The Entrepreneurial Physician

DID YOU KNOW?!

• 45 million Americans go on a diet each year. (Boston Medical Center)
• Americans spend $33 billion on diet-related programs and products annually. (Boston Medical Center)
• The global weight-loss products and services market was on track to grow from $275.97 billion in 2022 to $299.39 billion in 2023. (Research and Markets Report 2023)
• Globally, it is predicted that the proportion of adults 65 and older will increase from 9.3 percent in 2020 to almost 16 percent in 2050. The rising aging population is expected to propel the weight loss products and services market. (Research and Markets Report 2023)
• Global obesity rates have almost tripled over the past decade. It is currently estimated that 1 billion people are clinically obese, of whom around 650 million are adults. (World Health Organization)

As startling as the statistics are, Dr. Mary Claire Haver was not thinking of the burgeoning diet market when she began researching weight gain, specifically in women as it related to menopause. A wife and mother of two teen girls, she also had a busy OB-GYN practice at the University of Texas Medical Branch (UTMB) in Galveston. For 10 years she was involved in the education of medical students in her role as program director, but as the corporate structure of the hospital began to change, so did the amount of nonpatient tasks. She became increasingly dissatisfied with the direction of corporate health care. The onset of menopause combined with the loss of her brother and a patient death created the perfect storm that resulted in depression and the need for a change.

As Haver began to experience menopause symptoms—weight gain, brain fog, not sleeping, and hot flashes—she realized that what she had been taught about menopause was lacking, and what she had been telling her patients—eat less and exercise more—was wrong. As she gained weight and sunk deeper into depression, she took her own advice and was frustrated that no matter how much she tried the weight wasn’t coming off. Having heard this from her patients for years, the truth hit home once she too experienced the same things. Haver saw a gap in her training.

In medical school and beyond, students learn little about menopause and almost nothing about how it relates to nutrition and hormones. Haver was restricting her caloric intake to dangerous levels, exercising obsessively, and drowning in negative self-talk when her husband reminded her that her daughters were watching and becoming concerned.

Knowing that something had to change, Haver started talking to the nutritionist at the hospital and learned that there was a correlation between inflammation, changes in body composition, and menopause. A determined researcher, she began reading everything she could about menopause, and as she went deeper, she saw that the gap in her training was indeed huge. She’d had about one hour of discussion in medical school, and a little more during her residency, devoted to menopause. At the time, the big discussion was about hormone replacement therapy (HRT), and because little was known, the treatment was discouraged.

As Haver began hormone therapy, she saw that her fears of the treatment were unfounded for her personally. She also realized that she had received little to no training and understood very little about changes brought on during menopause—hair loss, problems with skin and nails, urinary problems, weight gain, osteoporosis, and hypoactive sexual desire. As the correlations between nutrition and especially weight gain became evident, Haver earned a degree in culinary medicine from Tulane University.

THE MOTHER OF INVENTION

The path to entrepreneurship is familiar to founders and CEOs: Necessity becomes the mother of invention. As Haver’s research gave her greater understanding of the big picture of menopause, she took the information she had gathered and created a “back of an envelope” program for herself, her patients, and her friends. Her patients talked up the results, and more people began to come to her clinic, but the big breakthrough came when her daughters convinced her to talk about menopause on social media.

Initially reaching out on Facebook during the COVID-19 pandemic, Haver became a TikTok sensation talking about nutrition, weight gain, and how it was all connected. She initially offered the program free and gained several thousand participants, thanks to social media. Her following caught the attention of another entrepreneurial physician who suggested Haver consider turning her program into a business. Initially, she was hesitant, believing that as a doctor she shouldn’t charge for information that would help so many women.

Haver’s first attempt at a business venture was writing an e-book, which was a failure. No one bought it. Although Haver had no idea how to create or market an online course, she took an online course to learn how to create an online course, then decided she could take the information she had gathered, create a course, and charge a nominal fee. By the end of the first year, the online course had garnered $20,000 in sales at $25 per enrollment.

As her following grew on social media, she began to ask herself if she could leave her medical practice and focus on nutrition and her business. Just before COVID-19 hit, she left her practice to become a hospitalist, which allowed her to continue in medicine but work part time.

Once COVID-19 hit, people began to gain weight and began to connect to her program. With more time on their hands, people were turning to social media for answers, and her daughters convinced her to try reaching out through TikTok. Today, Haver has 2.1 million TikTok devotees and continues to give advice on social media.

“I was absolutely in the right place at the right time,” Haver says. “Everyone was home on their phones. No one was talking about menopause, and women were still having hot flashes and weight gain. They had nowhere to turn, weren’t getting the right information, and they were not willing to just take the same old diagnosis and advice. They had time and found me. I exploded on TikTok. The message was on point. No one else was sharing that kind of information, and it took off.”

