Transcript for "Metabolic Disease Reversal: The Revolution that’s Saved $1B+ in Healthcare Costs": Alright. Well, good morning and good afternoon, everyone. We're delighted to be with you today for a webinar on metabolic disease reversal and Virta's first of its kind report, a revolution that saved $1,000,000,000 in health care costs. I sometimes say your biggest health care costs you don't know that you're struggling with. I am, our host and moderator for today, Laura Wamsley. We'll dive into, more, introductions in a moment. But first, just a little bit of housekeeping. We are recording this session, and we will share out afterwards. So if you have to drop or wanna share it with, your colleagues, please know that that's coming. We love questions and would love to hear from you, so please drop them in the chat as we go along. We've reserved some time, towards the end, to address questions specifically, But we also love to follow-up on questions, after the session as well. So, chat them in as we go. And last but not least, we'd really like to hear what you think about this session. Obviously, we're here to, educate the marketplace, educate our customers, prospective customers, and really the, you know, the the larger community, on the importance of metabolic disease reversal, what makes it different, and I hope to hear from you as to whether or not this was helpful, and any topics that you'd like to hear in the future. You'll get a webinar survey from us in follow-up, and we really appreciate you prioritizing, a quick response on that. Alright. Let's go ahead and dive in. Before we have we with no further ado, we'd love to call forward, this great panel of speakers we have today starting with Nikki. Can you introduce yourself quickly? Sure. Yeah. Hi. I'm Nikki Bork. I'm the corporate well-being program manager at Regions Bank Excited to talk with everyone today. Wonderful. Doctor Frank? Alright. Thanks, Laura. So I'm Frank Dumont. I'm an internal medicine physician by training. Been practicing medicine for about twenty seven years, the first twenty as a primary care physician. But for the last seven, I've been here at Virta. I'm executive medical director here. But the reason that I get so excited about being able to share in these types of discussions is to contrast that experience for twenty years, taking care of people with chronic metabolic conditions, getting pretty disheartened, watching them get worse in spite of everything that I was doing, that my team was doing. All of the medicines I was prescribing, I was still watching people get worse. And so contrasting that experience with what I now see, the experience that my patients have as they turn around metabolic disease, the experience I have as a physician, and the outcomes that we're now able to share after scaling this and offering this broadly throughout The United States. Wonderful. Thank you so much. And, lastly, your humble host here, Laura. As I've already mentioned, you can see I'm the chief commercial officer here at Virta Health. I have built a career, developing, delivering, selling, and servicing, and proving the value of healthier and more engaged people for employers and health plans. After about twenty five years of of this work, I joined Virta just earlier in 2025. And when I did so, I I felt really proud to tell my boys, to to go from telling my boys that I'm a businesswoman to telling my boys that I am saving lives with the work that I'm doing. So really, passionate about Verda's care, and what we have to share today. Speaking of which, I'll also go ahead and introduce Verda. Verda delivers metabolic disease reversal. That is addressing 10 cost centers with one recourse solution that you'll hear more about as we go today. In a crowded field of weight, diabetes, heart health, vendors, we're really differentiated with a different method, different care, and different outcomes with, without, and after GLP ones. Our clients enjoy savings like you see here on the screen. 8 to $12,000 average savings per member over two years, for our engaged members. What I like to say, return in your returns straight to your bottom line. Not only does that save money, but it can help fuel other, benefit and HR projects that you're looking to invest in that it get ever squeezed and harder to do in today's rising health care costs and rising pharmaceutical cost time. Really excited to share more with you about what we do as we go. First, let's zoom out a little bit, on what the key top drivers of that cost that I just mentioned really are. This is a a snapshot of cost drivers from, business group on health, a recent, survey that they put out this summer on the conditions that are driving, the the largest spends in health care costs throughout the last few years. And you can see many of them are actually related to metabolic health. If you're not familiar with metabolic health spend, almost everything across the top line here either has its root cause, in, metabolic disease, or can be positively influenced through a healed and improved metabolic functioning. We'll talk more about that today. But I hope you look at this today and really, take a a a little bit of a a stock of where you see the cost for your organization or, for your clients' organizations blooming. And then join us on a survey, as we gain a little bit of insight from the group that's on the, the hundreds of folks on the call with us today, as to how you're thinking about your health care costs. But also maybe more specifically, how would you describe your metabolic health cost today? As in are they a concern, not at all, or a really high concern, and something that you know is really impacting your overall budget. You can see a pop up there to go to the polls tab. Hopefully, you can, easily, go through there and share some results there. Alright. We've got some live results coming. It sounds like, generally speaking, on the higher end. Right? Our largest in, in level four. But I think, if we saw the spike of this graph, we'd say, many folks in the, either it's a high cost or it's breaking my budget perspective. So thanks for sharing that. Let's jump to, a second poll question here. And if you're having any trouble with the tech, I know there's a couple of q and a going on there, so feel free to dive in. We're loving this new system for more interactivity. What metabolic health programs have you previously invested in? And, again, I know we don't always, think of things like disease management or GLP one coverage as a metabolic health program, but in their root, they are. And, hopefully, these, these names are kinda self evidency of, of what you've done before. Alright. So it sounds like maybe, it looks like we've got two big bookends disease management, which is obviously kind of the stalwart, traditional way of thinking about, managing chronic diseases. How do we just keep them from getting much worse, keep them compliant with the medication. And then second up, we see traditional diet and exercise programs, with some, some, GLP one coverage, metabolic disease reversal, and kind of the burgeoning area of pharmacy navigation in there as well. Alright. Wonderful. Thanks for those results, everyone. Really insightful, to hear what you're working with, what your perspective is, and