Feb 4, 2026 · 40m · a16z
How Truemed Is Incentivizing Americans to Invest in Prevention
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gold bands on the timeline = statements, start to end. Hover to read, click to jump. CC turns on captions
Truemed founder Justin Mares joins Erik Torenberg on The a16z Show to unpack how toxic food environments, agricultural subsidies, and misaligned financial incentives drive America's chronic disease crisis. He details how Truemed and other health innovations can unlock pre-tax healthcare dollars to incentivize root-cause preventative care.
How this conversation actually went
Every chapter scored 0–10 on four independent dynamics. Hover any point for the reasoning behind the score. The host holds 15.4% of the talking time here. How this is scored →
The host as informed peer 2.4 Guest teaching 4.6 Guest disagreement 0.8 The host pushing back 1.0
speaking balance: gold is the host, purple is the guest (3 minute bins)
Sharpest disagreement ▶ 26:48 Rejection of outlawing soda and ultra-processed food
Justin directly rejects Erik's premise that addictive foods should be banned, asserting that consumer choice must be preserved while subsidies should be removed.
Hardest push from the host ▶ 8:44 Universal Basic Ozempic challengeErik directly challenges Justin's systemic policy focus by suggesting that broad distribution of Ozempic could bypass the entire problem.
Biggest teaching moment ▶ 19:40 US GRAS vs European chemical approval gapJustin educates Erik on the regulatory mechanics of GRAS in the US versus EU protocols, pointing out tens of thousands of unapproved chemicals in American foods.
The host holds their own ▶ 30:57 Daniel Gross mental health frameworkErik demonstrates strong domain familiarity by citing Daniel Gross's diagnostic hierarchy to validate Justin's points on metabolic and lifestyle root causes.
the scores for every segment, with the reasoning behind each
| Chapter | Topic | The host as informed peer | Guest teaching | Guest disagreement | The host pushing back | Why |
|---|---|---|---|---|---|---|
| Justin Mares' Journey and Obsession with Health | 1 | 4 | 1 | 1 | Erik asks open-ended questions about Justin's background and Amish lifestyle choices. Justin educates on how modern food environments differ from historical ones like his great-grandmother's time. | |
| Big Food Corporate Incentives and the 1970s Shift | 2 | 5 | 1 | 1 | Erik asks follow-up questions on historical inflection points and international differences. Justin explains the impact of 1970s corporate shareholder pressure, crop subsidies, and soybean oil prevalence. | |
| Why GLP-1s and Ozempic Aren't a Universal Fix | 3 | 5 | 2 | 3 | Erik poses a provocative question regarding universal basic Ozempic as a solution. Justin respectfully reframes the idea, detailing how GLP-1s fail to fix underlying nutrient deficiencies if diet remains poor. | |
| The Origin of Truemed and HSA/FSA Integration | 1 | 5 | 0 | 0 | Erik asks Justin to outline the origin story of Truemed. Justin provides a monologue detailing Letters of Medical Necessity and tax-free HSA/FSA mechanics. | |
| Evolutionary Mismatch and Designing Healthier Environments | 2 | 4 | 0 | 0 | Erik prompts Justin to explain evolutionary mismatch and later mentions viral social media posts about phone usage. Justin uses a zoo animal analogy to illustrate environmental health impacts. | |
| Health as a National Security Issue and Chemical Regulation | 2 | 6 | 1 | 1 | Erik introduces a national security framing for the health crisis. Justin details regulatory differences between the US GRAS system and EU chemical safety testing. | |
| Big Ag Lobbying, Monopoly Barriers, and Grocery Innovation | 3 | 5 | 1 | 1 | Erik brings up theories regarding corporate power like Monsanto and asks about non-traditional grocery store models. Justin explains glyphosate lawsuit shields and health-centric grocery models. | |
| Institutional Capture, School Lunches, and Consumer Choice | 3 | 4 | 2 | 3 | Erik asks whether junk foods and soda should be outlawed altogether. Justin explicitly disagrees with prohibitions, upholding consumer choice while arguing against government subsidies for harmful ingredients. | |
| Psychedelics, Metabolic Psychiatry, and Mental Health | 4 | 5 | 0 | 0 | Erik asks about psychedelics and shares Daniel Gross's insight on biological basics before psychoanalysis. Justin explains metabolic psychiatry and dietary interventions for severe conditions. | |
| Exploring the Nature and Science of Consciousness | 2 | 3 | 0 | 0 | Erik asks about consciousness research and potential future ventures. Justin discusses consciousness as a personal interest and proposes health-focused physical communities. | |
| Scaling Truemed, Peptides, and Ray Peat Dietary Exploration | 3 | 5 | 1 | 1 | Erik guides the conversation through niche health topics like peptides and the Ray Peat diet. Justin contrasts Ray Peat's pro-metabolic philosophy with Brian Johnson's caloric restriction approach. |
Statements from this episode (29)
Justin Mares: Most food consumed in the U.S. is ultra-processed
“When you look at our food system today, the majority of what people are eating is ultra processed crap.”
Mares: Average US child gets less outdoor time than a prison inmate
“The average child spends less time outside than, like, a maximum security prison where people are spending eight plus hours on phone.”
