Dr. Florencia Halperin is the Chief Medical Officer at Form Health, where she designed, implemented, and scaled the company’s science-driven virtual care model. Leveraging her unique expertise in obesity medicine, Form Health has developed its telehealth platform to deliver personalized, comprehensive care to patients nationwide, driving measurable improvements in patient outcomes while addressing critical gaps in access to high-quality obesity care.

Florencia Halperin, MD, MMSc, Chief Medical Officer at Form Health

The Pulse: Could you tell us about your background and how you ended up at Form?

Florencia Halperin: I’m an endocrinologist by training, and I did all my training at Harvard Medical School. When I was training in endocrinology, I honestly thought I would have a career in diabetes, but I got the opportunity to work on a research study that got me interested in the concept of people losing weight to improve their health. I saw how transformative it was for patients. When people lose weight, we can take them off insulin and blood pressure medications, but we also see how much it improves their quality of life – they say things like they can walk around the lake now or get on the floor and play with their grandkids. It’s an incredible thing to participate in as a healthcare professional. It was a very exciting time in obesity medicine because we were starting to understand more about bariatric surgery and were seeing obesity medication coming into the clinic. I did my internal medicine residency and endocrinology fellowship at Brigham and Women’s Hospital, then was given the opportunity to be the Founder and Co-Director of the Center for Weight Management and Metabolic Surgery, and served as the Chief of Endocrinology at Brigham and Women’s Faulkner Hospital.

It was actually a patient of mine who introduced me to Form’s founder and CEO, Evan Richardson, who shared his mission to expand access to high-quality obesity care through telehealth. I thought that was phenomenal because one thing that the patients at the hospital always complained about was the difficulty of scheduling appointments and traveling to the hospital since treatment requires accountability and frequent visits. So, in 2019, I joined Form to develop this model to prevent and treat obesity.

The Pulse: How has obesity medicine changed since GLP-1s entered the picture?

FH: They have truly transformed this field. And the main reason is that they drive so much more weight loss than the treatments that we had before. Medications for obesity are not new, but we used to see 5-8% weight loss and now we’re seeing 15-20%. It’s very exciting that medications are getting much closer to the results that bariatric surgery drives. I’ve been happy to see how the conversations in media have driven forward the understanding that obesity is a chronic metabolic disease. The old mentality was that obesity was something experienced by a person who doesn’t have the willpower not to eat certain foods or who’s lazy, but it doesn’t make sense that a medication would treat it if that’s what it is, right? It’s really driven by biology. Weight regulation happens through the brain with all of these different hormones and pathways.

But there is also a flip side. This demand for a specific medication is unprecedented. No one walks into cardiology clinics asking for a specific blood pressure medication. This is something different that we’re dealing with, and that has changed the practice of obesity medicine and the conversations with patients. The medications are extremely expensive, and we need to figure out this access piece – how economic and healthcare access affect people’s ability to get these medications, as well as how payers think about coverage. There are some real positives and definitely some challenges for us as a society to work through in this new era of obesity treatment.

The Pulse: What are the unique aspects of Form’s care model and team that are driving Form’s impressive patient outcomes, compared to traditional in-person treatment models?

FH: At Form Health, all care is provided through telehealth and that’s very impactful for patients because it’s so convenient, but it also really allows us to serve people everywhere. We serve at a national scale and can reach people where there are no obesity clinics or experts. So that’s really core to our impact. Every patient gets a care team, which includes an American Board of Obesity Medicine (ABOM) physician who’s an expert in obesity care, and a Registered Dietician who also has specialized training in obesity. We only use evidence-based tools. That means we hold ourselves to the standard that randomized controlled trials have to prove impact before we incorporate that tool into our toolbox. We believe in a comprehensive approach that provides individualized care plans and medical services rather than just being a place to get a prescription. If you work at night, for example, you have a different metabolic profile and different challenges to a healthy lifestyle. We think about patient disease severity and about sustainable behavior change because it’s one thing to know that certain lifestyle pieces are healthier than others and it’s another thing to change your habits and to have them stick.

