get in South Korea,” he recalls. “I’m very proud of that, and it helped me discover I have a little talent for entrepreneurship and operating.” He was making good money from the music, but his father’s death forced him to step back and assess what he was doing with his life–to ask, he says, “Why am I working hard? For what?” He realized he needed a radical restart.

 

A conversation he’d had with his father shortly before his death grew into a kind of guiding principle. His father–one of many members of the extended Jeong family who worked in health care–was proud of having helped people in his career, but as he ­reflected on his life, he wondered why he had always treated people once they were already sick, even though he knew there was a whole population of people out there missing the chance to prevent or better manage their conditions. The question “really heavily got into my soul,” Saeju remembers, “and I became curious about why the health care industry worked really as a sick-care service.”

WooGil also counseled young Saeju to explore the world. The elder Jeong had gotten his medical training in the U.S., and he felt one of the greatest advantages of his life was the chance he’d had back then to be around talented people from every part of the world. Saeju, who’d been studying electrical engineering at Hongik University while running the record label, decided to drop all of that after his father’s death, serve his compulsory time in the South Korean army, and get out into the world.

 

Three years later, he was living in New York City, and only a few months after his arrival, at a dinner following a wedding he’d attended with his cousin, he found himself seated next to a young Ukrainian Princeton grad, Artem Petakov. It was 2005, and Petakov had just returned to the States after a stint in Berlin leading the development of a team of soccer-playing robots that went on to win that year’s world RoboCup in Japan. He explained to Jeong his twin fascinations with computers and the human mind. As a kid, he’d written a program that played Tetris using a neural network. The two bonded over their shared immigrant status and interest in technology, and that night’s conversation bled into many more over the coming months.

 

Petakov had taken a class at Princeton with the Nobel Prize-winning psychologist Daniel Kahneman, and it had led him to think about behavioral change. “How might we get people to do things like go to the gym and start getting healthier without spending a ton of money on personal training?” he mused to Jeong in one of their idea jams. Petakov had joined a fancy gym and booked some personal-training sessions, and he couldn’t believe how dated the technology was there. The idea to build some kind of fitness catalyst hit Jeong in the heart, right where he’d been holding onto his dad’s most important life lesson. “Oh, my god, we have to build that company,” he replied.

 

Petakov was just starting a new job at Google, though, working to improve the geographic search function for the then-nascent Maps product, and he wanted to see where it would lead. Jeong, who went on to work odd jobs hawking Korean products to Americans–window blinds, 99¢ perfumes–as part of a state-sponsored program, wore his friend down by refusing to drop the idea. Within a year, Petakov was beginning to chafe at the limitations of his job. The geo-search team often tested its work by looking up places to get pizza in New York. “That’s nice for helping people find pizza,” he thought, “but am I making a giant change in people’s lives? No.”

 

Noom launched in early 2007 under the name WorkSmart Labs, and it was little more than a side project for the first two years, especially for Petakov, who didn’t leave Google until 2008. But even once Petakov joined full time, the two founders went another three years, until the end of 2011, before they turned their focus to weight loss–and another five years after that before they hit upon the model that would vault them into the startup stratosphere.

 

“WE MADE SO MANY mistakes,” Jeong says. It’s a clear fall day in New York, and sunlight and the sounds of the city pour in through the windows of his century-old apartment building, his remote pandemic office for much of the time that Noom has grown into a household name.

It’s a big change from that first year, when Jeong was the only full-time employee and lived in an illegal garage apartment in Queens where he had to wear a headlamp at night to use the bathroom. Back then, he’d commute into Manhattan for an early status meeting with Petakov, and then work out of Petakov’s apartment while the latter was at Google for the day. They funded the operations with Petakov’s salary and Jeong’s $3,000-per-month income from the sales gigs–and somehow managed to create a prototype of the company’s first product. They’d decided their startup’s mission would be to use technology to “help as many people as possible live healthier lives,” and their first attempt to do that was a touchscreen computer that attached to a stationary exercise bike and made the experience more rewarding.

 

There were a handful of other startups in the space at the time, Petakov remembers–“but they were exactly what you might expect from a bunch of nerds trying to think about fitness.” He recalls one out of MIT called CycleScore whose program, as users pedaled, had them flying around in balloons and dropping precision bombs. In WorkSmart’s version, users would pedal along on a rainbow catching butter­flies. They persuaded a gym in Queens to install the prototype, “and people absolutely loved it,” Petakov says. “There was positive and wonderful music playing in the background, and it felt so good to catch butterflies. People told us, ‘Wow, this is actually motivating me for the first time, as opposed to just being self-driven.’ “

 

They started working on additional prototypes for free weights and cable machines, but there were underlying problems–not with the technology, but with the business idea. For one, gyms were never going to be a huge market. Only a small percentage of all people have gym memberships, and a far smaller percentage actually go, let alone regularly. That was a deal-killer for potential tech investors, who chase ideas that scale naturally; they scarcely even took Jeong’s cold calls. Eventually, Jeong and Petakov realized gyms were a deal-killer for them, too: The narrow market segment would never let them live up to the “as many people as possible” part of their mission.

