The email was unexpected. I scanned the opening paragraph of the message quickly while I juggled a variety of afternoon activities in my office. But the words captured my full and complete attention once I realized the gravity of the meaning behind them. “We are very sorry to inform you that, effective immediately, Arivale can no longer provide our program to you and other customers.” It was April 24, 2019 and Arivale — one of the most exciting and promising personal health companies I had ever interacted with — had just shut the doors, turned off the lights, called it quits. Effective immediately.
Over the course of my career, I’ve seen many companies come and go. We all have because that’s the nature of business in our modern world. But there was something about Arivale’s abrupt announcement and sudden closure that rattled me at a deeper level than news of a corporate demise typically would. Within hours, my inbox was filling with Arivale-related messages from colleagues who had heard the news and had opinions and comments to offer. By the end of that week, I had been on the receiving end of requests for advice or referrals — talented people in my field had lost their jobs, where could new opportunities be found? News stories were published. The founders spoke. Reasons and explanations were provided. Acceptance should have set in and taken hold, and yet I continued to ruminate. I was feeling Arivale’s downturn in a very personal way, as were many supporters who had celebrated and followed this company that was trying to create a new business model for health.
The Launch — A Flashback
Arivale opened its doors in 2015. From day one, it was a company that attracted international attention and interest. Less than a year after launch, GeekWire, a popular technology news site based in the Pacific Northwest, named Arivale Startup of the Year at a gala event in Seattle. GeekWire’s online coverage of that evening captured not only the excitement of the award presentation, but also the promise and potential that Arivale embodied, at least among the tech community. Journalist Taylor Soper wrote the following: “Led by genomics pioneer Leroy Hood and venture capital veteran Clayton Lewis, Arivale has plenty of star power (and cash in the bank). The Seattle health startup emerged last summer, developing a new type of system that combines cutting-edge genetic analysis with personal coaching, with the goal of improving individuals’ health.”
Both Leroy Hood and Clayton Lewis are indeed dynamic and renowned stars in their respective fields. It’s no wonder their company was generously funded, their vision was widely celebrated, and their enthusiasm was infectious. Here again, GeekWire captured the energy: “Both Hood and Lewis, along with a huge group of Arivale employees, accepted the award on stage. Hood noted that ‘scientific wellness has a really big job ahead of us,’ while Lewis thanked his team and Arivale’s clients. ‘Our clients understand that the secret to wellness is science,’ he said.”
The Concept and the Clients
I absolutely understood the concept of scientific wellness — and I was VERY excited by it. I am a clinical biochemist by training and I have started and owned medical laboratories. I have also had a very successful career in the natural products industry and my specific area of expertise is nutritional research. Finally, I am a lifelong educator. For many years I was a professor of chemistry at the University of Puget Sound. I was a protégé of Linus Pauling, PhD, who was a two-time Nobel Laureate. I coined a term — Functional Medicine — and I established a successful nonprofit organization that offers training courses for physicians and other healthcare providers. I was — and still am — a proud bioscience nerd.
I met Dr. Lee Hood in 2013, two years before Arivale was launched. When I was told of Hood’s initial project — the Pioneer 100 — and was offered the opportunity to participate, I jumped at the chance. I had been measuring my own blood chemistries for more than 30 years, so I found Hood’s approach to be novel and innovative. His team was seeking to make scientific wellness actionable using a combination of genetic testing, tracking of functional biomarkers and physical function, microbiome analysis, and health coaching. I was honored and eager to roll up my sleeve for a blood draw.
By 2017, Dr. Hood and his colleagues were publishing articles in prestigious medical journals about the scientific wellness concept and data gathered from the initial group of 108 study participants (myself included). Critics of Hood’s model and methods were also writing articles, including one that appeared in Science magazine under the title “‘Scientific Wellness’ Study Divides Researchers.” The medical and scientific communities, it seemed, were proving to be a tougher audience than the tech experts and data phenoms who had hailed Arivale’s entry into the wellness marketplace with great fanfare.
I had signed on as a client with Arivale when the initial study I had been involved with ended. In total, I spent about five years using the services Arivale and its predecessor provided, and I found my experience very compelling. My profile included genetic data, gut microbial analysis (done every three months), blood chemistry testing, nutritional evaluation, toxic metal blood testing, and salivary stress hormone analysis. In addition, personal data from my fitness tracker was collected and I also used a blood pressure monitor. My body composition and body mass index were measured and noted, and I completed a comprehensive symptom profile and health history. Arivale matched me to a scientific wellness coach who was also a clinical dietitian. Every quarter, my coach and I would talk by phone and review my data. Overall, these services and the interactive nature of the coaching relationship felt like a very good way to explore the personalization of the scientific wellness movement.