and, hopefully, again, welcome those questions as we go, on topics that you'd like to hear more about. Alright. So with that, we will dive into a little bit more of of the content here. And you can see I I I think when I on that previous slide, when think about disease management and traditional diet and exercise programs, I really think about them as the status quo. They're common in employers and health plan offerings today. They've certainly been around for some time. But this is not a novel thought here on the screen. Right? I think a lot of folks are saying, jeez. What we're doing just isn't working. The costs are rising, yet the health does not seem to be improving, at a population level. So, our maybe position is the status quo has failed. Right? Or conclusion, I should say. And you can see some other data points here on how prevalent that status quo is as far as impacting. Ninety three percent of US adults are metabolically unhealthy today. The conditions drive a a massive amount of spend within our overall health care, experience, and they're getting increased attention. You can see, reports, from the likes of, McKinsey on the right hand side there as well as this problem continues to bloom, and is blooming in some ways in a way that is uncontrolled. So, doctor Frank, why do you think we've accepted management as the default solution? Well, so the problem you articulated is exactly why I had become so disheartened as a primary care physician. I was trained in a very different way, managing disease. So a particular problem, I would try to throw a medication at it. The medicine would usually fail. I'd add in more medicines. But I was doing that across multiple different conditions and overall watching my patient get worse. And these were indeed the results that I had come to expect. I didn't expect my patients to get better. I expected to try the best that I could to slow things down if I could convince them to do things like take medications consistently. So why? Why why have we come to accept this? There are a number of things. The first one I think is skepticism, and really pessimism about lifestyle. I I think most of us have had the experience ourselves or watching someone else struggle with lifestyle change, seeing them maybe make a little bit of a difference, but then ultimately go back to what they were doing before. Most of us are just convinced that it's hard to do and it's hard to do sustainably. And and I would argue that that's true if you do it in an eat less, exercise more approach. We can talk more about that. The second thing is medicine focus, that really going back, I think, to the early nineteen hundreds, we've been very focused on medicines. Things like the development of insulin for the treatment of type one diabetes, the development of antibiotics to try to take care of bacterial infections. Those types of things convinced us that medicines could be very effective, and in fact, I think many people bought into this idea that medicines were the solution to our problems. And so we've really been very medicine focused. All you have to do is look at what's happened with diabetes care over the last three decades, and what you will see is many, many new medicines introduced trying to fix the problem. But, of course, it hasn't fixed the problem. The prevalence of diabetes, the level of control hasn't gotten any better. And then the third thing, I think, is really just what we're taught or what we're not taught. In medical school, I was not taught a different approach. I was taught about diabetes management, and things like lifestyle were really given just a very small amount of attention. And so until we change the way that we're teaching our medical providers, I think we're gonna remain more focused on the medications and, unfortunately, accepting the same types of lackluster results. Great. Thank you for that. Nikki, how about you? How what do you think about traditional programs and why they've fallen short? And how do you see metabolic health impacting health care spend overall as a benefits leader? I I I believe that the traditional programs, they've really fallen short because most aren't designed for the whole person health, or they focus, on making too drastic of changes too quickly. I always like to tell our associates that weight gain and insulin sensitivity, high blood pressure, high cholesterol, all of those things, none of it happens overnight. Yeah. So the solution should not be expected to work overnight either. It shouldn't be so drastic, super restrictive, or difficult to follow because we know that, life doesn't stop when we're trying to reach a goal or make a change, Yep. and weight loss in particular. People need something that builds on their knowledge. It builds on their habits. It's sustainable through life changes. You know, can you work this program into social settings? Can you be successful at work or within your, family dynamics? Is it financially draining? If you think about, you know, programs out there where you pay for a subscription or you get food delivered, you know, that type of financial impact, you know, because if it doesn't fit into your life, it's going to be the first thing that goes when life gets hard. And then, regarding spend, No. you know, metabolic health, it's it's like these roots of a of a tree, you know. They they they, you start there and it grows into life changing conditions. You know, what starts as just extra weight or insulin sensitivity, it leads to so many more complex, more expensive, more difficult things to treat, you know, and more, difficult or or more intensive, treatments like surgery, dialysis, heart attack, stroke. You know, it's all connected. And we know that even a small amount of weight loss can cause huge improvements, you know, giving less inflammation, less joint pain, avoiding surgery or dialysis or cardiac rehab, you know, reducing or avoiding that spend. Yep. And then you think about the impact too that that that has on the individual or their family to avoid cardiac rehab or to avoid dialysis. You know, I think that really says enough about, the spend and the and the impact that that has. Yeah. Wonderfully said. And certainly something that we're going to dive into a little bit more here, but, great examples of, of how, metabolic disease has so many, well, as as is described here. Right? Limbs to that tree. So let's talk about what we mean when we, re when we refer to reversal and metabolic care, and contrast it to the status quo. Right? So Stratus Quo solutions, tend to do those things on the left hand side, when they're weight focused, and, condition focused, they can be calorie restrictive. When they're management focused, like a a traditional disease management program for diabetes or other, quote, unquote chronic diseases. Right? They can, see, per rely on prescriptions, that can progress, and increase over time. They think about GLP ones as a lifestyle as opposed to, a temporary boost as we've really proven can be, delivered. And, ultimately, the outcomes from this program as was seen on the these types of programs as was seen on the prior slide. And I think as is proven with just the overall trajectory of health and health care costs, is modest and temporary. Contrast that, of course, with the