 

That year of struggles was also the year the iPhone launched, and the next year, 2008, came the debut of Android. Jeong and Petakov saw the app economy as their way out of the gym-equipment business and into the hands of consumers: Petakov left Google, they raised a couple hundred thousand dollars in angel investment capital (from a Google colleague of Petakov’s and two Korean contacts of Jeong’s), and launched CardioTrainer, an Android app for tracking runs and bike rides. It debuted at the same time as the Android marketplace.

 

The founders had figured that Android would quickly eclipse Apple’s iOS in user numbers, and that would give them instant scale. They were right, sort of. Over eight months, the app climbed to the top spot in the Android rankings of most-downloaded fitness apps. The problem was that Google’s more mass-market approach meant that users wanted free apps and were too often unwilling to ­upgrade to the paid premium version of CardioTrainer. Even though it was a hit, eventually amassing a million users, too many of them interacted with the app only occasionally and passively–which translated to a lot of noise in the user data. It was hard to draw insights to improve the product.

 

Petakov and Jeong did, however, notice one pattern among their users that would prove immensely helpful: An overwhelming number of their customers were using the app as a step counter rather than as a run tracker. And when the founders started polling users, they heard over and over that people had underlying health issues and needed to lose weight. They were counting steps because they couldn’t run. “And that’s the moment we said, ‘Wow, there’s a huge opportunity in the weight-loss market,’ ” Jeong recalls. Here was a direct way to engage people who needed the kind of preventive care that Jeong’s dying father had lamented not pursuing, and it had come to light through continual evolution of the company’s product and strategy–but never by changing the mission itself.

 

Noom’s mission is to change health care at maximum scale, to become what Sequoia Capital’s Ravi Gupta calls a “transformative company.”

 

The company’s evolution into the Noom we know today was far from complete, but Jeong and Petakov had cemented one of the principles that would continue to guide it. CardioTrainer’s app-store ranking not only gave the company lots of users, but eventually, in early 2011, also helped land an investment from the powerful Silicon Valley venture capital firm Kleiner Perkins, which led a $2.6 million seed round. The pressure to chase easy revenue and start carrying advertising was intense, though, and the founders thought doing so would detract from their mission. “We had multiple opportunities to increase revenue,” Jeong remembers, “and you can see today that there are many good fitness applications doing good business.” But when they really studied those opportunities, they saw a mismatch with their company. “We were naive back then, but we had a very strong belief, which we still have today, that if we deliver great health care value to end users in massive scale, then business will follow,” Jeong says. “That’s why we founded the company, and it’s still the way we make decisions.”

 

The WorkSmart team had taken its weight-loss insight and started a second app in 2010, a calorie-counting tool called Calorific, that also found an audience. But again they felt a series of perverse incentives to optimize for revenue first, rather than results. One of the company’s first angel investors, a Korean psychiatrist who was also Jeong’s sister’s boss, had long been hammering the view that the key to weight loss and healthy living was not diet but psychology. Jeong finally started hearing that message, and in 2011 Noom Weight Loss Coach launched with a freemium model that allowed users to pay to unlock access to personalized coaching.

 

The foundation for today’s Noom was in place. The company had drilled down through multiple products and user reactions to find its way to addressing the greatest number of people. In the process, Jeong both found his company’s purpose and honed a method for gathering ideas, testing them, discarding some, and refining others–and refining and refining. “I learned the importance of a very well-disciplined, unbiased sandbox for ideas,” he says. “Because many of the good ideas turn out not to be good ideas. We let our users be the judge.”

 

Most companies run tests, of course, but Noom had developed a grading system it called ICE (for impact, confidence, and ease of implementation) to measure how big the potential results of an idea would be, how much the team believed in it, and how doable it was. No matter who suggests them, all ideas get assessed this way internally, and the best make it to consumers, who issue their own verdicts. And the main way Noom determines whether something is working with consumers is by monitoring a single number, what Jeong calls the OMTM, or “the one metric that matters”: paid active weekly users. “Our team is laser focused and pays attention to that one single metric every day–every hour,” he says, sounding suddenly quite metal in his intensity.

 

JEONG’S BOYISH ENTHUSIASM has a way of zooming from unbridled joy and gratitude to pure hustle. He believes deeply in what he’s building, and he’s in a hurry to tell you about it, with no time for dawdling. He’s 41 years old this year, just 10 years younger than his father was when he died, and the thought of having the same kind of limited time here has long nagged at him and urged him forward–to the point, he says, that his wife got worried about him a few years ago, because of the intensity with which he was working, and the seemingly endless hours he was putting in. She even reached out to his therapist. Jeong reassured his wife that he was not in imminent danger because he eats well and uses Noom. Still, he says, the vivid memory of his father’s passing regularly reminds him of life’s fragility and reinforces his sense of purpose.

