Arabic healthcare: for us, by us

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Hi friends! 👋

Obesity isn’t just a healthcare challenge. In the GCC, it’s the result of a confluence of factors, from urban planning and rising affluence to cultural norms colliding with modern consumption.

In Saudi Arabia alone, around 70% of adults are overweight or obese. Add GLP-1s like Ozempic, now widely available and often self-administered, into the mix, and you risk creating a recipe that masks the root causes.

Saudi-based Kilow is betting on a different outcome.

Founded by Fahed Al Essa, a healthtech operator who’s built startups across the U.S. and LATAM, and who’s battled both chronic pain and obesity firsthand, Kilow combines asynchronous care, localised coaching, and an Arabic-first interface to tackle metabolic health from the ground up.

The company launched out of Sanabil’s venture studio and announced a $2.5 million Seed round last month.

Rather than reinvent clinical infrastructure, Kilow layers behavioural design atop what already exists, threading telemedicine, lab logistics, and pharmacy delivery into one seamless experience.

Its design choices reflect the realities of the region:

• Async care for shame-sensitive journeys

• Local partnerships over clinical reinvention

• Habit loops built for long-term change

In this conversation, I chat with Fahed about Kilow’s dual-track model for GLP-1 and non-medicated users, why D2C is a necessary (but temporary) proving ground, what asynchronous care gets right about tackling shame and scaling access, and why GLP-1s might be the iPhone of health, with the real innovation still to come in the app layer.

Here’s what we covered:

• 🍽 Why obesity in the GCC isn’t just medical, it’s infrastructural, emotional, and cultural

• 💊 How Kilow’s GLP-1 program uses async coaching and protein-first protocols to beat rebound risk

• 🎯 Why the company’s real moat is not clinical ops, it’s behaviour reinforcement at scale

• 🧠 What Hims & Hers got right about shame-based use cases, and how Kilow localises the model

• 🌍 What it means to build “for us, by us” in Arabic digital health

• ⚖️ How Kilow thinks about weight loss, relapse, and the lifelong dynamics of retention

Let’s get into it 👇

Actionable insights 🧠 🛠️

If you're short on time, here’s what the smartest healthtech operators, product builders, and investors should take away from Fahed Al Essa’s Kilow playbook.

Premium members get the full version of this article, plus a TLDR summary with key takeaways and actionable insights right here.

Okay, let’s dig into it 👇

You’ve built health-tech startups on both sides of the globe, from chronic pain in the U.S. to preventative care in LATAM. What specific problem in Saudi inspired you to return and build Kilow, and how did your past product experiences inform Kilow’s first principles?

We were kids when Dubai was being built up. We saw the growth, but we were too young to participate. For me, the Saudi story feels like that same moment again. I see a complete overhaul of what we knew Saudi to be, and I didn’t want to miss out. I wanted to be part of that evolution. That’s the first part.

The second part is, if you look at obesity, it’s a global problem. It’s something I’ve struggled with throughout my life. But it’s especially acute in the GCC. It’s too hot to walk outside. Our cities aren’t walkable. We don’t really know how to talk about our emotions, so we feed our emotions to people. Love is expressed through food.

You combine that with a very fast rise in affluence, from a Bedouin, nomadic lifestyle to a high-income, sedentary one, and we’ve lost the track of what it means to be healthy, or how to live as a healthy, wealthy population.

We became morbidly obese, lazy, and unprepared for the way we now eat. And this problem isn’t unique to Saudi, it connects Mexico, the U.S., and our region. We all rank among the highest obesity rates globally. The population dynamics, especially in terms of waist demographics are very similar. And the problem persists across all of them.

My experience in startups always comes from personal problems I’ve faced. My previous startup in the U.S. tackled chronic pain, because I lived with chronic pain for over 10 years. During that time, I was only sleeping three hours a night.

I’d wake up in pain, take painkillers, go back to sleep, wake up again. It was just constant. That’s what drove me to build that startup.

To me, every startup is a learning journey. Each one builds on the last.

That chronic pain startup, that was my first real foray into digital health. I think I moved too fast. I tried to build a physical product and a digital platform at the same time. I was working with just a million dollars, in hindsight, I should’ve started with a community, then layered in the product.

And those lessons? I’m applying all of them to how I’m building Kilow today.

I’ve also come to appreciate the central role of human behaviour in health. Because at its core, healthcare is behavior change. It’s education. The pill is just a band-aid.

We need to help people truly change their lives, and that’s the hardest thing to do. It’s a complex, difficult undertaking.

But if we can marry that goal of behaviour change with the right incentives and touchpoints, then we can make it feel more manageable, something that doesn’t feel so far away. Especially for people struggling with obesity or who feel like they’re too far gone in terms of weight or habits.

So today, even with medications, our role is to help people understand that meds alone aren’t the solution. We tell our patients: “If you stop your medications but haven’t changed your lifestyle, the weight will come back.” That’s the truth. Anything temporary produces temporary results.

If you don’t invest in changing your relationship with food, and in dealing with your emotions, it won’t work. You can’t medicate away emotional eating. You’ve got to confront it. And when people stop eating their emotions, the emotions themselves come up, sometimes depression, sometimes other things.

So it’s about rebuilding the blocks, slowly. Teaching people how to shift behaviours. Helping them experience the benefits. That’s what we’re really building toward.

Before we get into the complex stack you've developed, I wanted to touch on something else that stood out to me, the fact that Kilow emerged from Sanabil’s venture studio. What drew you toward the venture studio model?

The remainder of this interview is for members.

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