Gut Feelings: One founder’s bold approach to thinking differently about gut health

It is estimated that up to 15% of Europeans suffer from irritable bowel syndrome (IBS), a chronic condition that is associated with a reduced quality of life, psychological distress and economic burden. IBS can be a challenging disease to treat, as it lacks a definitive test, cannot be cured, and must be managed long term. Individual therapies to manage symptoms may not work for all suffers, and each patient's experience can be very different from one another. While these difficulties might have put off other healthtech companies, it is precisely these challenges that the founders of Bold Health consider the most rewarding problems to solve.

Elena Mustatea and Jossy Obi Onwude are the co-founders of Bold Health, a company building solutions to chronic health conditions using cognitive behavioral therapy. In June, the company launched their first app, Zemedy. Zemedy is a non-pharmaceutical therapy for irritable bowel syndrome and gut disorders which empowers users to take control of their health. By assisting with changes in nutrition, exercise, mindset and psychological change, Zemedy helps users address the root causes of their conditions and treat themselves. Zemedy is deployed through a chatbot that guides users through a care journey and adapts to each individual’s unique symptoms, preferences and experience.

I connected with Elena, Bold Health’s co-Founder and CEO to learn a bit more about her founder story. Elena has come into healthtech from a background working previously as an analyst at JP Morgan, as an investor at Atomico, and as co-founder of TechTogether in London. After her time working in VC, she knew that she was ready to make more of a direct impact as a founder. Bold Health was launched in London in January 2018.

Hi Elena, thanks for sitting down to speak with tech.eu! Can you tell me a little bit about your founder journey? When did you realize you wanted to become an entrepreneur? 

I come from an entrepreneurial family and I grew up seeing my dad and brothers start up various businesses and therefore saw myself running a company too. My first job was as a sales person with the family business in markets across my native country of Romania, starting with the age of 8 and continuing through high school every summer. Later in college I ran a media business with over 100 years of tradition and it was an incredible experience creating something with a team - I then felt I just had to repeat after gaining valuable skills in strategy, corporate finance and early stage growth. So I went on and got jobs in strategy consulting, investment banking and venture capital with entrepreneurship in sight.

How did Bold Health get started? How did you know that this was a problem to solve?

My cofounder Jossy and I were part of company building program Zinc, where we set out to solve the interdependence between chronic stress and physical illness. My interest in this started when, working in high-pressure jobs, I developed various physical ailments such as IBS, chronic back pain and burnout, which affected my ability to perform and live normally. I got myself back into vibrant health, and I wished to make this possible for others.

We chose to focus on digestive health because I had suffered with gut issues throughout my life, and because I was not the only one - c. 30% of the population suffers from some form of digestive disorder. The gut is very complex — it has the largest number of immune cells, the largest number of nerve cells outside the brain, the largest number of hormonal or endocrine cells. The gut produces 90% of serotonin (the key hormone linked to mood regulation), 50% of our dopamine (our reward neurotransmitter), and hosts 70–80% of our immune tissue, being where most of the bacteria in our body live. The gut also plays a key role in stress regulation: when a person becomes stressed enough to trigger the fight-or-flight response, digestion slows or even stops so that the body can divert all its internal energy to facing a perceived threat. An imbalanced gut left unhealed can lead to functional or immune abnormalities and other health issues: irritable bowel syndrome, psoriasis, depression, chronic fatigue, type 1 diabetes to name a few.

Researching ways to empower patients to treat their digestive illnesses from the root cause, we realised that approaches rooted in “alternative” therapies such as cognitive-behavioral therapy and hypnotherapy can actually be a lot more effective than conventional approaches such as drugs. So we set out to make this available at scale - bringing behavioral medicine to the masses through fully digitised, patient-centric, personalised care experiences guided by a virtual health coach.

When it came to raising investment, how have you supported the company thus far? Why did you choose to pursue this route, over alternatives?

We bootstrapped and were lucky to be supported early in the journey by Zinc VC. Then we participated in the Startup Bootcamp Digital Health accelerator in Berlin where we started generating revenues and building Europe-wide partnerships. We have a select number of angel investors who have a passion for healthcare and wellbeing, and most are a patient themselves or know someone dear and close suffering of IBS or other digestive illness. We are also lucky to have on board an American VC fund who can accompany us longer-term in our international growth.

Bold Health is based in London. What are some of the benefits or bright spots of the local startup ecosystem there?

From a digital health perspective, I would say that the UK healthcare system forces you to be creative, to get close to patients and solve their needs directly because the NHS is really hard to sell into (and captures 90% of medical services and spend). The UK is a good spot between Europe and the US, while the association with the NHS and the scientific community here gives us good credibility internationally, but on the downside, we find that not that many investors are willing to put in the patient capital required in life sciences investments. So we often find ourselves talking to Swiss, American or Asian investors instead.

In your journey as a founder, what is a key lesson you've learned along the way?

In particular as a digital health founder, I learned that in healthcare the best idea and solution for patients won’t necessarily win, that it’s even more important to have the right medical and scientific talent in your team, and to build partnerships across the industry for acceptance, distribution, and scientific proof. Don’t underestimate relationship-building across stakeholder categories. On the bright side, healthcare offers such strong missions to solve, and it can really fuel you to build very meaningful businesses. We are constantly humbled by all the people who want to work with us because they love the idea of relieving suffering and solving inequalities in the medical system and access to care.

What is next on Bold Health's journey? What should others know about what's on the horizon for you and the team?

On June 6th, we held a special event on gut health innovation to bring together startups and scientists working in the area. We will continue to work to educate the market, partners, patients and carers through additional events to educate about the many misconceptions around gut health. In healthcare, gut health often is not a priority, and there are not a lot of good solutions. And we want to raise awareness in the community and empower patients and encourage people to take charge proactively.

Is there anything else that we should cover that I should know about?

Our app Zemedy, the world’s first digital therapeutic based on CBT for IBS is in testing in private beta, and we’d love any sufferers to try our care journey guided by our friendly IBS virtual coach Elle. You can sign up here.

Thanks Elena!