Consumers are becoming the CEOs of their own health

It is no secret that consumers are increasingly taking ownership of their own health. Since the advent of google (well, the internet), consumers have had access to much of the world's information at their fingertips. This includes details of symptoms and side effects, prevention methods and cures. It's readily accepted that this has made medical professionals' lives more complicated because we all arrive to appointments with a 'good sense' of what could be the issue. We'd need to be told we were wrong, convinced of the truth and we'd walk away with our tail between our legs to do as the professionals suggested (mostly).

But now, the game is changing. We have access to information about our own bodies, data on our habits over time and evidence-informed guidance on positive steps to take to better manage our health, including actively managing conditions that we have developed.

Accordingly, consumer health has become a hive of startup activity, helping people learn about their bodies, adjust their behaviours and work towards healthier lives.

We dove in to this area and the TLDR: there are a LOT of opportunities and if you are building in this space, we'd love to hear from you!

We hope you enjoy!

---

We cover a lot of ground, so here's some assistance with your navigation:

1. Executive summary: the dual transformation

2. Proving the trend: the dual transformation evidence

3. Key enablers/ trends: what's driving the dual transformation of evidence?

4. Market framework: the market map

5. Vertical deep dives: science going mainstream

6. Success patterns: winning in the dual transformation

7. Risks and challenges

8. Investment outlook: capitalising on the megatrend

--

1. Executive summary: the dual transformation

Consumers are stepping into the driver’s seat of their health just as the tools of science are breaking out of clinics and labs and into everyday life. On one side, people expect agency: they want to set goals, track progress, and choose interventions that fit their biology and lifestyle. On the other hand, diagnostics and evidence-based protocols - once expensive, specialist, or inaccessible - are being packaged for direct use by consumers through mobile interfaces, connected devices, and at-home testing. These two forces reinforce each other, creating a flywheel where desire for control meets products that translate complex science into simple, daily decisions.

This dual transformation is already visible in the numbers.

Spending outside traditional healthcare is compounding at ~8% annually, as consumers reallocate budgets to prevention, optimisation, and self-management.

The willingness to pay is strongest among younger cohorts - Gen Z leads with an average willingness to spend $7,856 per year on their health, compared to $5,186 for millennials - while mainstream adoption is catalysed by the ubiquity of wearables, now used by roughly a third of US adults.

What started as “wellness” is hardening into a new consumer health category that behaves like technology: fast product cycles, direct distribution, and tight feedback loops from data to insight to action.

For investors, this shift unlocks a $2T+ opportunity ($500B+ in US), with 84% of US consumers calling wellness a top priority (79% in the UK), primarily across four verticals:

• Metabolic Health

• Women’s Health

• Functional Health & Longevity

• Mental Health

These intersect with three powerful horizontals:

• Community/Social

• Premium/Hybrid Experiences

• Data/Diagnostics.

Winners will translate scientific validity into world-class consumer products, then compound defensibility through communities, proprietary datasets, and integrated care pathways. As a leading European health-tech investor put it:

“The future is the scientification of consumer health- anchoring products in real diagnostics and lab data.”

That is the centre of gravity for this market: credible science made usable, delightful, and continuous.

2. Proving the trend: the dual transformation evidence

Consumer empowerment is here. Post-pandemic, health moved from episodic to ambient. McKinsey finds 67% of Gen Z actively manages health outside traditional healthcare. Out-of-pocket spend is flowing towards products that make people feel in control - precisely measured, personally relevant, and instantly actionable. The behaviour change is cultural as much as clinical: data as daily habit, not a once-a-year check-up.

Science is becoming consumer-grade. The best proof points are category migrations. Continuous glucose monitors have evolved from a ~$6B diabetes tool into a ~$13B+ market that increasingly includes non-diabetic wellness users by reframing monitoring as performance and prevention. Fertility testing that cost four figures in clinic settings now arrives at home for a fraction of the price, bundled with interpretation and planning tools. At-home testing has surged since 2020, while entire subfields, from genetics to microbiome, have gone from niche to crowded. FDA-cleared devices like consumer ECGs exemplify the path: clinical capability, consumer packaging, everyday use.

