‘Nobody should be left alone with a strong drug and a printout’: After Ketto, Kunal Kapoor’s next healthcare bet

India is seeing a growing number of metabolic disorders, prompting a shift in healthcare towards preventative measures before conditions like obesity, diabetes, PCOS, and thyroid problems worsen. According to Kunal Kapoor, Co-Founder of MetaGO and Ketto, the future of healthcare involves the early detection of metabolic risks through an integration of diagnostics, clinical expertise, technology, and continuous patient engagement. In an interview with The Economic Times Digital, he delves into MetaGO’s business model, the opportunities and challenges associated with GLP-1 therapies, the valuable lessons from his experience with Ketto, and his perspective on why sustained metabolic care, rather than short-term weight loss, is shaping up to be one of India's most substantial health-tech prospects. Edited excerpts.

The Economic Times (ET): You spent more than a decade helping families raise funds for serious medical conditions through Ketto. Was there a specific moment or pattern that convinced you that India needs to move from financing treatment to addressing metabolic health?
Kunal Kapoor (KK): Fourteen years of building a crowdfunding platform teaches you to see patterns. At Ketto, we worked with thousands of families navigating serious health emergencies, a bypass, a dialysis cycle, and a diabetic foot that had gone untreated for too long. Over time, it became clear that a significant share of that fundraising was for conditions that had been metabolic long before they turned into emergencies, Type 2 diabetes, cardiovascular disease, obesity, and other related disorders that are often deeply interconnected.


What struck me was how little attention gets paid to the years before that, when the body is already drifting, but there is no symptom loud enough to make anyone act. Advances in diagnostics, medical science, and digital healthcare have now made it possible to catch that drift early, with deeper metabolic insights and more personalized, sustainable approaches to treatment.

That thinking led to MetaGO. We are not building a weight loss company. We are focused on the decade where the numbers are still movable and the right intervention is a consult, not a surgery. In many ways, it is the same job we had at Ketto, improving outcomes for people, except now we have moved it upstream, well before a crowdfunding page would ever need to exist.

ET: India is often described as the diabetes capital of the world, but obesity, PCOS, thyroid disorders, and metabolic syndrome are now rising rapidly as well. In your view, what are the biggest misconceptions Indians still have about metabolic health?
KK: One of the biggest misconceptions is that metabolic health is the same thing as the bathroom scale. It isn’t, and in India that mistake quietly hurts people. We tend to carry more visceral fat at lower body weights than most populations, so someone can have a normal BMI and a fasting glucose that is already creeping up and assume they are fine.

The second misconception is treating these conditions as unrelated: a diabetes doctor in one room, a thyroid specialist in another, and a gynaecologist for PCOS in a third, when often there is one underlying metabolic problem connecting all of them. Understanding them together opens the door to far more personalised and effective care.

There is also a tendency to see obesity as a matter of willpower rather than what it actually is, a complex biological condition shaped by genetics, hormones, sleep, stress, and environment, alongside nutrition and activity. That framing makes people feel guilty not just about their weight, but about their choices and who they are, and the science simply does not support it.

As diagnostics and healthcare technology continue to improve, I expect the conversation in India to shift from treating individual conditions to understanding metabolic health as the foundation everything else is built on.

ET: MetaGO operates in a rapidly evolving health-tech market. Can you walk us through your business model, the key revenue streams, and any target milestones?
KK: MetaGO is an annual subscription platform. People pay a monthly fee for care, which is Rs 24,000 for a year, and this includes diagnostics, doctor time, and coaching. That makes the economics easy to describe and harder to run well. The subscription is how we survive, which means the number that matters is retention. A patient who leaves after two months is a loss no matter how efficiently we signed them up, so we are not optimising for registrations, which are the easiest metric in healthcare to inflate.

India is home to one of the largest populations living with metabolic health challenges in the world, yet structured, evidence-based care remains out of reach for most people. The milestone we care about is how many patients move through a full protocol into maintenance and what share of them are still with us a year later.

ET: Delivering meaningful metabolic care requires far more than just technology; it needs doctors, diagnostics, coaching, and long-term patient engagement. How is MetaGO operationally structured to deliver this end-to-end care model, and what have been the biggest challenges in scaling it efficiently?
KK: At MetaGO, we believe you need to “stop fighting your biology alone.” Most weight loss products sell you a tool and disappear, and you are left to figure out the rest by yourself. We built the part that stays, the part that makes sure people don't just lose the weight but keep it off.

Our approach brings together multiple layers of care—from at-home metabolic testing and diagnostics to doctor consultations, personalised treatment plans, medication management where clinically appropriate, nutrition management, fitness coaching, and weight marker data syncing. Technology plays an important role in making this experience seamless, but it is really the combination of clinical expertise and continuous support that drives outcomes.

ET: MetaGO is entering the market at a time when GLP-1 drugs have become a global phenomenon. Do you worry that social media and celebrity culture have turned these medications into a quick-fix weight-loss trend rather than a serious medical intervention?
KK: Every major healthcare innovation goes through a phase where public attention moves faster than public understanding, and GLP-1s are firmly in that phase right now.