 

That’s the kind of story Jeong tells often–sweet and sincere, and selling hard. Which is also an apt description of Noom today. It was 2016 when the company finally hit upon its winning formula. The 2012 version of the weight-loss app had offered its coaching via artificial intelligence, mainly because that’s what made sense to Petakov and his team of engineers, some of whom had followed him to Noom after working with him building soccer robots in Berlin. But then, in 2014, the company brought on a full-time chief of psychology, a clinician from Long Island named Andreas Michaelides, and he started hiring human coaches to supplement the A.I. These were entry-level positions for “really passionate people from different backgrounds,” as Michaelides puts it. He developed a training program to teach them basic psychological principles and how to communicate with empathy and enthusiasm. Meanwhile the company infused the app’s content with the principles of cognitive behavioral therapy, a form of psychological treatment that focuses on changing underlying thought patterns rather than, say, exploring buried trauma.

 

Today’s Noom is a chipper mix of quizzes and exercises and short reading assignments combined with chatty prompts from a user’s designated coach, all tailored by A.I. to each user’s specific case and informed by pretty standard food and weight logging. The coaches are now the center of the operation, and Jeong says the company’s “core IP” is how the A.I. allocates coaches’ time to eliminate repetitive work and maximize meaningful exchanges with users. (That’s what allows each of the company’s now 3,000 full-time coaches to have a few hundred clients, whereas a typical therapist might have a few dozen.)

 

The tone of the app’s actual content, which Noom constantly tests and optimizes, is meant to be motivational but, depending on your level of cynicism, can feel like standard ad copywriting voice, as if it were always trying to sell you on its own efficacy, with every passage ending with a rimshot.

 

That tension between high-minded purpose and mass marketing extends to the company’s revenue model. In 2016, Noom abandoned its freemium business and put up a paywall for all customers.Behavior change requires a lot of commitment,” Jeong explains. “So we want to screen out the people who aren’t going to make the effort.”

 

As innumerable subscription companies have found, though, getting people signed up and to stay signed up requires a careful dance of special offers, long-term deals, and fine print. In Noom’s case, complaints started appearing on the internet from people claiming they’d been hit with “surprise” $199 annual subscription charges after their trial offers expired, or that they got the runaround when trying to cancel–so much so that a $100 million class-action lawsuit is pending in a New York federal court.

 

Nobody at Noom will comment about an active lawsuit, but in August 2020, Jeong published an open letter in response to it in which he pledged to expand the customer-service operation and honor cancellation requests even if they come in past the stated deadline. “Our refund rate, if they ask, is 99.9 percent or more,” he told me crisply. “I think that’s quite high, and we don’t make it tricky at all. I take a lot of pride in my team, and we are here to make sure that we deliver what we promise, period.”

 

The lawsuit hasn’t slowed investors’ enthusiasm for Noom. In May 2021, the company announced it had raised that whopping $540 million round of venture capital. “Noom’s combination of technology and human coaching is compelling,” says Ravi Gupta, who led Sequoia Capital’s piece of the investment. “In our experience, the best A.I. companies are not artificial intelligence but augmented intelligence. And, in Noom’s case, the success they’ve seen in weight loss has real potential to be applicable elsewhere. We see them becoming a digital-health platform, much more than a point solution.”

 

ACCORDING TO A SURVEY by the American Psychological Association, some 42 percent of U.S. adults gained unwanted weight in the first year of the pandemic–which helps explain the monster year Noom had for its weight-loss service in 2020. The same APA survey found that two-thirds of Americans were having pandemic sleep trouble, and half were experiencing extra stress. Noom, meanwhile, heard firsthand from its users how those figures were connected. In its user research, when the company would ask its weight-loss customers what else they were struggling with, stress was the number one answer.

 

Michaelides, the chief psychologist, knew that the methods he’d helped implement for Noom Weight were made for treating other conditions. “There’s a large population of folks who don’t really meet the criteria for a diagnosis and don’t necessarily need to be in therapy, but also need a lot of skills that can help them cope with their day-to-day lives,” he says. Hence the launch of Noom Mood, the first of multiple new verticals to come in the near future, based on four pillars of care: nutrition, exercise, sleep, and stress management. The company is also diving into the enterprise market, as employers look for ways to provide healthy work conditions for employees who may never return full time to the office.

All of which is occurring against a broader backdrop of innovation and deal-making in the digital wellness space in recent years–perhaps most notably the merger announced in August between well-known mindfulness app Headspace and the on-demand therapy platform Ginger. Michaelides sees Noom’s services filling a space directly between those two players. “Programs that offer digital therapy are really targeting a more clinical population. And there are a lot of great mindfulness apps out there, but mindfulness is just one skill,” he says. Noom Mood, he contends, is complementary to those. He calls it a “psychoeducational approach.”

That approach has largely worked for weight loss, where the results are physical–easy to see, feel, and measure. Whether it works for stress management, a much fuzzier concept, remains to be seen. Plenty of studies have shown online cognitive behavioral therapy to be a viable and effective alternative to in-person therapy. But will Noom’s army of coaches and bite-size breezy quizzes ­deliver a version that works?

