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The $18 billion nutrition industry has a dirty secret: most dietitians make below minimum wage. 

Sam Faycurry couldn't watch his mom and sister, both registered dietitians, get screwed by this broken system. So he dropped out of Harvard to help them make a decent living.

In 3 years, he turned helping his family into a $50M+/year healthcare startup called Fay with over 3,000 providers.

They've now raised $75M total across three rounds @ a $500M valuation.

Let's dive into the wild story of Fay and their master plan to disrupt the entire nutrition industry👇.

From family favor to healthcare revolution

Sam never planned to start a healthcare unicorn. He was just a protective son & older brother who couldn't stand watching his family work for minimum wage.

He is the oldest of five kids from Chicago's northwest suburbs. His mom and sister are both registered dietitians, and they were getting absolutely crushed by the healthcare system. They spent months trying to get credentialed with insurance companies and handling billing nightmares that would make a tax attorney cry. 

Most importantly, they are not getting compensated for all the admin BS they have to deal with on a daily basis.

"Dietitians are super sidelined in the healthcare system. They really wanted to start their own private practice and be the star of the show. The core problem is that they often have to spend over 6 hours prepping for a session to provide high quality of care but only getting paid for that one hour long appointment for about $100.”

Sam

Simple math here:

  • Earning: $100 / one hour session

  • Hours spent: 6 hours of prep & admin work to get paid + 1 hour session

  • Effective earning: ~$14/hour

As he dug deeper into the nutrition space, a few key insights stood out:

  1. Nearly half of U.S. adults suffer from at least 1 or more preventable chronic diseases, most of which are linked to poor eating habits. Yet many patients don’t realize that their health insurance often covers visits with registered dietitians.

  2. At the same time, insurance companies are spending heavily on reactive treatments rather than prevention and they lack solid data on the outcomes of lifestyle interventions. They’re actively seeking preventative solutions that can help patients get healthier and reduce long-term costs.

It's a system where literally everyone loses. Except maybe the pharmaceutical companies…(GLP I am looking at you).

So he did what any rational Harvard MBA student would do: he built them a solution. 

Product evolution: building the "business-in-a-box" 

1/ The duct tape MVP (2022)

The MVP tech stack was simple: WordPress for the website, Zoom for video calls, Calendly for scheduling, Airtable for database, and some dirty, dirty Python scripts.

The new system completely transformed the way his mom and sister worked. It wasn’t seamless. At first, they were frustrated by the learning curve and skeptical of the changes.

But even in its rough, Frankenstein-like MVP form, the tool did what it needed to: it automated billing, scheduling, and other manual tasks that used to take 6.5 hours per session.

Their hourly rate jumped from $20 to $75 🔥.

This experience gave him the confidence to double down on this idea. He partnered with Mark Stefanski as his technical cofounder to build a best in class product that leverages AI, dropped out of Harvard, and raised a $5M seed led by General Catalyst in early 2023. 

2/ Three sided marketplace product

Since 2023, Sam and his team have been quietly building a business-in-a-box platform for dietitians, along with a robust set of tools for patients, enterprise clients, and insurance companies.

For dietitians, it's like having a supercharged business manager, all for FREE. Besides standard admin features like scheduling and payment, Fay offers an AI meal planning tool that turns multi-hour tasks into 30-second workflows, automated insurance billing that actually works, client management tools built specifically for nutrition counseling, an AI research assistant with clinical-grade databases. 

For patients, it's like having a concierge service for nutrition, fully covered by insurance. Fay now offers a mobile app for patients. They can find and book in-network dietitians instantly through the app. They can log meals and journal while having access to dietitians 24/7 (50% of conversations powered by AI). 

For employers and insurance companies, Fay acts as a preventative care engine. The platform plugs directly into existing benefits systems and provides access to a nationwide network of 3,000+ registered dietitians across 30+ specialties. Fay shares aggregated health engagement data and outcomes to help partners track ROI on preventative care, while lowering long-term costs tied to chronic conditions.

3/ Fay’s business model

Dietitians: FREE to use the platform and get paid a contracted rate 

Patients: FREE for most due to insurance coverage

Fay: Makes money from referral partners, including employers and insurance companies, for providing them with a group of in-network dietitians that they can refer patients to.

Fay’s growth playbook

1/ Supply side growth: dietitians

Getting quality registered dietitians onboard has been a priority from day 1. It’s where the Fay team has invested the most time on the product side.

Majority of the growth here has come from Facebook groups and peer referrals.

  1. FB groups: posting in different dietitian Facebook groups about Fay. It’s not a hard sell since the platform is free to use for dietitians. However, I suspect this is becoming a harder sell with increasing competition from Berry Street and Nourish

  2. Peer referral: one growth hack is that for any dietitian that wants to get activated on Fay, they would have to refer 3 other dietitian friends. It further accelerates the existing organic WOM spread.