Virta method. The the Virta method really focuses on, a personalized, biomarker based, nutrition first approach individualized to each person that results in, you know, the types of things you see here, reduced food craving cravings, rapid improvement in weight and inflammation that drives, reduction in need for, prescriptions and other medications, across a number of conditions. And, of course, as I've already mentioned, views GLP once as a important and valuable tool, when it's available, but also as a temporary tool, that can be supported, after that with, with great, with good lifestyle adherence, and that personalized Virta method approach, and ultimately delivers outcomes that are meaningful and sustained over time. Nikki, this is obviously a story that you heard a couple of years ago when you chose to invest in reversal for your team members. What made you, make that decision, and what's been your experience in offering this as a benefit? So during our RFP, we looked at a lot of solutions, and, Varda was the only one saying reversal. It really piqued my interest, but I was incredibly skeptical. And once we saw the results, you know, we're we're at $1,818,000 pounds lost company wide, and a 38% medication elimination. We at Regions are true believers, in Virta. It goes beyond the data, though. HR HR, Virta has this function called, HR love in the app. I don't know about you, but, in HR, we typically don't receive lots of, positive emails and feedback saying, hey. Things are really running great. It's usually complaints. Right? So this HR love function allows Virta users to send feedback to us, and we hear member testimonials like, you know, this really changed my life. It's the best thing I've ever done. It really, really speaks for itself. We initially started with the prediabetes and type two diabetes programs, and then we added the clinical weight loss program the second year. We refer associates that are working with other programs, like, an associate who might be struggling with mental health and mentions that they're overweight. You know, they've been overweight their entire life. We'll refer them to Virta. We had a recent menopause event, where we were talking with women who whose normal methods for losing weight no longer work. So we're referring them to Virta, as well, and, you know, it's everywhere at Regions. We've we've just had such great success with it, and and it's been one of our easiest, benefit That's amazing. Well, you've done such a terrific job. And, obviously, your perspective is so great as to the, many use cases that metabolic launches. disease reversal can apply. And your results are amazing. Congratulations. You were skeptical. I'm sure some of your people were skeptical too. How did you get it? How did you make sure that, Virta was so widely adopted? I mean, it it's hard to be the first, right, both as a vendor saying that you can reverse diabetes, but also, for us working for a company where we need to be good stewards of our employer budget, to jump into something, you know, that makes this big claim. I think between the education gap and the skepticism and as doctor, Dumont always said before, you know, the the message has always been you take this medication for this condition. Right? Yep. But we're proof that that's not the only way. So, you know, looking at the data, talking to peers about their experience, you know, because we're seeing the proof that these are fixable things with food as medicine. So, Yep. making sure it's widely adopted. We just really overcommunicated it and, made sure that in every single, discussion about benefits that we mentioned Virta and we sent to all associates rather than just those with a chronic condition. And that was something that really made it successful as a law. Amazing. Thank you for that. Doctor Frank, as a provider, how does this approach show up in practice? Well, I I think it primarily is in the experience of the patient that you're taking care of. And so when I think about the individual following the status quo approach, you know, what I know is it's a pretty depressing experience. When you're diagnosed with metabolic conditions, of any type, whether we're talking about obesity or diabetes or blood pressure or cholesterol or inflammation issues, the bottom line is that generally you're told this is a chronic progressive condition. It will get worse over time, but we can use medicines to try to make it better, to try to slow things down so you can do as well as possible. But in spite of that, what most people experience is that in spite of the fact that they are trying to eat less and exercise more, they're still gaining more weight. That in spite of taking their medications, their blood pressure is still climbing over time, and they're generally seeing those complications, those effects of those chronic metabolic conditions start to build up over time. It's really a disheartening situation. Now in contrast, reversal is very different, and that's why the last seven years have been so exciting for me because I'm watching my patients experience things totally differently. They're being given information, support tools, and that's turning around the course of their metabolic conditions. Instead of adding in more medicines, they're taking away medicines. Instead of watching things get worse, blood sugar, weight get worse over time, they're watching them actually get better. People are feeling empowered. And so it's such a different experience clinically for people with one approach to the other. That's awesome. And I'm gonna keep you, on the on the microphone, to go ahead and and maybe back up to just explain a little bit more about what metabolic disease is, and exactly what we're talking about, not only from a condition set, but also how it impacts the, the entire body. And I do see a question on speaking to the nutritional recommendations that we have on the next slide. So, would love your, you to jump in there. Yeah. Certainly. So metabolism at its heart is our body trying to utilize energy. We're breaking down foods. We're taking in the energy. We're getting the energy shuttled to cells and taken up by cells so they can be used and then stored when it's appropriate, when you have excess energy, having your body put it in storage. And when the body is doing well, it does this extremely well. But the problem is that the majority of us, as adults in The United States, have metabolic dysfunction. We're not doing everything that I just described normally. And one of the key factors that affects that is our inability to really listen to insulin. Insulin is one of the key hormones of metabolism or of energy utilization. It's made a hormone made by our pancreas. It basically tells our cells to take energy out of the bloodstream and into the cells. It tells our cells to store that energy as fat when it's appropriate to do so. But, unfortunately, with our food environment in The United States, the majority of us actually develop something called insulin resistance. We start ignoring that insulin signal, and therefore, we become less able to regulate what we're doing with that energy the way that we should be. And when that happens, that's metabolic dysfunction. And when that occurs, we start to reduce with the when we stop