The Crunchbase “Female Founder Series,” is a series of stories, Q&As, and thought-leadership pieces from glass-ceiling-smashers who overcame the odds and are now leading successful companies.
Casey Means, M.D., is a Stanford-trained physician, chief medical officer and co-founder of metabolic health company Levels, as well as associate editor of the International Journal of Disease Reversal and Prevention. Her mission is to maximize human potential and reverse the epidemic of preventable chronic disease by empowering individuals with tech-enabled tools that can inform smart, personalized and sustainable dietary and lifestyle choices.
Means’ perspective has been recently featured in the New York Times, Men’s Health, Forbes and more.
In this Q&A, Means shares her inspiration behind starting a metabolic health company, Levels, and the most valuable lessons she’s learned as the co-founder of a company.
Q: Did you always know you wanted to be an entrepreneur?
Actually, not at all. I spent my life training to become a surgeon, and it was only until I was deeply embedded in the medical profession and able to directly see systems issues up close that I realized I needed to join forces with entrepreneurs to scale innovative solutions to our largest health care problems.
The practice of medicine is inherently a 1:1 interaction; as a physician you are spending time with one individual in that clinic room or operating room, and so there is a limit to how many total people you can serve. However, when you pair clinical knowledge and insights with an entrepreneurial approach, you can create products and services that enable a one-to-many interaction that can, potentially, reach far more people.
In the U.S., it’s estimated that 88 percent of Americans — that’s hundreds of millions of people — have evidence of metabolic dysfunction, and yet we don’t have good tools to track and improve metabolic health for ourselves. For an issue of this magnitude, we need solutions that scale.
Q: What inspired you to start your company?
Empowering individuals to understand their bodies and live their healthiest lives inspires me as a physician and an entrepreneur. Levels is a tool that does this for people.
The majority of chronic illnesses that plague our country are rooted in metabolic dysfunction and insulin resistance. Heart disease, stroke, diabetes, obesity, Alzheimer’s dementia, fatty liver disease, even erectile dysfunction — all link back to problems with our metabolism, and are in large part preventable through dietary and lifestyle choices. These chronic diseases also contribute to 90 percent of our $3.8 trillion health care costs. Unfortunately though, individuals have very little information about their metabolic health throughout their lives, so making optimal food and lifestyle choices is often a frustrating and endless guessing game. With Levels, individuals wear a metabolic sensor called a continuous glucose monitor and use the biofeedback to understand the impact of their food and lifestyle choices in real time.
Very little is normal about modern life. The majority of the food we consume is highly processed, we sleep fewer hours than we need, we experience chronic low-grade stress, and we move less than ever before. In the face of these realities, it can benefit us to have additional support to help us feel our best, and wearables can do that by providing personalized information, motivation and accountability.
Q: What problems were you trying to solve with your company?
Our mission is to reverse the metabolic disease crisis. With 128 million Americans being diabetic or prediabetic, and 72 percent of Americans being overweight or obese, it is imperative that metabolic health is addressed on a large scale in a way that is empowering and patient-driven.
Levels gives members the ability to understand and track their blood sugar levels continuously as a window in their metabolic health. We leverage continuous glucose monitors — a wearable technology — and pair it with insight-driven software to make it easy to know how foods and lifestyle choices are affecting health in real-time. It’s like wearing a mini-lab on your arm, and is the first tool to create a closed feedback loop on nutrition. We’ve had wearables for feedback on fitness, sleep and stress, but never before for nutrition.
People often find that moving toward stable and healthy blood sugar levels improves many aspects of their current functioning, like sleep quality, energy, mood and athletic performance. The long-term goal of keeping blood sugar more stable is that it may reduce the risk of chronic metabolic diseases.
There are many dietary ideologies out there, many that promote conflicting information. According to 59 percent of consumers, this conflicting information makes them doubt their choices. Objective data can cut through some of this noise and make it easier to make personalized choices.
Q: How did you network, find communities and make the connections you needed to succeed?
I think a key to building a professional community successfully is having a clear perspective on your interests and desired impact, and then putting that perspective out there publicly and regularly through evergreen content like writing, podcasts, social media, recorded lectures, or other channels. When your stance on a particular topic or issue is clear and visible, and you share it, community naturally gravitates toward you.
In 2019, I knew I wanted to focus on creating systems or technology that would empower individuals to make better daily choices around food and lifestyle. I explored this concept and started giving talks at local meetups in my area, started posting my thoughts on social media, and became the editor of a medical journal that promotes preventative health. All of these things generated content that more closely associated me with my mission, and made it easier for others to be able to identify me as someone who might add value to their community.
I then put together a slide deck for the company I wanted to start in this space, and circulated it widely to my family and friends for feedback. Very soon, word got around that this is what I was interested in, and I was connected — by my brother, actually, entrepreneur and investor Calley Means — with my Levels co-founders, who were working on a project with some overlap. The rest is history.