Convergence creates the opportunity. Empowered consumers don’t just want more data; they want trustworthy, science-backed answers and a path to outcomes. Consumerised science supplies the raw materials, measurements, models, and validated protocols, while winning products turns them into sticky daily experiences. The market is no longer asking whether consumers will take charge of their health; it is asking who will give them the most credible, compelling tools to do it.

3. Key enablers/trends: what's driving the dual transformation?

3A. Technology enablers (science consumerisation)

At the same time, advances in AI are translating complex biological signals—genomics, proteomics, microbiome data - into simple, personalised recommendations. A vivid example of this “science becoming consumer” trend comes from Thymia. As CEO Emilia Molimpakis explains:

“We can identify everything from fatigue levels to mood, appetite loss and concentration — all through just 15 seconds of voice.” 

This demonstrates how once-clinical diagnostics like speech biomarkers are now frictionless, at-home assessments - turning complex science into daily consumer interactions.

What once required a specialist now arrives as actionable daily guidance. With smartphones as the universal health hub, mobile-first platforms integrate these insights into the rhythms of daily life, making science continuous, contextual, and consumer-friendly.

3B. Consumer behaviour enablers (CEO empowerment)

The pandemic reset consumer expectations around health. COVID accelerated preventive habits, with millions taking a more active role in tracking and managing well-being outside the clinic. Biohacking, once a niche subculture, has gone mainstream as people seek to optimise sleep, energy, and performance, trends amplified by social media and influencer-led wellness culture.

Generational dynamics reinforce this shift. Digital natives, accustomed to data-driven personalisation in every other aspect of life, increasingly reject one-size-fits-all healthcare. They expect health tools that are tailored, interactive, and measurable, mirroring the usability and immediacy of consumer apps they already trust.

3C. Healthcare system enablers

System-level gaps are pushing consumers toward alternatives. In the US, high costs and fragmented care models create demand for direct-to-consumer solutions that feel faster, cheaper, and more empowering. In Europe, prevention is often slow-moving or underfunded within public systems, leading consumers to seek private options where traditional pathways fall short.

Insurance models are also beginning to shift. Private payers are increasingly embracing preventive and optimisation-focused solutions, signalling growing institutional acceptance. Vitality Health places a strong emphasis on preventive care and wellness, covering for health screenings, vaccinations, and health assessments. Similarly, YuLife has gamified health insurance in the UK, allowing members to earn points based on health metrics and daily activities, creating engagement through rewards for preventive behaviours. Willis Towers Watson (WTW) has partnered with analytics firm Klarity to integrate wearable metrics- including resting heart rate, sleep quality, and recovery rates directly into life insurance underwriting processes, representing a fundamental shift toward data-driven risk assessment.

However, European value-based care models differ significantly from US approaches. While American insurers often implement complex shared savings arrangements and bundled payments with providers, European private insurers focus more on member engagement and prevention incentives within existing healthcare frameworks.

Meanwhile, regulation is moving more slowly than innovation. The prevailing model is often to “ask forgiveness, not permission”, allowing startups to move quickly, capture consumer demand, and shape new categories while oversight catches up.

4. Market framework: mapping the opportunity

The dual transformation of consumer empowerment and science consumerisation is creating a structured set of opportunities. We can frame the market through four health verticals  (metabolic, women's, functional health and longevity, and mental health) where change is most advanced, and three horizontals (community, premium/ experience, and data) that define how solutions scale and defend themselves. We do not go into the data horizontal because all of the solutions use data to inform their support.

The market map below is not an attempt to be exhaustive - it is our interpretation of the space. Some companies appear twice, highlighting the cross-overs and intertwining nature of the space and the means of differentiation.