Here is what I think people get backwards. These are not vanity drugs that happen to have medical uses; they were developed as evidence-based medical therapies and have opened real possibilities in the treatment of obesity and metabolic health.

The trend does carry a real cost. Drop weight quickly, and you lose muscle along with the fat, and the weight tends to come back. So, the medication itself is not the danger; doing it without medical supervision and the nutrition, lifestyle, and ongoing support that should sit alongside it, is. That is why at MetaGO, we see GLP-1s as one part of a comprehensive care journey rather than the destination itself.

ET: Clinical oversight and patient safety are central to any credible metabolic care intervention. Can you walk us through how MetaGO’s clinical governance model is structured and what safeguards ensure that patients on GLP-1 therapies or other metabolic protocols are receiving adequate supervision throughout their care journey?
KK: This is the part of our work that requires the most care, because it is where people can actually get hurt. Nobody at MetaGO gets a prescription off a web form.

Every patient begins with real diagnostics and a detailed health history. A doctor reviews all of it before anyone writes a prescription and, based on that assessment, develops a personalised care plan and treatment pathway. Once someone is on a GLP-1, they are reviewed on a fixed schedule, the doctor decides every dose change, and the coach is watching for what the labs alone don't show, whether they are hydrating, getting enough protein, or quietly pushing through the nausea instead of telling us.

The design principle is consistent; care should never be episodic. Nobody should be left alone with a strong drug and a printout. There is always a clinician who knows their numbers, and that continuous engagement, rather than one-off interactions, is ultimately what lets patients feel supported and confident at every step of their journey.

ET: One criticism of the metabolic care space is that it often serves affluent urban consumers while the larger population remains excluded. How do you respond to concerns that personalised metabolic health solutions could become another premium wellness product rather than a meaningful healthcare intervention?
KK: It is a fair concern, and one every company in healthcare should take seriously. When people hear ‘personalised’, they think expensive, and that's a confusion. Personalised just means the plan is built off your own markers instead of a population average. Also, technology and the use of AI help us to go wider without compensating on the fundamentals of the offering. The real test for companies in this space isn’t how premium the experience feels; it’s how many people they actually reach.

ET: The business of health-tech has attracted enormous investor interest in recent years, but many platforms have struggled with trust and long-term engagement. What lessons from building Ketto have shaped the way you’re building credibility and retention at MetaGO?
KK: Building Ketto taught us the least glamorous lesson in business: trust isn’t a campaign; it’s whether you call back.

We were present for some of the most significant moments in people’s lives, a child’s surgery, and a parent’s diagnosis, and they trusted us because we sent updates even when we had nothing to sell them. That same principle holds true in healthcare. People don’t stay loyal to an app; they stay for the doctor who replies in week six, when side effects show up and motivation dips, and helps them work through it with real guidance instead of leaving them to figure it out alone.

At MetaGO, we’ve built around that same idea—clinical care at the centre, with the technology supporting it rather than replacing it. That means access to qualified medical professionals, decisions guided by real data and diagnostics, and an ongoing dialogue throughout the journey, not just at the start. Long-term engagement and outcomes go hand in hand; people stay committed when they can see real progress and feel supported through it.

Ultimately, credibility in healthcare comes from consistency, transparency, and outcomes you can actually point to. Those are the principles that shaped how we built Ketto, and they continue to shape how we’re building MetaGO today.

ET: GLP-1 therapies can be expensive and often require long-term use. How is MetaGO addressing affordability to ensure these treatments are not limited to a narrow slice of urban, premium consumers?
KK: GLP-1 therapies are just one part of metabolic care. Long-term outcomes come from a combination of clinical guidance, behaviour & lifestyle change, nutrition, and ongoing monitoring, which is why our focus is on getting people the right level of support for their needs, rather than viewing treatment through a single therapy alone. To add to this, we’re a digital-first platform, and our programme is structured to ensure the medication is tapered down effectively yet cautiously and starts building up the dependency on lifestyle modifications. Also, as generics and lower-dose options become available, the pricing floor will keep dropping.

But the reframe I think matters most is this: the truly expensive option is the one nobody puts a price tag on, the bypass, the years of dialysis, a decade of slow, accumulating damage. We watched families carry that cost for years at Ketto, sometimes selling property or jewellery to cover it. Care upfront is the cheaper version of this story, even in the months it doesn’t feel that way, and our job is simply to keep narrowing the gap between those two prices.

ET: There is a concern among some clinicians that long-term reliance on GLP-1 medications could substitute lifestyle change rather than complement it. How does MetaGO’s care model address the question of medication dependence?
KK: I think the conversation is often framed as medication versus lifestyle change, when in reality the two are most effective when they work together.

At MetaGO, we’ve built our model around that philosophy. Medication is only one part of the journey; every care plan is supported by metabolic testing, doctor supervision, personalised coaching, and regular progress reviews that help people build sustainable habits alongside treatment.

This is also why maintenance is a real phase for us, not a send-off. As people stabilise, we step the dose down, sometimes off entirely, and step the coaching up, because by then the habits are meant to be carrying the result, not the drug. We're essentially trying to make ourselves slowly unnecessary for each patient, and a company built to wean you off itself is the opposite of one selling dependence.