listening to the insulin, we release even more insulin into the system trying to overcome that insulin deafness. And those high insulin levels and what goes along with that, things like high glucose levels, high inflammation levels, that's what leads to all of these conditions that we think about in some ways as being different conditions, but are really due to the same problems with metabolism. Those are things like elevated blood sugar in the setting of diabetes, elevated inflammation in the liver in the setting of metabolic dysfunction, liver disease, or fatty liver disease, kidney dysfunction, blood pressure issues, cholesterol issues, all tied to that same thing. And so the great thing about this is if you start to address that root of the metabolic problem, what's going on metabolically, with the metabolic dysfunction, you can actually start to affect all of these positively. And so if you can jump to the next slope, what we're hoping or next slide. What we're trying to do is break that cycle, that vicious cycle that's taking place on the left hand side. So this is what I've already described. People start to develop insulin resistance. Their body doesn't respond well to the foods that they're eating. When that occurs, they start to see things like elevated blood sugar, elevated insulin levels, elevated inflammation levels. That's leading to metabolic diseases, including worsened insulin resistance, which then feeds into the cycle, and people just get worse and worse over time. But if you can break that cycle, you can actually help people turn around the course. And that's what we're trying to do with Virta. We're trying to help people learn to eat in a way that actually works for their metabolism based on where they are. That means eating the right amount of carbohydrates, the right amount of protein, the right amount of healthy fats for them. And when you do that correctly, when you're not feeding into this cycle, things actually start to turn around in the other direction. And the great thing is you can do this in a very precise way using the science and the technology that we have. We can send equipment to someone's home so they can listen to their body in real time saying, am I getting it right for me at this point in time? But the other thing that's so important is the ability to personalize. You need to personalize based on that person's individual level of metabolism, and that's what we're listening into with the biomarkers and getting that mix of macronutrients right for them. But you have to do it in a way that works for their world, because the bottom line is people have different backgrounds and cultures and food aversions and food tolerances and intolerances and allergies and budgets. The bottom line is all of those need to be taken into consideration to come up with a plan that is real food, rich food, satisfying food that doesn't leave you hungry all the time, but just happens to work with your metabolism so that you can turn around the course of metabolic disease. Awesome. Thank you. Let's pivot back to the cost. I shared the savings, that Verda is delivering to customers, today. But, of course, for all of us, if you're paying claims, you're paying for metabolic dysfunction. Nikki, what's the value that you put on a solution that can impact a broad a broad portion of your population health and multiple cost centers? How do you think about that? I mean, it's a long term solution that's focused on preventive care to prevent those downstream costs. Right? It's an approach that that improves both our insides and our outsides, by improving physical health. We're reducing weight. We're reducing the impact of comorbidities that also help to improve our mood. It boosts our self esteem. This is helping our associates to be better versions of themselves. Right? They do better at work. They're better in their marriage, better as a parent, better, you know, more present, more aware. They're operating on a more efficient level. This has kind of a trickle down effect. You know? It has a positive impact on their coworkers and collaborative teams, their families, social workers, social social circles. You know, when we feel better, we do better, and that casts a very wide net. Yep. And so, you know, just being able to improve presenteeism and and, you know, the morale and the engagement and all the other aspects too, just because, like I said, when we feel better, we do better. Amazing. Agreed. Okay. With that, let's really bring this to life. You know? I I think there's, some, an old stalwart, some of that old school thinking that says, is metabolic disease reversal even possible despite, you know, tomes? I think we have 23 or, maybe maybe now 25, peer reviewed published studies that show not only is it possible, it's happening every day, but, let's let's really bring this to life in the real world about what happens when metabolic disease does get reversed. And to that, we'll bring forward, one of our amazing Virta members in Kandi. So, Kandi, welcome to the to the front of the stage. We're so, pleased to have you here and, obviously, so proud of, of your engagement and, the control that you've taken of your health in reversing metabolic disease. Please tell us your story. Sure. Back in 2022, I was two hundred and fifty six pounds. I had high cholesterol, high blood pressure, pain in my back and my knees, suffering from depression. And then my doctor diagnosed me with, prediabetes and wanted to start talking to me about medication. Unfortunately, my son's, my son's dad, also suffers from diabetes. It runs in his family. His dad even lost a leg from it, and I was like, I'm not gonna go down that path. Somebody needs to be here for our son. And, at that time, GLP ones wasn't even a thing for even a a jump off. Yeah. And then I remembered the, Virta program that my company, JLL, provided, through the town halls and the newsletters, and I decided to go ahead and look into it. And I really love the fact that it was changing the way you eat, and it was all natural. And so I started the program and, you know, thanks to the support of the coaches and the nutritionist within the program, I found myself being very successful. Obviously, it was hard in the beginning. Everything. that you start is always hard, but that consistency really makes a difference. And I was able to go on vacations, celebrate holidays, and even participate in, family gatherings where, you know, it's a Latin background. So. I was able to take a posole that actually has meat and broth that I was able to eat, but I wasn't able to eat the the hominin, so I would pour that over cauliflower. So I was able to use the tools that I was learning through the program to modify the foods that was being presented every single day in order to help my body to process that food in a healthy way. Within fifteen months, I lost a 100 pounds, And my son hugged me and his hands touched for the first time, and he was like, mom, my hands can touch. It was like the best feeling in the world. Amazing. It was. And then, you know, he was, very successful in doing his first Spartan race in November '23. And I had already started working out because I wanted to be stronger, not just losing the weight. I wanted to to have that strength as well. And because