 

It’s a different question from whether Noom can sell the concept. No doubt there’s a market for the latest self-improvement scheme, as innumerable lifestyle and success gurus have found. And Noom has built a formidable alternative to Weight Watchers and Jenny Craig, as innumerable App Store reviewers and hundreds of millions in revenue attest. But those are not the benchmarks Jeong set for himself when his father passed away. Noom’s mission is to change health care at maximum scale, to become what Gupta calls “a transformative company.” And getting there is going to take more time. And dollars.

 

Five hundred and forty million dollars is a lot of money, but I don’t think of it that way,” Jeong says, his eye on the long-term goal, focused on building out his vision. “As the CEO, I don’t think this is enough dollars. We need more money.” That, and a continuing regimen of heavy metal baths.

 

 

Noom’s Journey of Self-Discovery

The pandemic’s favorite weight-loss program seemed like an overnight hit. In reality, it took more like a decade.

1999

  • Saeju Jeong, 19, starts South Korean heavy metal record label BuyHard Productions.

 

2002

  • Inspired by his father’s dying words, Jeong pivots his dream from music to health care.

 

2002 – 2004

  • Jeong enters the South Korean army as an IT specialist.

 

2005

  • Jeong moves to NYC and meets Artem Petakov, a Ukrainian immigrant software developer.

 

2007

  • Jeong and Petakov create WorkSmart Labs and their first prototype, a stationary-bike gamification accessory.

 

2008

  • Petakov leaves Google to go full time with Jeong; they raise funding from acquaintances to build prototypes for other gym equipment.
  • Jeong and Petakov launch CardioTrainer, one of the first apps in the Android marketplace.

 

2010

  • After learning that users are using their app to count steps, the duo launch calorie-counting app Calorific.

 

2011

  • WorkSmart Labs changes its name to Noom and raises a $2.6 million seed round led by Silicon Valley firm Kleiner Perkins.
  • Noom Weight Loss Coach, a freemium app that charges for A.I. weight-loss coaching, launches on Android.

 

2012

  • The Noom team starts to shift its focus to psychological solutions.

 

2013

  • Noom secures an NIH grant to study binge eating, raises $12 million more, and tinkers with a B2B solution.

 

2014

  • Noom completes its pivot to the psychology of weight loss and hires therapist Andreas Michaelides as its chief of psychology. The company raises $16.2 million more.

 

2015

  • After experimenting with peer-led group therapy, Michaelides starts hiring human weight-loss coaches. The first, Peter Athans, will still be with Noom in 2021.

 

2017

  • Armed with $14.5 million more in venture capital, Noom Healthy Weight launches, focused on the B2C market, with human coaches as the centerpiece.

 

2019

  • After a $58 million Series E on the heels of $14 million in 2018, Noom’s annual revenue tops $200 million.

 

2020

  • With millions of people packing pandemic weight, Noom’s revenue soars from $237 million to $400 million.

 

2021

  • A certified hit, Noom raises $540 million more, aiming to expand beyond weight loss. Next up: Noom Mood.

Athletes for the Mental Wellness WIN!

In 2021, it was (once again) athletes who changed the way we think about mental health.

BRAVO – Athletes for the WIN!

Icons and heros to many, professional and elite-level athletes train their bodies and minds to exceed expectations – often at physical and mental costs that are impossible to sustain.

Some might say that this is their “job” – this is why they get paid the big bucks – and that is at least partly true. “No Wimps!” “No Quitters!”

But as a growing number of top-tier athletes speak out about their personal challenges with mental health, there is a growing understanding of the critical importance (for all of us) of what I refer to as Mental Wellness – and the high end of that – Mental Fitness.

Some of the notable and most vocal athletes include Kevin Love (5-time NBA All-Star); Michael Phelps (most decorated Olympian swimmer of all-time); Naomi Osaka (Grand Slam winning tennis star); and Simone Biles (greatest gymnast of all-time and TIME magazine’s ATHLETE OF THE YEAR).

I want to share two excellent articles on these topics. Both were published just a few weeks ago (in December 2021) – one by Alice Park and Sean Gregory in TIME magazine (naming Simone Biles its Athlete of the Year) – and the other by Louisa Thomas in the New Yorker (documenting Naomi Osaka’s struggles).

As Olympian Allyson Felix (the most decorated female track & field of all-time) said of Biles’ actions, “To see her choose herself, we’re going to see the effects of that for the next generation.”

To which I say – Let’s hope so.

My text highlights appear below – with links to each original article.

 

TIME Magazine Athlete of the Year 2021 – Simone Biles

 

BY ALICE PARK AND SEAN GREGORY

 

DECEMBER 9, 2021

 

Original article at = https://time.com/athlete-of-the-year-2021-simone-biles/

 

Around 9 p.m. on July 27, as Simone Biles soared high above the vault at the Tokyo Olympics, she lost herself. You could see the confusion in her eyes, which darted sideways instead of locking onto the ground as she made her way back to earth. She would later reveal that she was suffering from a frightening mental hiccup, known as “the twisties,” that left her unsure of her whereabouts in midair.