So, we’re really about sustainable lifestyle change, and then we leverage medications if appropriate. It’s not just GLP-1s; it’s everything that’s FDA-approved since we believe in using the full toolbox while holding ourselves to that standard of evidence-based care. We have a huge focus on safety that allows our clinicians to deliver high-quality care. Something that’s been of concern to me is using compounded versions of GLP-1 medications because they are not FDA-approved or regulated and come with real quality concerns and safety risks.

The Pulse: As a fast-growing venture-backed company, what strategies or tenets do you adhere to as a clinician to maintain a patient-centered approach and ensure provider satisfaction?

FH: One thing I’ve learned in this journey and for me personally transitioning from an academic center to a venture-backed company: there is a tension between a patient centered approach and financial business reality. But I feel so lucky Form’s leadership team puts patients first as our top core value. That comes from the top down, and the people on the business side are aligned as well. We’re here to provide safe and effective and evidence-based care. The reality is Form needs to operate in a financially viable way for our clinicians to have an impact with patients, so we try to be very honest with ourselves about those trade-offs.

There are only about 10,000 ABOM diplomates, which isn’t enough, and we’re also in a provider burnout crisis in healthcare. Creating a meaningful workplace has been a passion of mine, and we put a huge emphasis on provider satisfaction. We utilize technology, AI scribes for instance, to ease the burden on providers and let them spend time with patients, which is their area of expertise and what they find most meaningful. It’s also wonderful to work in a community of clinicians who all have a similar passion. While our clinicians work remotely across the country, we foster a strong sense of community through weekly meetings, journal clubs, and clinical case discussions. This helps our team stay connected and find purpose in their work.

The Pulse: As Form continues to expand its employer partnerships while maintaining a direct-to-consumer (DTC) offering, have you adapted your care model to address the unique needs, constraints, and expectations of these distinct market segments?

FH: Form Health started with a DTC model because it was the easiest to stand up and allowed us to demonstrate outcomes, safety, and efficacy. Now, as we work with employer partners, the core of our care model remains the same. However, we work closely with employers to define benefits and educate them about obesity as a chronic disease and the different models available.

One unique aspect of our employer model is the disease severity stratification system we’ve developed. This helps us identify employees with the highest levels of metabolic dysfunction and focus more intensive treatment on them, while still offering care to everyone, whether it’s preventative or weight-loss-focused.

We also leverage lower-cost medications for lower-severity patients while reserving more advanced treatments, like GLP-1s, for higher-severity patients. Some employers don’t cover GLP-1s, some cover them broadly for anyone meeting FDA criteria, and others use our severity-adjusted model to tailor treatment access.

Employers with longer employee tenure may prioritize preventative care differently than those with shorter-tenured employees. Ultimately, we aim to expand access to high-quality obesity care. By using the full range of treatments, we can drive ROI and ensure everyone gets appropriate care, even if not everyone is prescribed GLP-1s.

The Pulse: Amidst the rapid pharmaceutical innovation we’re witnessing, what do you think the various stakeholders in the obesity care space should pay careful attention to over the next 5-10 years so that long-term patient outcomes can be achieved with sustainable healthcare spending?

FH: With over 120 drugs reportedly in the pipeline, this is an incredibly exciting time for obesity care. At Form Health, we work to stay at the forefront as new therapies become available. Our expert care model ensures we can identify which drugs are best suited for specific patients based on the best available evidence.

That said, we need to address the high cost of these medications. As more drugs enter the market, we’re hopeful that competition will drive prices down. Over the next five to ten years, treating obesity as the root cause of so many cardiometabolic diseases can lead to significant health benefits for individuals and economic benefits for employers and payers. By preventing conditions like prediabetes or heart attacks, we can substantially reduce healthcare spending.

It’s also critical to refine how we match treatments to the right patients. We’re already seeing progress—for example, Wegovy is now approved for preventing cardiovascular disease in individuals with obesity or who are overweight along with established cardiovascular conditions. This is an excellent step toward tailoring treatments to specific populations based on rigorous evidence.

Looking ahead, the range of treatments will continue to expand beyond drugs. Gene therapies, devices, and procedures may play a growing role in obesity care. Ultimately, the goal of long-term sustainability remains — both in weight loss and disease prevention.

Interviewed by Vikram Chari, December 13, 2024.