of the fact that I had been changing my lifestyle, the pain and inflammation had gone away. The depression was gone. All my numbers were were good again. And so I decided to do my first Spartan race in April of of twenty four. And so now we do it together. I've done two five k's and two ten k's, and, you know, I'm still with the program. I still am, you know, changing this my son says a diet, and I always say, it's not a diet. It's a lifestyle. But it's been great for me, and I love sharing my story and hoping others, you know, take that same, step towards their health for long term success and not just for the moment. Amazing. Amazing. Well, congrats on, on your success, and, and the amazing, things that you're doing with your son, the amazing example that you're setting, and the experience that you're having together. You know, when I hear you talk, what really resonates with me, and we hear this a lot, from our members around Virta, is how so much of, the outcomes that you get by taking control of the root cause of metabolic dysfunction through nutrition has really a lot of impacts. Right? Not only are you impacting your life, but you're impacting your son's life. What I also heard was really there was, like, a whole health improvement. You mentioned, you know, there was back and knee pain. There was, there was, depression. There was other things going on that were maybe triggered by a prediabetes concern. How have you felt, you know, kinda, other outcomes. in your own life, and feeling, feeling across those sorts of things that were, kind of culminating as problems in the beginning, now that you're, at this at this new stage of life. Yeah. I would definitely say that, taking that step to changing how I'm eating has changed my whole life. I mean, I would say today I am happier than I have been in in many years and it's all part of it, right? If your body is not well, your mental state is not going to be well either And taking control of that in a natural way has been life changing, honestly. And not having to rely on a medication, on some other foreign item that you're putting into your body, and just changing what you choose to eat every single day. So that way your body is getting the nutrients that it needs, it's getting the support that it needs, and it's not anything that it's foreign. It's something that you can go ahead and and, continually use every single day. Yeah. Amazing. Well, Candy, thank you. Thanks again for sharing, and thanks for all that you do, to to bring up those around you, and to lift all of us up today. I will wish. you well. Feel free to, jump off now. But, again, really appreciate the time and see that there's some, great love in the chat too. So I'm gonna I'm gonna take that and, and, use that opportunity to really talk about those the the types of impact that Virta is having more broadly as well. Candy has shown us that she's had a broad impact on her community, on her own health from, multiple points of view. And here's some here's really the power that metabolic disease reversal offers. Virta, just as one organization, has seen, over our time, about £4,000,000 lost, over $1,000,000,000 in health care costs saved, for those folks who were insulin dependent when they came into Virta. 75,000,000 units of insulin reduced and eliminated, which is, just amazing. And here's what it looks like to, the results, outside of the great cost savings that we're having, or in addition, I should say, is, is real weight loss that sustained over time. So, we see about 13% average weight loss at twelve months for Virta members, using just our nutrition approach. And then when we look at individuals who have GLP one access for weight loss, Virta's approach is to give choice and support to individuals that focuses on, nutrition only being a terrific opportunity, but also an off ramp for GLP ones being an important part of a future journey even if they are a tool that's gonna be important in your personal journey. When we look at those populations, we see, those folks who did only nutrition just at nine months are tracking about right about what you'd see on the left, at 9% weight loss. And those folks who are doing nutrition only and a GLP one, are seeing just a little bit more, really, what you'd expect. Right? A great way to kind of accelerate results. But we've also effectively cut, GLP ones by about 50% in the populations that we're managing this with. And you can see in just a little bit of time that GLP ones for weight loss has become, such a, a center point in our in our, in our community and in our country. We have avoided a 118,000,000 in GLP one costs across our clients, who offer GLP ones for, for weight loss and who, rely on Virta to help manage that experience effectively, both from our cost investment and from a health outcomes perspective. When, when we think about GLP ones and Virta's or a reversal solutions, placed within them, This is really the perspective that we found really powerful and would encourage you to think about both for your business and for your people. Our perspective is nutrition first. And not only does that is that, Virta's ethos and belief in what, is most impactful and, most efficacious, from a health improvement perspective, it is often surprisingly to some people. It's what most people want. I think there's a a default kinda narrative in our country right now that everyone's looking for an easy button. And, yeah, I think we all want a good place to start. But our our data shows that sixty nine percent of individuals would rather lose weight or sustain their weight without medication, which tracks with how we think about other medications. Right? Now people don't wanna be on insulin for diabetes forever, etcetera. So, we love this left hand turn this left hand option, where, Virta and, disease reversal are is really seen as an alternative to GLP ones. The ability to get equal results, or, equivalent results with just using nutrition that's personalized to your body, and then as a complement to GLP ones as well. We see that really in these three phases. A great gatekeeping opportunity, right, to make sure that people aren't gonna start and then fall off. So having a centralized GLP ones management in a partner like Virta really does help make this, not just something that people are gonna go grab for vanity, but actually see it as a serious choice. As a co therapy, a great way to maximize GLP one's impact is to learn how to eat right for your body at the same time. So not only can you, minimize, side effects and negative side effects from a GLP one, but you can also maximize, the the impact of those results and, of course, as an off ramp. If you look at, the pharmaceutical company's data, they will show that if you come off a GLP one, you are going to gain all that weight right back. And I don't doubt that that's true if you haven't changed the way that you eat, from before GLP one to after. But as we're, provided as a co therapy to coach people how to understand their bodies and eat right for their bodies at the same time that they're taking GLP ones, we're able to eliminate that GLP one, in a really personalized way for each individual based on their outcomes, and based on, their health in, in, obviously, in agreement, with their provider from Virta, and we're able to see really minimal weight, weight gain afterwards. 