 

As the Greatest of All Time (GOAT) in a sport that captivates the globe every four years, Biles is all about control. Her life is dedicated to micromanaging every possible element—her diet, her training, her sleep—that goes into performing, so when the lights are brightest, and the stakes highest, little is left to chance. But for Biles, control isn’t just about winning; it can be the difference between life and death. She now has four skills named after her, each a breathtaking combination of daring flips and twists. Avoiding disaster requires a constant, firm grip on mental acuity.

 

On that night, however, the careful tapestry of control that Biles, 24, had stitched began to unravel. Or at least started to, until she responded in a way that stunned millions of viewers around the world. In the middle of the Olympics for which she had trained for five years, and which was supposed to be the triumphant capstone on a historic career, Biles slipped on her warm-up suit, packed her competition bag and told her teammates she wouldn’t be competing with them, but rather cheering them on in the team event. Her mind and body weren’t in sync, she said, which put her at serious risk. She also withdrew from her next four events, returning only to participate in the final one. At an Olympics in which five gold medals for Biles seemed preordained, she won a team silver and a balance-beam bronze.

 

For her teammates, her withdrawal from events was a decision they didn’t have time to process as they scrambled to fill her position in the lineups. “We all knew we had to continue not without her, but for her,” says Sunisa Lee, who stepped up to win the all-around gold in Tokyo. “What Simone did changed the way we view our well-being, 100%. It showed us that we are more than the sport, that we are human beings who also can have days that are hard. It really humanized us.”

 

An athlete’s clout is increasingly measured in much more than wins and losses. If 2020 showcased the power of athletes as activists after the murder of George Floyd, this year demonstrated how athletes are uniquely positioned to propel mental health to the forefront of a broader cultural conversation. While a few sports stars have opened up about mental health—Michael Phelps, for instance, has been candid about his post-Olympic depression—in 2021, the discussion became more wide-reaching and sustained. After withdrawing from the French Open in May to prioritize her well-being, citing anxiety, Naomi Osaka wrote in a TIME cover essay, “It’s O.K. not to be O.K.” Biles, by dint of her status at one of the world’s most watched events, raised the volume. “I do believe everything happens for a reason, and there was a purpose,” she tells TIME in an interview nearly four months later. “Not only did I get to use my voice, but it was validated as well.”

 

While supporters lauded Biles, critics lambasted her for “quitting.” But what Biles did transcended the chatter: she fought the stigma that has long silenced athletes, and shrugged off the naysayers who belittled her decision. “If I were going to quit, I had other opportunities to quit,” she says. “There is so much I’ve gone through in this sport, and I should have quit over all that—not at the Olympics. It makes no sense.”

 

A month after the Games, Biles put her vulnerability on display once again. Along with three other of the hundreds of other athletes who had been sexually abused by former team doctor Larry Nassar, Biles gave emotional testimony before the Senate about the failures of institutions like the FBI, USA Gymnastics (USAG) and the U.S. Olympic and Paralympic Committee (USOPC) to stop him.

 

Colin Kaepernick, no stranger to criticism for taking a stand, praises Biles’ “grace, eloquence and courage.” “Simone Biles has used her remarkable position as the world’s greatest gymnast ever to inspire a long overdue global conversation on mental health,” he tells TIME. “Her influence extends far beyond the realm of sports and shows us that another world—a better world—is possible when we speak our truths with integrity and authenticity.”

 

At a time when anxiety and depression rates are skyrocketing—the CDC reports a 50% rise in suicide attempts by teenage girls during the pandemic—and many people are struggling with what they owe themselves vs. what others demand of them, Biles made clear the importance of prioritizing oneself and refusing to succumb to external expectations. With the eyes of the world upon her, she took the extraordinary step of saying, That’s enough. I’m enough.

 

Biles thought she was, as she puts it, “good to go” before the Games. In retrospect, she acknowledges that she was shouldering a heavy load as she trained. She was the face of Team USA, and fans around the globe were anticipating watching her gravity-defying skills. Gradually, she began to feel the Olympics were less about her fulfillment and more about theirs.

 

In the past, when she left the gym, she didn’t allow issues with certain skills to spill over into the rest of her day. But as Tokyo loomed, “my mind was racing and I wasn’t going to sleep as easily,” she says. The pandemic, which had delayed the Games from 2020, played a huge role in that, she thinks, since safety protocols meant she was limited to going to the gym and staying home. For the gregarious Biles, that meant more time alone with her thoughts. Things only got worse in Japan. “We couldn’t hang out because of COVID-19 protocols,” she says, “so things you normally don’t think about because you don’t have time, now you have hours on end to think about—those doubts, those worries and those problems.”

 

Biles is the only survivor of the Nassar sexual abuse scandal still competing, and pushing for USAG and USOPC to be held responsible is part of what’s driven her over the past few years. “I definitely do think it had an effect,” she says of that burden. “It’s a lot to put on one person. I feel like the guilt should be on them and should not be held over us. They should be feeling this [pain], not me.”

 

It took Biles about a year after the first Nassar survivors came forward to reveal publicly that she is one of them; her mother Nellie remembers Biles calling her in tears in 2017, saying she needed to talk to her. Training every day only served as a reminder of what she had been through and the lack of accountability by USAG. Biles didn’t feel she could even drive herself to and from her therapy sessions, so Nellie did, waiting outside in the car in case her daughter needed her.