Mares: US healthcare outcomes are worsening with chronic disease at record levels
“If you look at any data in the US healthcare outcomes are horrible. Like, they're bad, they're getting worse, like obesity, you know, heart disease, all of these conditions are basically at record levels and continue to go up.”
Justin Mares: Poor health is the default outcome in modern American environment
“And so I think that the environment that we exist in is just structurally just hard to be healthy, which is why you see the default health outcomes in the U.S. Being so poor.”
Justin Mares: Amish communities achieve significantly better health outcomes than modern Americans
“Certainly, they have much better health outcomes, and they live very differently than you or I.”
Mares: US childhood obesity and heart disease escalated in the 1970s
“Things started to get much worse in the 19 seventies. You know, basically I think my view is that that is around the time when you started to see childhood obesity tick up. You started to see obesity, heart disease, things like this kind of start to move.”
Mares: Ultra-processed foods make up 70% of children's diets today
“Most kids today are eating like 70% of their diet is ultra processed foods.”
Mares: Fixing crop subsidies is single biggest lever for food reform
“From a food system standpoint, I think the biggest single lever that we could pull, which would be extraordinarily politically challenging to pull, is fixing our, like, crop subsidy system.”
Mares: US spent nearly $100B on crop subsidies over past decade
“The U.S. Government over the last I think it's the last decade, has spent close to, like, a hundred billion dollars on crop subsidies.”
Mares: Average American gets almost 20% of calories from soybean oil
“Today, the average American gets almost 20% of their caloric intake from soybean oil.”
Mares: Combined US Overweight and Obesity Rate Is Nearly 80%
“Given that the average American is overweight, we're looking at almost 80% obesity over rate, overweight rates.”
Mares: Ozempic Is Unlikely to Be a Cure-All for Obesity
“You know, and I just think that it is quite unlikely that Ozempic is the one thing that is going to be a cure all.”
Mares: Ozempic users eating standard diets will suffer nutrient deficiencies
“If you're still eating the same crap that the average American is eating today, but you're on Ozempic and eating less of it, like, you are almost certainly going to be deficient in protein and micronutrients and a bunch of things that will have, like, long-ter…”
Mares: Previous dietary guidelines recommended sugar for kids under two
“It's crazy that it took until now to say maybe we shouldn't be giving kids, you know, 15 servings of whole grain and saying that, like, sugar is totally fine for kids under two. Like, we recommend some amount of sugar for kids on the age of two which was the p…”
Mares: No US healthcare payer covers exercise for heart disease prevention
“And yet, if you look at our healthcare system, nothing in the healthcare system thinks about someone who is at risk of heart disease exercising as a healthcare intervention. No payer pays for it. No one incentivizes you to do that.”
Justin Mares: Costco and Walmart are top US organic food sellers
“Things like Costco and Walmart are the two largest sellers of organic products in the country.”
Mares: Health requires changing personal environments, not relying on discipline
“I think that that is, like, an important idea that people don't think about enough is just how do you shape your environment so that it's naturally health promoting, as opposed to you know, having to, like, Discipline yourself and doing all the stuff that most…”
Mares: Most US political issues stem from chronic health crisis
“I think many of our political problems are downstream of the fact that many, the majority of the country is just sick.”
Mares: US permits 60,000 to 80,000 chemical compounds banned in EU
“And the end result is we have between like 60 and 80,000 chemical compounds in the U.S. That are not allowed in, in the EU.”
Mares: Monsanto spent tens of millions lobbying for glyphosate liability shield
“A couple months ago Monsanto was lobbying hard, spent tens of millions of dollars to get a rider and a bill that would basically make sure that no one could ever sue them for the potential health impacts of one of their most popular products, glyphosate.”
Mares: Glyphosate is the number one pesticide sprayed in the US
“Glyphosate is the number one pesticide sprayed in the U S”
Mares: $14B in legal damages awarded over glyphosate health exposure
“There's been fourteen billion dollars of damages awarded to people that have gotten cancer or other diseases from glyphosate exposure.”
Mares: 80% of US schools hold contracts with soda companies
“80% of schools have contracts with soda companies.”
Mares: Coca-Cola spent $140M influencing US nutrition guidelines over 15 years
“Coca-Cola spending one hundred forty million dollars to influence our nutrition guidelines like they have over the last, you know, 15 years.”
Mares: Ketamine therapy works better than SSRIs for severe depression and PTSD
“Ketamine therapy, ketamine assisted therapy works better than SSRIs in many cases, especially for treating things that are very intense, like treatment resistant depression, PTSD, things like this.”
Mares: Lifestyle and functional medicine interventions outperform talk therapy for depression
“There have been studies that show just by focusing and taking a functional medicine approach, you know, focusing on sleep, focusing on gut health, focusing on lowering your inflammation through diet and exercise, that combination of therapies works better than…”
Mares: Ketogenic diets can resolve schizophrenia, epilepsy, and bipolar symptoms
“One of the best therapies for someone that is schizophrenic or epileptic Or even, in many cases, bipolar. If you put them on a ketogenic diet, these things will, in many cases, just resolve.”
Mares: Non-patentable peptides will be exceptionally disruptive to pharma
“Oh man, I think peptides are going to be so disruptive to our current healthcare system. You know, I think that if you look at peptides there needs to be way more research. I'm like, not totally yet a peptide believer. But there needs to be way more research, …”