Time does not scale, but content does. A one-on-one networking conversation is great, but it doesn’t scale. I think the time investment in creating content will have significantly more impact on building an intentional community and help you clarify your thoughts and goals.
Q: What is the most valuable lesson you’ve learned as the founder of your own company?
Learn to say no at the right times. There are such plentiful opportunities and connections that can be made in this digital, abundant, connected world, and without saying no in an effective way, it is easy to lose focus on key strategic initiatives for the company and to become ineffective and scattered. While it can feel weak to say no, I actually think it’s the most powerful thing you can do to keep your company focused and directed.
Q: How did you connect with VCs? Can you describe your process of raising your last round?
Levels CEO, Sam Corcos, led our fundraise. For a deep dive into all aspects of our fundraise strategy, I highly recommend his two-part series with Jason Yeh “The Secret Science of Fundraising.”
A core principle behind how we approached the raise was transparency. Ideas are cheap and execution is hard, so we are not afraid to share our company strategy and do not spend time worrying about competition. At Levels, we have an constantly growing collection of long-form memos written about nearly every aspect of our company strategy, and we were very open about sharing them with prospective investors and other individuals in our community.
Giving investors a deep look into what’s happening inside your company and how the company is thinking and operating builds confidence. You’re going to get many of the same questions over and over during a raise, so write the answer down in a memo, and follow up investor meetings with this documentation. Since we raised in the middle of the pandemic with no in-person meetings, I think our focus on transparency and ability to effectively share information was especially helpful.
Q: How did you know you were choosing the right investors?
a16z had been our top choice going into the raise, largely because of our interactions with Jeff Jordan. Sam formally raised in September, and Jeff had been involved with the company since earlier that summer — joining our beta program, having a strong personal interest in metabolic health, reading through all the details of our long-form company strategy memos, and being extremely helpful along the way in response to various asks that we had.
When it came time to sign term sheets, Sam sent out a survey to about 50 founder friends asking them how to evaluate what firm we should ultimately go with, and almost every founder said the most important thing is the partner you’re working with. You have to really like the partner, because you’re basically married to them. Jeff is widely known as one of the best people you can work with as a founder, and is universally well respected. Given all of this, going with Jeff and Vijay Pande at a16z was a clear choice.
We also have about 130 angel investors involved in our early funding, ranging from professional athletes (Matthew “Delly” Dellavedova) to tech founders (Michael Arrington. founder of TechCrunch and Crunchbase) to medical leaders (Dr. David Perlmutter, author of Grain Brain), and these individuals have been unbelievably helpful. We keep our investor network updated with our detailed monthly Investor Updates outlining all aspects of our progress, successes and challenges of the prior month, and frequently ping our investors for help with specific things — we call them “Investor Asks” — whether it is strategic advising, facilitating introductions, helping with our hiring pipeline, contributing to press and media, and more. Our investors are a key part of our growth and progress.
Q: What have you found most rewarding about your experience as a founder so far?
Three things:
- As a company building a completely new type of product, customer feedback is everything. Customers are your best resource: They will tell you exactly what you need to build. Get your product in the hands of people early. About 6,000 people have gone through our Beta program, and we interview almost every one for detailed feedback on their experience, which has fed into over 800 releases of our app over the past year. Seeing Levels members make positive changes in their lives using a product our team has built is absolutely incredible. Our product empowers people with their data, so when our members have meaningful, personalized improvements in their lives, it is beautiful to watch.
- It is incredibly rewarding to work with a team of individuals with diverse backgrounds and skill sets, who live all over the world, who are all focused on the same mission that we feel so passionate about.
- Being able to use our platform to educate people about foundational health. Despite metabolic dysfunction being the root cause of most chronic disease and weight gain, many people aren’t fully aware of how much blood sugar plays into their lives. From the very beginning of the company, we’ve been committed to putting out research-based, high-quality content to educate on this topic, so when we see that this has an impact on people, it’s hugely rewarding.
Q: How has your experience as a founder impacted those around you (i.e. friends, your community, family)?
Everyone around me is now obsessed with tracking their glucose. More seriously, I think those around me are more cognizant of how food affects the way they feel, and how individual and personalized their response to food is.
Q: Do you have a favorite quote or “personal mantra” you use to keep yourself motivated?
“Perfect and beautiful.”
These were some of the last words my mother said just moments before she passed away from pancreatic cancer, and they are my mantra for life. These words remind me that the world is full of abundance, and every moment — no matter if it’s challenging — is an opportunity to be grateful, peaceful and joyful. In the face of an imminent death, my mother saw the world as perfect and beautiful, and it reminds me that a positive attitude is a choice. I’m fortunate to work with a team that has an abundance mindset and doesn’t get caught up on the little things; this helps us move fast and maintain positive energy at the company.