 

That work, Biles felt, mentally prepared her for her second Olympics, which she attended without family because of COVID-19 restrictions. She had stopped going to therapy for about six months before the Games, Nellie says, insisting, “I’m fine, Mom.” But after her scare on the vault, she called Nellie crying. “The only thing Simone kept saying was, ‘Mom, I can’t do it. I can’t do it,’” says Nellie. In the days that followed, Biles says she got support from Team USA’s mental-health experts, who were on-site for the first time at an Olympics. That helped her make another courageous choice: competing in the balance-beam final. “At that point, it was no longer about medaling, but about getting back out there,” she says. “I wanted to compete at the Olympics again and have that experience that I came for. I didn’t really care about the outcome. On that beam, it was for me.”

 

Biles’ assuredness in speaking her truth and taking ownership of her fate offered permission for athletes and non-athletes alike to talk more openly about challenges they’d once kept to themselves. “Sacrifice gives back way more than it costs,” says Kevin Love, a five-time NBA All-Star whose 2018 discussion of his in-game panic attacks helped start to destigmatize mental struggles in his sport. “I do believe that it often takes one person to change the trajectory of a whole system.”

 

Olympian Allyson Felix, who gave birth to her daughter Camryn in 2018, knows how athletes are expected to make winning their everything. She says Biles will have more influence for stepping back and taking stock of what really mattered than she would have by snapping up more medals. “To see her choose herself, we’re going to see the effects of that for the next generation,” says Felix, who became the most decorated female track-and-field athlete of all time in Tokyo. “When thinking about role models for Cammy, wow, here is someone showing you can choose your mental health over what the world says is the most important thing.”

 

The message is already being put into practice. As head coach for women’s gymnastics at the University of Arkansas, Olympian Jordyn Wieber, another Nassar survivor, sees Biles’ decision as an opportunity for her team to “take those lessons she’s displaying on a worldwide level and apply them to their daily lives as student athletes.” During the Olympics, Ty-La Morris, 14, an aspiring gymnast from the Bronx, stayed up past her bedtime to watch coverage of the gymnastics events. When she heard people questioning Biles’ fortitude, she defended her. “Everybody kept coming after her, and nobody was in her shoes,” she says. Witnessing a Black woman thrive in a traditionally white sport gives Morris the confidence that she too can make the Olympics, but in addition, she’s now more likely to tell her coach if she’s having difficulty, which she wouldn’t have been comfortable doing before.

 

Experts agree that especially for young Black women, Biles’ actions were a signal that it’s acceptable to claim agency over both their minds and their bodies. Since the days of slavery, says LaNail Plummer, a therapist who specializes in providing mental-health services to Black and LGBTQ communities in the D.C. area, the bodies of Black women have been subject to fetishization: for purposes of labor, reproduction or athletic entertainment. Throughout their careers, for example, tennis stars Venus and Serena Williams have been the targets of racist and sexist comments because of their appearances. “Our bodies have always been under scrutiny,” says Plummer. “Oftentimes, Black women are not given the freedom to be able to just be authentic. Oftentimes, they have to be what somebody asked them or designed for them to be.”

 

So when a Black female athlete like Biles takes visible steps to safeguard her own mental and physical health, to indicate that it’s worth protecting, that action carries a special power. Plummer has noticed that since Tokyo, more personal and professional contacts have initiated conversations about their mental health. This is significant, as research has found that many Black women feel they must project an image of invulnerability and the stigma around mental health deters them from seeking help. And although Black adults are more likely than white ones to report symptoms of emotional distress, only 1 in 3 Black adults who needs mental-health care receives it. “It is a privilege of people who have money to see a therapist,” says Reuben Buford May, a professor of sociology at the University of Illinois Urbana-Champaign who studies race and culture. “Intertwined with that is that African Americans have disproportionately been among the poor and have not been able to have health care to pay for mental-health services.”

 

Biles alone won’t change mental-health inequities or force a society that has long paid lip service to the importance of mental health to do more. But she made it that much harder to look away. And, according to school psychologist Shawna Kelly, a member of the National Association of School Psychologists’ board of directors, Biles’ actions will help accelerate a trend that was already under way. Recently, Kelly has seen more kids asking for help, as well as expressing concern for their friends. “Often that’s before a real crisis, which is where I feel there is more opportunity to work with kids preventively and proactively.”

 

In June, before she had any idea of the experiences to come, Biles had Maya Angelou’s And still I rise tattooed on her collarbone. “It’s a reminder and a tribute to everything I had been through, and that I always come out on top,” she says. The Olympics did not go the way she or anyone else expected, but she’s not wallowing in what-ifs. She’s back in therapy, just finished headlining a U.S. tour and is feeling confident about the decision she made in Tokyo. “I was torn because things weren’t going the way I wanted,” she says. “But looking back, I wouldn’t change it for anything.” —With reporting by Nik Popli and Simmone Shah

 

 

 

A Year That Changed How Athletes Think About Mental Health

 

The psychological challenges of sports have been talked about for ages. In 2021, athletes in a number of disciplines took action.