85 of weight loss on a on a GLP one is sustained afterwards. You can see some of the other terrific impact, like, really life changing impact, that metabolic disease reversal is having. We focus a lot on the elimination of medications and the reduction and sustained reduction of weight over time. But when we make when we heal the metabolism from the root, we see massive impact across a number of condition states. Virta has been proven to, reduce heart attack, stroke, and death by fifty six percent in our patients compared to a rigorously matched cohort. We see reduction of new onset, CKD at forty five percent, and we see reduction in advanced liver disease, including NASH of sixty two percent. Really, yeah, you know, really, truly, food as medicine, is not only impacting weight. It impacts so much of the, conditions and the cost centers that you're experiencing as well. And Virta's really proven that that root cause healing will have massive, results throughout all of the the, the limbs of the metabolic disease tree. And as we saw with candy, right, we can we can look at metabolic conditions and the improvements thereof. But this is a whole person improvement. It's a whole person perspective. And we see results like brighter moods, having more energies, reduction in depression, improvement in MSK and other conditions as well, which is just a a phenomenal, as Nikki already mentioned, phenomenal gift to give your people. And when we can be a better version of ourselves, the net is really wide as to, the impact that we can deliver. Virta also is and and, the Virta method really fits every plate from barbecue to burrito bowls. Right? When we look at our, at our populations just like candy, right, many of them have Latin American, roots and, food preferences that they either grew up with or adhere to. Many, grew up in in households that, have a a large basis on rice or other grains as part of their, culinary traditions. Many grew up in places where pizza crust was part of their culinary tradition. But you can see across all of those cuisines enjoyed, we see really similar success, on Virta and the ability to really meet people where they are through simple swaps that can continue to keep, their culinary preferences, but simple swaps like the crepe prisole, swap that Candy taught us as well. Alright. With that, I'd love to, bring in our panelists a little bit more for a wide a wider discussion here, on, and with this kind of statement in mind that the best disease management today is really disease reversal. So with that, doctor Frank, what excites you about the data that we've shared today? Well, I think it's really the real world results and what that means from a patient's story level or a member story level. You know, I just think about Candy's story and just the tremendous progress that she's made and how it's changed her life. And I contrast that, you know, with what I experienced for twenty years. The patients that I watched suffer their first stroke because of their diabetes and hypertension and watch how they suffered after that, how their family suffered. Watching people go into kidney failure and end up on dialysis. So seeing the real world impact in such a powerful way is really important. You know, people have been trained in diabetes management for decades. A lot of people don't know this kind of an approach is possible. We have our clinical trial, which we started over ten years ago to demonstrate what we were able to accomplish with this approach. Now we have real world data. And the data that you were talking about, these are hard endpoints. These aren't risk factors. They're not surrogate markers. They're things like heart attack, stroke, death, progression to kidney disease, progression to liver disease. You know, these types of things showing up in the claims and affecting the cost of care is just amazing to me how powerful this can be, demonstrated again and again. And the last thing I would say is just, the ability to see this translate into population after population. So that's all exciting to me. Yeah. Amazing. Nikki, what would you share in addition? I mean, I have to second the personal stories. You know, they're they're so impactful, and I think on the report, there's there's somewhere I've seen it, that there's 500,000 new pair of jeans, you know, that that are, purchased, Yes. from board of members, and everybody understands that. Right? Buying. a smaller pair of jeans or fitting into an old pair that you've saved in the back of your closet for the you know, someday, that is one of the most exciting things. And then the when we look at the medication, you know, if we're talking about just even a blood pressure medication, that doesn't make you typically feel better mentally, emotionally. Yeah. It doesn't typically, you know, make you boost your confidence or boost your self esteem, you know. So this food as medicine idea, it really has that whole person impact. And that to me is is so exciting because it's like one thing that can fix a lot of things, right, and can have this huge, effect. And then the the cost savings, not not only from an employer perspective, but a a personal, you know, the individual perspective. So as I said earlier, we have a 38 prescript 38% prescription elimination. That's real numbers. And as as, you know, an individual that improves quality of life, not having to remember to take that daily pill, that, you know, money that they've saved at the pharmacy and eliminating those side effects. So all of that, it's all great stuff. Yeah. Yes. Absolutely. Well said. And let's talk a little bit more about GLP ones. Obviously, they've been, you know, a huge presence in our cost experience, on TV ad ads, in news, etcetera over the last couple of years. Where do they fit in, and are they the solution that everyone has been looking for? Doctor Frank, maybe you can start us there. Certainly. Well, so the first thing I would say is they are not the entire solution. These are powerful medications. We are not anti medication. We're just nutrition first and appropriate medication use when it is appropriate. But I guess the thing that I think about when I take a step back is that, again, the way that I was trained was to work on all these individual branches using medicines appropriately when it was appropriate for the blood pressure, for the sugar level, for the cholesterol. And that meant a lot of medicines for a lot of different branches. One of the things that I think is interesting about the GLP ones is that, of course, they're working on multiple conditions. And that's probably, in my mind, because they're working a little bit further toward the trunk. They're working on bigger branches, if you will. So in a way, it's not too surprising that their metabolic overlap starts to affect things like glucose and being able to treat diabetes, helping people lose weight, helping people with the fat deposition within their liver. These medications are working a little bit closer to the root, and so they do have more of an effect in more areas. But they're still not addressing the root cause in the way that nutrition can. And so my perspective is very strongly that they can be a piece of the puzzle, but