My Data and How I Used It
My genetic analysis revealed a number of things that I found meaningful. I had potentially sluggish detoxification enzyme systems and a reduced potential for utilizing vitamin D. I had good carbohydrate metabolism, but lower potential to metabolize certain fats. My blood analysis revealed something unexpected, but explainable (and modifiable): I had elevated levels of mercury in my blood, likely because I had a tendency to eat a lot of tuna sushi (I made some dietary adjustments). Further insights included the fact that my antioxidant nutrients were sufficient, as well as my vitamin and mineral nutrition. My gut microbiome analysis demonstrated that I consumed a good balance of plant foods that were rich in fiber (this stimulates production of the friendly bacteria that produce butyrate in the gut and is generally associated with good health).
I also learned valuable lessons about the many ways that stress can affect health. During my first year of monitoring and tracking my data, my elderly mother became very ill and I had to spend considerable time overseeing her hospital care. During these months, my blood sugar, insulin, and stress hormones all pinged into ranges that were considered unhealthy. It was a learning opportunity for me to better understand how stress directly impacts my health. After my mother’s situation stabilized and she was discharged from the hospital, my troublesome levels returned to a healthy range. This experience provided me with first-hand knowledge about the ways that lifestyle and environment can be modified in a manner that affects functional health status.
Every year, I travel extensively and speak to audiences all over the world. From stages and podiums, I shared my experience with the Pioneer 100 project and Arivale with thousands of health practitioners. Additionally, I invited some of Arivale’s scientific leadership team to speak at conferences I hosted through the Personalized Lifestyle Medicine Institute. But even that wasn’t enough for me. I also championed an ongoing collaboration between the Institute for Functional Medicine and Arivale because I believed that health practitioners should know as much as possible about this approach to assessing wellness. In essence, I was “all in” on Arivale. I felt the concept could prompt healthcare providers to reimagine our industry. I felt certain that health conscious consumers were ready to become “citizen scientists” who would be deeply invested in their personal wellness. I was emboldened in my belief about the value proposition of the Arivale model, both from the scientific and the commercial perspective.
What Went Wrong?
It is not possible for me to definitively answer this question. I was not an executive with the company. I was not an employee or a consultant or an investor. But I am a perceptive listener. As I traveled around the world presenting my educational talks to different groups, some doubts about the Arivale model began to take shape in my thoughts. For example, I know many people who have had a genetic analysis. A theme began to emerge as I talked with these colleagues and friends. Quite a few of them anticipated that this type of testing would provide a clear blueprint for staying healthy and preventing disease, and they were disappointed to find that this is not, in fact, what these tests do. Our genes don’t tell us specific things about wellness or illness. Rather, genes provide us with information about the unique way that we respond to our environment and lifestyle, which can be a complex concept for people to understand.
Next, I believe Arivale had to meet a very high bar when it came to customer expectations. It was an expensive program to participate in, and I had a number of people express feelings of confusion to me about the personalization of their programs. The health coaching services that were provided were heavily nutrition-focused. Nutrition is my field and so I found this emphasis engaging on a personal level, but would customers have perceived a higher level of benefit if consultations with a wider range of medically certified professionals had been a part of the program? It’s an important question to ask, especially since I was sensing a general feeling of disillusionment about services that are data heavy, but light on clinical recommendations.
Lastly, I have a philosophical observation to offer with regard to the concept of using disease risk reduction as a motivational tool for behavior change. I have been considering this idea from numerous angles over the last several years. Prevention is a hard thing to quantify. How do you know you prevented a disease you never got? In the case of the Arivale program, even if test numbers changed and ranges shifted, were the clients connecting incremental data point adjustments to overall health, daily functioning, and long-term impact? I have a theory that if more information related to how a person looked, acted, and felt each day on the program had been incorporated, greater engagement might have been the result.
Regrettably, Arivale is gone. Even so, is it appropriate to jump to the conclusion that scientific wellness — as a business concept — is a complete commercial failure? Absolutely not. I believe that Arivale got so many things right. In the end, I think the elusive, critical piece was customer engagement — that is, how to communicate with people about complex data and make it personally relevant and compelling. I am confident that very soon we will all witness a 2.0 version of the concepts that Arivale pioneered — a next-level iteration that will address the essential communication and behavioral components. Wellness is the future of health care. As disappointed as many of us are about Arivale’s failure to thrive, it has paved the way for many exciting opportunities that are yet to come.