 

By Louisa Thomas

December 20, 2021

 

Original article at = https://www.newyorker.com/culture/2021-in-review/a-year-that-changed-how-athletes-think-about-mental-health

 

Back in February, it felt like an ordinary instance of something extraordinary: Naomi Osaka, losing and facing match point against Garbiñe Muguruza, in the fourth round of the Australian Open, unfurled a top-spin forehand that curved into the far corner, forcing an error by Muguruza. Osaka went on to win the match and, three rounds later, the title. It was her second Grand Slam in a row and her fourth in three years. She had other, more spectacular highlights in the tournament: a slice drop volley off her shoelaces against Ons Jabeur; a forehand down the center of the court so powerful that Serena Williams, standing just a few feet away, barely leaned toward it. But it was the saved match point that I returned to during the next few months, when I thought about Osaka’s performance in Melbourne. It was one of those moments that sports used to offer me with some regularity—a moment when everything else fell away, and only the stakes of the competition mattered.

 

I hadn’t experienced that feeling much during the previous year, for all the obvious reasons. When Osaka lifted the trophy in Australia, things were not back to normal, of course, nor did they even seem that way—Melbourne was just emerging from a short but brutal lockdown, not its first, and Jennifer Brady, Osaka’s opponent in the final, had begun her time in Australia in a two-week quarantine, doing agility drills in the space beside her hotel bed. But the mood was starting to shift. There were people in the stands. The coronavirus vaccines were becoming more widely available, and the worst of a brutal winter wave of infections was receding. Restaurants were reopening. Tom Brady had just won another Super Bowl. Soon, the weather warmed, and spring training started. The pandemic hadn’t ended, but it felt possible to imagine the day that it might. Sports, always a fun-house mirror of the wider world, reflected that sense of possibility.

 

The mood didn’t last. Many people refused to get vaccinated; some parts of the world could not get enough vaccines from the wealthier countries that had them; the covid death toll for 2021 caught up with that of 2020, and later surpassed it. The feeling that came to predominate was not hopefulness but whiplash, in sports as in everything else. It was not clear, anymore, what even counted for normalcy, or what should.

 

In the midst of all this, toward the end of May, Osaka posted a long note on social media explaining that she was not going to do any press during the French Open. “I’ve often felt that people have no regard for athletes’ mental health and this rings true whenever I see a press conference or partake in one,” she wrote. Osaka’s candor elicited both praise and pushback. On Reddit, Osaka’s sister, evidently trying to defend her, suggested that Osaka was trying to insulate herself from criticism of her play on clay. But Osaka’s remarks seemed to hint at something more serious. A week later, after the four Grand Slam tournaments issued a joint statement threatening fines for any player who did not speak to the media, she pulled out of the French Open altogether, and then she took to social media again, where she elaborated on the reference to mental health in her initial post, explaining that she had suffered from periods of depression ever since she was catapulted into stardom, in 2018, by beating Serena Williams in the U.S. Open final.

 

Osaka is hardly the first prominent athlete to speak openly about her psychological struggles. In the past several years, in particular, stars in a range of sports have publicly discussed dealing with depression, anxiety, and suicidal thoughts. The N.B.A., the N.C.A.A., and even the N.F.L.—probably the league most closely associated with a man-up, get-over-it mentality—now have fairly robust counselling and mental-health services. Still, Osaka’s withdrawal seemed like the sort of event that could change how mental health was talked about in the sports world, and perhaps beyond it. This wasn’t only a matter of her candor; it was that she had chosen not to play.

 

In July, at the Tokyo Olympics, Simone Biles withdrew from the women’s gymnastics team final. She had lost her air sense—gotten a case of “the twisties,” as gymnasts evocatively put it. Biles, the all-around favorite and the unofficial face of a controversial Games, had been competing in the aftermath of widespread sexual, emotional, and physical abuse in her sport—abuse that she herself had suffered. It was too much for anyone, she later acknowledged. Biles said that she hadn’t initially intended to make a statement; she simply knew that she was not in a state to compete. But, after she withdrew, Google searches of the phrase “mental health” spiked worldwide. At the Olympic Village, Biles was swarmed by athletes who wanted to thank her. She returned for the final in the beam, performing with a modified dismount and winning bronze. She said that she had made the decision to compete for herself, and no one else.

In October, the Atlanta Falcons receiver Calvin Ridley stepped away from the N.F.L., to “focus on my mental wellbeing,” as he put it. The Philadelphia Eagles tackle Lane Johnson missed three games while battling anxiety and depression. The former U.S. Open champion Bianca Andreescu announced that she would not be competing at the Australian Open, writing that she had been affected by frequent periods of isolation and her grandmother’s hospitalization with covid. She “was feeling the collective sadness and turmoil around and it took its toll on me,” she wrote. The U.S. soccer star Christine Press, after becoming the first player to join the much-hyped expansion team Angel City F.C., of the National Women’s Soccer League, announced that she was stepping away from the sport, for a time, to focus on her mental health and process the grief that followed the death of her mother. When, a few weeks later, the N.W.S.L. suspended games for a weekend, amid allegations that a prominent head coach had psychologically abused and sexually coerced players—one in a series of accusations of harrassment and misconduct within the league—the players’ association announced that the break had been demanded by the players, and was intended to give them “space to process this pain.” (The coach has denied most of the allegations.)