it always needs to be coupled with something that is really focused on that nutrition and on that lifestyle and trying to get that right first, using the medicine as an adjunct to that as they were approved by the FDA, but not trying to rely on it as the sole part as the sole solution. Amazing. And, Nikki, I know you your organization has a specific point of view on GLP ones. Do you wanna share it with the audience as well? Yeah. I mean, this is probably the most obvious statement today that the cost with GLP ones are incredibly high, and I think that not every employer who decided to cover them was prepared for that. At Regions, we do not cover GLP ones for weight loss only. We we did for a while, before before this this hype, with with GLP ones for weight loss, we did not have that, that restriction in place. And so we had about 400 associates that were taking GLP ones that did not have a diabetes diagnosis. And so when we stopped covering those, unless you had a type two diabetes diagnosis, we launched Virta at the same time to help off ramp from the GLP ones and and kind of give, you know, just something else for an associate who still wanted to have that great success, and and not leave them hanging. We did have some pushback initially, and and then once people got into the program and really saw that, I mean, it's a physician led program. They have a whole team of people who have this wrap around support. They've got a health coach that they can chat with at any time that they want. There's an online social community where they can share obstacles. They can get recipes and tips and tricks, you know, from what worked for you to get through, you know, this this time frame, or or Thanksgiving, you know, like that holiday that's so surrounded by food. How do you get through a holiday like that? You know, this social component really has helped people to share their experiences, and they get to see how day to day, their food, you know, impacts their blood sugar, affects their weight, with these biomarkers and and checking those in the within the app. You know, in a world where we are craving that instant gratification, I think that's as close as you can get to it in weight loss, is seeing how your choices affect your biomarkers daily. That plus building. on the knowledge, the the education that comes with the program, all of that equaling long term success, and and a decrease in the medication spend. Yeah. Excellent. Well said. I'm gonna actually, ask you to to to stay on here. I think we have a couple of questions on how to position this to your organization. You know, obviously, all of us know, there's a process to get new programs approved, new budget approved. What would you recommend, in for individuals who are looking to, bring this forward and get it approved? Yeah. I I I think just looking at your your spend, your top costs, and and and obviously seeing that, metabolic health is probably right up there at the very top. And then look for solutions that drive true outcomes. A lot of solutions will say that they they will provide these outcomes, and not just short term symptom management, you know, so but you gotta find one that fits your culture. You know, vet very deeply through that RFP process. Make sure that they do what they say they're gonna do. Don't be afraid to ask difficult questions. You know, what does the data say? What do your participants say? Not just in the first month of the program, but then after that first year. And then once you, have made that decision, you know, over communicate it. Like I said earlier, you know, constantly talking about the program, to make sure that not just those who have the chronic condition, but every associate, everyone company wide knows, hey, we've rolled out this great program. Because when we have shared success, when, you know, an associate talks about frustration with weight in the work environment and a coworker says, hey, didn't we just get an email about this this program? And so, you know, just making sure that you look at what fits your culture, and talking about, the participants and how they, went through the program and what the participants are saying. Excellent. Thank you. Frank, anything you would add? Well, I think when you're evaluating potential solutions, it's always important that you come away with a decision that you feel, is going to be effective, that is really going to move the needle and make a difference for the health and also for the cost of taking care of folks. And that means working with something that is really based in the science and in the evidence, that ideally has validation, third party validation, peer reviewed publications, so so that you have confidence in that. And I think the second piece to that is how are those outcomes demonstrated after you launch, after you start? You really wanna know how those are gonna be manifested in terms of clinical outcomes, but also hard dollar savings. What is that really gonna mean for the bottom line, especially when you're talking about very expensive care like the use of GLP ones? And the last thing that I would say is, you know, be open minded. Be willing to take a step back and consider approaches that might not be the standard of care or the status quo. If you're wondering about whether or not this might be right for you, talk to your peers. There's a lot of experience out there with different solutions. You can get a pretty good idea of what's working and what isn't working. Great. Good advice. Alright. Well, we're going to, go into, like, our our q and a session here, a little bit more q and a. But before we wrap up there, I just wanna, summarize here that really reversal can redefine the trajectory of chronic disease, which means reversal can really redefine the trajectory of your health care costs associated with those chronic diseases. And you can see, again, a handful of the results that, of the clinical outcomes that represent that, including that average of 13% weight loss, without a GLP one. And I think another important one there, about, almost fifty percent, pharmaceutical reduction, which would be compared to seven percent increase, in prescriptions in traditional, benchmark care. So a huge opportunity to think differently than the status quo and get different results than the, higher costs, poorer health that we're seeing from the status quo today, not to mention the massive impact across the full spectrum, including heart attack, stroke, and death. With that, we'll go into some q and a, and I'll leave this slide up for our audience to have a couple of, takeaways with them if interested. We're talking today about some of the results that are in our, annual report on metabolic disease reversal. And if you haven't read it, I appreciate that Nikki clearly has because she knows the genes reference in it as well. Go ahead and, you can snag that, report right there. You can also find it on our website, of course, and so on. And if you're interested in learning more about, Virta, but also more about, metabolic disease, and the reality of metabolic disease reversal, please join us for our upcoming moonshots event. This is our, our premier event for the year, where we bring together a pretty full day of, of thought leaders, both scientists and, other, lifestyle