5. Vertical deep dives: science going consumer

With the benefit of the market map, we are now going to dive into some of the different sub-sectors.

5A. Metabolic health: medical monitoring becomes lifestyle optimisation

The democratisation of diabetes management tools represents the largest consumer health transformation, with CGMs evolving from $200/month medical devices to $99/month lifestyle optimisation platforms. Levels pioneered this shift by adding AI coaching layers that interpret glucose data for peak performance in healthy individuals, while January AI uses machine learning to predict metabolic responses before meals. Simultaneously, the GLP-1 market has revealed that prescription access alone is insufficient - companies like Found, Ro, and Calibrate recognise that sustainable weight management requires orchestrating the entire patient journey from initial prescription through long-term maintenance. This demands integrated ecosystems combining medical oversight, behavioural coaching, nutritional guidance, and crucially, post-medication lifestyle preservation strategies as patients transition off GLP-1s. Medical-grade monitoring for non-patients creates entirely new wellness categories worth billions—companies must now provide "vertical solutions" combining hardware, data, and coaching rather than simple point solutions.

5B. Women's Health: Filling Research Gaps with Consumer-Led Science

Historical medical research gender bias creates massive opportunity for consumer-driven innovation, with companies filling decades of research gaps through direct-to-consumer science. Modern Fertility transformed $1,500 clinical fertility testing into $159 at-home tests, while Evvy addresses completely overlooked vaginal microbiome testing for infection prevention. The most valuable insight is that women's health companies create defensible moats through proprietary datasets in historically under-researched areas. These companies don't just democratise existing science—they generate new clinical insights through consumer data collection at scale. Another opportunity area in the space characterised by high consumer willingness to pay is pre/postnatal care, standing out as one of the few areas where even lower-income households will spend out-of-pocket, giving startups rare pricing power in Europe.

5C. Functional Health & Longevity: Elite Performance Science for Everyone

Consumer demand for optimisation beyond "normal" health democratises elite athlete monitoring and longevity research for mainstream wellness markets. Success in functional health requires precise niche definition through brand voice, design aesthetics, and novel metrics that create category ownership. Oura's "readiness" positioning —targeting holistic wellness optimisation versus Whoop's "strain" messaging— focusing on athletic performance recovery demonstrates how identical HRV technology requires distinct brand personalities. Beyond traditional wearables, companies are pioneering advanced biomarkers: Nix tracks real-time electrolyte loss through sweat analysis, AliveCor democratises medical-grade ECG monitoring, and Incora combines continuous metabolic monitoring with female-focused design and hormonal cycle integration. Winning companies in the space define entirely new performance metrics—biological age, metabolic flexibility, hormonal optimisation—rather than competing on generic step counting, creating defensible categories through scientific sophistication and targeted positioning.

5D. Mental Health: Clinical Psychology at Consumer Scale

Mental health apps have scaled quickly but face commoditisation without validation. Headspace built a global brand around clinical mindfulness, while Woebot shows the promise of AI companions delivering CBT at scale. As we highlighted in our separate AI Companions report, mental health is one of the top categories where true companions will emerge - science-backed, deeply integrated, and designed for stickiness rather than symptom tracking alone. Investors stress that the next winners must prove outcomes through RCTs and payer adoption, but when combined with companion-style engagement and community, these platforms can become defensible, high-retention health ecosystems.

5.E-F.Horizontal applications:

Community/Social-Driven: Health behaviour change uniquely requires external validation and peer accountability because individual willpower consistently fails against ingrained habits, making community the strongest moat in consumer health. Strava demonstrates this through "social proof of suffering," where users share workout achievements for accountability. Peanut's women's health communities reveal how shared vulnerability around fertility, pregnancy, and motherhood creates deeper engagement than generic social networks. Community-driven platforms generate proprietary behavioural data at scale—tracking not just biometrics but social interactions, peer influence patterns, and group behavior change dynamics that become increasingly valuable datasets for personalisation algorithms. However, monetising community remains challenging because users resist paying for social connections, requiring companies to layer premium features, expert access, or commerce on top of free community foundations.