The entrepreneurial gods smiled again when her TikTok audience plateaued just as Reels was introduced as a feature on Instagram and Facebook allowed her to expand her audience once again. Currently, her most-engaged and fastest-growing audience is on Instagram. Through her videos, her superpower is taking a plethora of complicated information and data and turning it into smaller, more understandable chunks of information and advice. In total, Haver has more than three million social media followers.

FROM SOCIAL MEDIA TO BESTSELLER LIST

Haver’s growing following garnered the notice of Marnie Cochran, an editor at Random House who urged her to write a book. At first Haver was hesitant to take on another project; her business had grown exponentially and she had expanded her programs to include digital tools and live coaching calls. She finally decided she could reach a bigger audience through a book.

The process of writing and getting the book ready for publication was laborious, Haver says. In January 2023, The Galveston Diet launched and has sold more than 130,000 copies. The book, which touts eating and lifestyle changes to balance nutrition, has been on the bestseller list for 12 weeks. Buoyed by this success, Haver hopes to continue her mission to educate women about menopause and is working on a second book, The New Menopause, which she hopes to publish in the coming year.

The Galveston Diet “has helped so many people, and I am so happy with the reader feedback I have received. I’ve covered the nutrition and lifestyle aspects in The Galveston Diet so I am planning for the next book to be a guide to menopause, covering the medical aspects. Women have reached out to me by the thousands and said, ‘This hit me like a truck. I had no idea what to expect. Our mothers never discussed menopause.’ So if you are in your 30s, the book will let readers know what to expect.

If you are in perimenopause and menopause, it will address the myths around that time and will include information on hormone replacement therapy. For 35 years, a complete hysterectomy was the recommended answer to problems related to menopause. Today, I want women to know what questions to ask their physicians, have an informed conversation, and then, understanding their risk factors, make an informed decision about their options. I would like it to be the go-to resource book for women who want to improve their health overall.”

Continuously listening to her patients and followers, Haver saw a need for supplements and ready-made meals that would complement the nutritional advice in her courses and book. Finding that her online followers were interested in purchasing the supplements even if they were not going to participate in an online program, the business grew to include supplements and a meal program. Leveraging her social media presence has led to shipments of 7,000 to 8,000 units of supplements alone.

Haver continues to practice in her clinic where she has one-on-one consultations based on her research and program. The result is a multimillion-dollar company that continues to grow, educate, and inform women. On the horizon, the next step is starting a training program for other clinicians throughout the United States who want to practice menopause care and do for their patients what Haver has been doing for hers. The mission has become the product.

The ‘Secret’ to Successful Weight Loss and Optimal Health

“Nutrition is the most underutilized medicine yet it is the most effective,” Haver says.

More than five years after people lose weight on a diet, more than half of them gain more back. The Galveston Diet isn’t really a diet, it is a lifestyle change. There are numerous charlatans that say they have a “magic pill,” and while the pharmaceutical industry may be on the brink of finding it, so far doctors are seeing some patients having side effects that can be a problem.

But weight gain is just one thing that needs to be addressed for overall health. Visceral fat accelerates dramatically during menopause, and that represents risk for cardiovascular disease, stroke, diabetes, hypertension, and cancer. It is a powerful inflammatory agent. Women also lose muscle during menopause, and this affects how we function as we get older. Yo-yo diets and severe calorie restrictions lead to even more loss of muscle mass.

Haver’s advice is to stop looking at the scale and watch your nutrition. Track what you eat, eat the protein, see where you are deficient in nutrients, and do the resistance training to stay healthy and strong. Slow and steady weight loss, hanging on to as much muscle as possible, is the goal. If there is a “secret” to the Galveston Diet, it is to adopt a lifestyle that will support overall health. The magic is in learning how to do that.

Haver’s toolkit offers a variety of ideas that provide support and options to patients—nutrition, recommendations for movement and exercise, pharmacology (both hormonal and nonhormonal), advice on the risks and benefits of medications, discussion of supplementation, sleep optimization, stress reduction, and community. All of these things work together for optimal health.

LIGHTENING ROUND

What is your favorite Texas product?

Galveston Brewery Tiki Wheat. Old Gringo Boots.

What is the best advice you ever got?

In business, if you are in growth mode, everything that works will break every two years or so. Don’t take it personally.

How would you summarize your personal approach to leadership?

Lead by example.

What would surprise people about you?

I am part of a very well-known restaurant family, but having lived through my parents’ bankruptcy, I paid for my own college and medical school.

What’s your can’t-live-without-it technology?

Sigh … my phone.

How do you start your day?

Meditation, then exercise.