They have grown the platform from 50 RDs at launch to 3000+ today, the biggest network in the US. 

One interesting dynamic is that there are only ~100,000 RDs nationally, so future growth could be supply-constrained unless they expand into adjacent provider types or international markets.

2/ Demand side growth: patients

Similar to many other healthcare platforms, Fay has a B2B2C GTM motion on the demand side.

  1. Employer benefits programs: Companies like Amazon, Microsoft, and Pepsi offer Fay as a covered benefit. Employees discover it through their benefits portal.

  2. Doctor referrals: Primary care physicians and specialists refer patients to Fay when they need nutrition support. This creates high-intent, qualified leads since patients are coming with medical recommendations.

  3. Dietitian networks: Their 3,000+ dietitians bring their existing patient relationships to the platform. Many dietitians had clients before joining Fay and migrated them over for better insurance coverage and tools.

3/ Demand side growth: payors

a) Insurance companies:

Building trust with insurance companies is notoriously difficult, but Fay cracked the code by leading with proof, not promises.

Most startups approach insurers with theoretical ROI models and pilot proposals. Fay took a different approach: they showed up with working integrations and real data from day one.

"We very clearly solved the problem that they had and we were willing to integrate with their system, which is chewing nails."

Sam

Immediate value delivery: Fay plugged directly into existing claims systems and started processing real patients immediately. Insurance companies could see actual utilization and outcomes, not just projections.

Network coverage: Fay instantly solved rural provider gaps. Insurance companies could suddenly offer nutrition benefits in ZIP codes where they had zero local dietitians.

b) Employers:

The employer channel has become their fastest-growing segment, driven by the GLP-1 cost explosion.

Companies are seeing healthcare costs skyrocket as employees get prescribed Ozempic, Wegovy, and other GLP-1 medications at $1,000+ per month per person. For large employers, this can add millions to their healthcare costs.

Employers view Fay as:

  1. Cost alternative: Help employees try lifestyle changes before expensive medications

  2. Success amplifier: Support employees already on GLP-1s to maintain results long-term

  3. Prevention play: Reduce future medication needs through early intervention

4/ Traction today

Revenue: $50M per year (as of their most recent Series B)

Providers: 3000+ RDs on the platform

Funding: $75M to date from Goldman Sachs, Forerunner, and more

Valuation: $500M

🌶️ My take on Fay

Fay has built something genuinely impressive.

They're experiencing hyper growth, reaching $50M ARR in just three years. They have built a compelling value proposition that solves real problems for all stakeholders, and have assembled the largest network of registered dietitians in the US. The timing couldn't be better with the GLP-1 tailwind, and they've proven they can execute on the hardest parts, including insurance integration, provider onboarding, and creating real value for patients.  

That said, I do have some concerns.

One concern lies in the supply side bottleneck. There are only ~100,000 registered dietitians in the entire US. Compare that to 500,000 mental health providers. This supply constraint could ultimately cap their ceiling unless they can help expand the pie and encourage more people to become RDs.

In addition, they also face rising competition. Nourish raised $70M Series B in April 2025. Berry Street raised a $50M Series B recently. This is particularly concerning given the supply constraint.

The third area that makes me nervous is long-term customer retention. Nutrition counseling often follows episodic patterns: people get motivated, see a dietitian for a few months, then drop off once they hit their goals or lose momentum. Unlike mental health therapy which can be ongoing for years, nutrition counseling tends to be more project-based. 

Plus, with ChatGPT and other AI tools getting better at nutrition advice, patients might eventually question whether they need human dietitians for basic meal planning and guidance. However, it is important to point out Fay’s patient mobile app does boast an impressive 30% DAU/MAU ratio, which is significantly higher than 9% industry average, but sustaining that over 12-24 months will be the real test.

5 Key Takeaways 

1/ Do the boring, hard stuff. Insurance integration work that competitors avoid becomes your moat. Most want to build the sexy parts but winners do the grunt work.

2/ Free for users, paid by the system. Fay makes money from insurance/employers, not users. Sometimes the best business model is invisible to your customers.

3/ Ride multiple tailwinds at once. GLP-1 cost crisis, preventative care trends, insurance gaps—Sam positioned Fay at the intersection of several macro forces.

4/ Build for people you love first. Sam started by solving his mom and sister's problems. When you're building for family, you can't fake product-market fit.

5/ Rebuild during tech breakthroughs. Fay’s rebuild during the AI boom created 10x efficiency gains. Use major tech shifts as rebuilding opportunities.

See you next Tuesday 😉,

Leo

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