experts, to talk about and experts around the health, community, and HR community to talk about the impacts, that they're having from, metabolic disease, what the research is, and what the real life impact is as well. And speaking of real life impact, we'll be featuring, Ricky Lake, in that time as well, somebody that, I'm sure most of you, know and grew up with as I feel like, I I as I feel like I did as well. So with that, let's dive into, a couple of questions, that we have as well. We'll leave this, slide up. Can you talk more about, weight loss and the impact of reversal on GLP one costs? Frank, maybe I'll put that one for you first. Yeah. Certainly. So this type of an approach has absolutely the ability to affect the GLP-one use and the GLP-one costs. The first, as I think Laura described very well, is that this can be an alternative to GLP-1s, and we know that not everyone wants to take a medication to try to deal with their metabolic issues. So if you can avoid a GLP-one, of course, that affects the cost. The other aspect of that is that we know that many people that are using the medicines are not using them effectively. They're not using them at optimal doses. They're on the medicine, off the medicine. They're taking them and stopping the medicine and cycling on and off. The bottom line is there's a lot of spend there without a lot of clinical outcome. And the last thing is that I think some people are really getting this message that GLP ones are for life. And there are some individuals that probably do need to be on these medicines for chronic medical conditions that we can't cure, that we can't turn around, and that's appropriate for them. But for the majority of individuals, they don't necessarily need to be life term medicines. And so if you can provide a successful off ramp, of course, that truncates that cost. It significantly decreases the overall cost. So it affects that on all three of those fronts. Terrific. Thank you for that. Another question that came in has to do with really thinking about, you know, your whole benefits portfolio. And, Nikki, I'll I'll point this one to you, please. How does metabolic disease reversal fit into a broader benefits portfolio? Do you think of it as a stand alone solution, or can it fit alongside other offerings? At Regions, I mean, it has to fit alongside other offerings. It is, you know, mentioned in all of our benefits communications, whether we're talking about mental health, financial well-being, you know, whatever it is, it's mentioned there because it has an impact on everything. Right? We've we've talked about that. One of the first stats on the slides was that ninety three percent of adults are metabolically unhealthy. I mean, this alone is, a use case here for, incorporating this into our broader, benefit solution where, we're addressing the root cause and we're, incorporating it into all other aspects because it has that that trickle down effect. I personally have used Virta. I've lost 15 pounds. But even more important than that, there's three other things that really have woken me up, and and it affects other parts. And this is where I'm getting to with the other benefit, the the broader, benefit landscape is that, it increased my energy. I had an incredible energy shift. I'm 45. I'm perimenopausal. I've got kids in multiple sports in middle school. I feel like I had I'm exhausted tattooed on my forehead. You know, but this has given me an energy that I really didn't know I could summon anymore. The hunger, the food noise, I'm only hungry right before a meal. I'm not starving, like, hangry, get out of my way hunger. You know, I don't snack anymore. I don't really crave the the foods that I normally would. I don't wake up with my stomach growling. And lastly, the chronic lower back pain that I have had for as long as I can remember. It's not like an intense pain, but I'm aware of it most days. So about three weeks into Virta, I realized it was gone. It took me a day or two to really believe that it was gone, and that has it's been the biggest eye opener for me. So when we look at, like, chronic, chronic pain and knee and hip and back surgeries and all of that, you know, just this, this this time that I've spent with Virta has prevented me from going to physical therapy or, you know, something beyond that to see what's really going on. And so I think having this as kind of your your roots of your tree, in your benefit landscape, really will have that effect, branching out into all other areas. That's wonderful. Thank you. And I'll expound on, you know, being close to, you know, the hundreds of customers that Verta serves today and the millions of lives, in my role. I see employers, you know, make choices like, like Nikki did, really thinking about it holistically. We do see employers who are, you know, concerned with a starting point of, of not wanting to change the status quo too quickly so they actually put Virta in alongside a status quo disease management program or something like that. But increasingly, more and more employers, I think over 80% of the customers who bought, Virta so far in 2025, for their populations did so for what we call, like, the full suite of services. Right? Really to see it as a replacement and, a new, approach for how they want to, see, you know, traditional, eligibility things like diabetes and, and and weight, be addressed, but increasingly, obviously, as a root cause solution, for the metabolic disease that they're impacting as well. Alright. We've got, one minute and forty seconds left, and we will stop on the dime when this tie when the clock is done. So I'll ask one quick question, Frank, of you. Do you see any trend in demographics of people who are most likely to adopt the program? We know we're seeing up to 30% of populations engage inverted today, but any demographic trends that you're aware of? I I think the main thing is that people are becoming increasingly aware of the fact that when they're struggling with weight issues, it isn't just the weight issues. It's the host of metabolic conditions. And so where we used to be very focused on diabetes, the majority of our patients were patients with diabetes or prediabetes. Now we're seeing more and more people who are coming to us saying, look, I know I've got some weight that I need to lose, but I'm more interested in dealing with my metabolic health overall. Yep. Yep. It's yeah. It's a real revolution. And we're excited to be out here leading it and excited to have more people join us on it, understanding that the status quo doesn't work, hasn't worked, and that there is a new and better way. You know, the new disease management is disease reversal. And, thank you all for being a part of this time to talk more about that. Thanks always, doctor Frank Dumont. I'm doing so many great things in educating in the community. Thank you so much, Nikki. You are an incredible, partner, and incredible kinda advocate for, health for your people and for your business, and always inspired to have you along, as well. Thanks for sharing your experience, and thanks to all of our attendees for being part of today's session. As we mentioned, you'll get a survey that we'd love your reaction on, and a recording for today as well. With that, take care, everyone.