 

Most, though not all, of these athletes are Black, and it is surely not a coincidence that this has happened in the wake of a pandemic that, in the United States, has hit the Black community particularly hard. Osaka is one of many athletes who participated in the widespread protests for racial justice that followed the murder of George Floyd and that, for a time, in 2020, overtook even the coronavirus as the major story of the sports world. Public attention has subsided since then, but, for many, the hurt has not.

 

Putting aside the predictable bombast of the toy soldiers of the culture wars, the public response to Biles, Osaka, and others has been overwhelmingly positive. More and more people seem comfortable with the idea that mental health matters as much as physical health. “You have to take care of your brain just like you take care of your body,” the Tennessee Titans wide receiver A. J. Brown told reporters, after posting a video on TikTok and Instagram in which he talked about dealing with suicidal thoughts the year before. (Social media has figured prominently in the conversation about mental health in the past year, cutting both ways—heightening the intense scrutiny many athletes receive, but also allowing athletes to speak directly and candidly to fans and the public.) The stigma against talking about psychological pain is diminishing. This is a hugely positive thing.

 

And yet, however well-intentioned that conversation is, certain complexities are persistently elided or overlooked. You can perform an MRI to diagnose an A.C.L. tear, and then follow a well-established rehabilitation program that comes with a relatively predictable timetable for your return. Psychological issues are rarely so straightforward in their diagnosis or their treatment. The very phrase “mental health” is so broad as to become, at times, unhelpful. The phrase that people tend to avoid, of course, is “mental illness”—a tacit admission, perhaps, that these athletes are generally talking about more common psychological problems, and also, possibly, evidence that certain stigmas have not gone away.

 

Mental health has been invoked in serious ways by the athletes above and by other prominent sports figures, such as Michael Phelps, who has discussed suffering from depression so deep that he was unsure of whether he could emerge from it. It has also been invoked, for instance, by Aaron Rodgers, who, after weeks of trolling his team, the Green Bay Packers—and, apparently, devising a plan to avoid the covid vaccine—said that he spent the summer working “on my mental health.” Did he mean it, or was he being glib? It’s hard to say. Before the N.B.A. season began, the star point guard Ben Simmons said that he was done playing for the Philadelphia 76ers, despite the four years left on his contract. Many fans and even some of his teammates were openly frustrated with him, until he told the team that he wasn’t mentally ready to play—at which point his teammates, at least, moved to show their support. The timing of his statement, shortly after it became clear that Simmons would have to forfeit his salary if he simply refused to play, prompted cynicism among others, as did ​​Simmons’s initial refusal to engage with his team’s counselling services. (He reportedly worked with therapists provided by the N.B.A. players’ association, before finally agreeing to meet with the team’s counsellors.) His agent, Rich Paul, said that Simmons’s conflict with the team “furthered the mental-health issues for Ben.”

 

Reflexively doubting Simmons risks undermining the seriousness of these concerns; it is difficult to express skepticism without reinforcing the old stigma. In truth, though, athletes are almost inevitably imperfect role models for most of us when it comes to both physical and mental health. They train themselves to push their bodies—and their minds—toward extremes that can be at once awe-inspiring and unhealthy. They compete with torn cartilage and broken bones; they will themselves onward under pressure that would crush a normal person. We celebrate them for this, and rightly so: it is what allows them to perform almost unimaginable feats. But it often comes with a cost. This year, many athletes pointed that out, and some decided that, for them, the cost had become too steep.

 

Osaka missed Wimbledon. She returned to the international spotlight at the Tokyo Olympics. With so much time away from the tour, and with the intense scrutiny that came with representing Japan—she lit the torch for the Games—it wasn’t surprising when she was defeated in the third round. Still, it was clear that Osaka felt the loss deeply. A few weeks later, at the U.S. Open, she had a comfortable lead against the young, unranked Canadian player Leylah Fernandez; then her play began to unravel. More than once, she slammed her racquet into the ground in disgust.

 

After Osaka lost the match, she addressed the media, choking back tears. “I feel like, for me, recently, when I win, I don’t feel happy, I feel more like a relief,” she said. “And then, when I lose, I feel very sad. And I don’t think that’s normal.” The moderator of the press conference gave her the chance to end it, but, with visible effort, she kept speaking. “This is very hard to articulate,” she went on. “Well, basically, I feel like I’m kind of at this point where I’m trying to figure out what I want to do, and I honestly don’t know when I’m going to play my next tennis match.”

 

My mind flashed back to that moment in Melbourne, when she faced match point. Confidence on the court is a real but narrow kind of courage; what Osaka was doing now seemed to require bravery of another order. As painful as it was to watch, there was hope in it, too—a chance, maybe, to redefine what success can mean, and what we consider, after all this, to be normal.