Premium/Experience/Hybrid: Health is becoming the ultimate status symbol, where premium positioning feels both aspirational and defensible. Companies succeed when they turn care into identity and lifestyle. Forward reframes healthcare through concierge-style clinics and predictive analytics, making routine checkups feel like luxury experiences. Equinox shows how fitness clubs evolve into cultural signals of affluence and health-consciousness, proving that physical spaces build community and loyalty in ways digital products cannot. Hybrid services thrive here because they combine exclusivity with human connection - elements consumers will pay to maintain.

6. Success patterns: winning in the dual transformation

Community in taboo and behaviour-change categories. Community is strongest where consumers feel underserved or where behaviour change requires accountability. Fertility and menopause are prime examples of taboo areas where peer support drives retention. Meanwhile, fitness, weight management, and metabolic health illustrate how accountability loops and shared goals keep users engaged and prevent migration to alternative platforms. Platforms like Strava and Peanut show how social dynamics can be the most durable moat. While community is a powerful moat, it rarely drives revenue on its own. Successful platforms typically monetise around the community through paid coaching, consultations, courses, or commerce integrations. To raise ARPU and fight churn, leaders in the space use annual/family plans, device + subscription bundles, or outcomes-based guarantees that tie pricing to results.

Founder execution in an AI-commoditised world. With LLMs erasing tech barriers, execution is the moat. As Freya Wordsworth (Ascension) put it:

“What used to be defensible tech can now be built in weeks. Founders’ ability to navigate route-to-market and execute hybrid models is more important than the tech itself.” 

Founder credibility, operational excellence, and fundraising ability now directly determine whether companies can outpace copycats.

Unique datasets in under-researched biology. As Philippa Allen (Calm/Storm) emphasised:

“The real moat comes from creating first-of-its-kind datasets in historically under-researched areas.” 

Companies like Evvy (vaginal microbiome) exemplify how novel data creates defensibility - with similar opportunities emerging in longevity biomarkers and neuro-cognitive testing. Proprietary data fuels personalisation, product development, and even future clinical or drug discovery applications. However, investors have to scrutinise how companies collect, store, and monetise health data carefully. In the US, the distinction between HIPAA and non-HIPAA data determines what secondary use or sale is permitted, while in Europe GDPR requires a lawful basis (consent, contract, legitimate interest) and tightly restricts cross-border transfers. Startups must show clear consent portability, robust de-identification, and transparent licensing/secondary use policies.

Vertical integration wins vs. point apps. Point solutions — especially in femtech (e.g., cycle-tracking apps) — are diluted and undifferentiated. By contrast, integrated platforms that combine diagnostics, treatment, lifestyle, and medication (e.g., Aspect Health tackling PCOS end-to-end) create stickiness and defensibility. Freya’s warning was clear: in fragmented spaces, only full-stack solutions will endure.

Scientific validation creates regulatory moats, particularly in Europe. Clinical backing transforms from nice-to-have to competitive requirement, especially for companies targeting healthcare reimbursement. European investors observe: "If you are able to crack the European market and get regulatory approval, you already have your moat." This creates geographic arbitrage opportunities where European validation provides global credibility and trust advantages.

Brand positioning requires precise niche definition. Success demands distinct market positioning beyond generic wellness messaging. Companies must define proprietary metrics and create category ownership—biological age testing, metabolic flexibility, hormonal optimisation—rather than competing on commoditised health tracking.

AI companions and integrated platforms create personalised health relationships beyond simple tracking. As user experience importance grows, winning companies integrate AI-driven personalisation that transforms passive monitoring into active health coaching relationships. The most successful platforms evolve from basic data collection tools into personalised health advisors that learn individual patterns, interpret complex biomarkers, and provide increasingly sophisticated recommendations tailored to each user's unique health profile. These AI companions create sticky, personalised experiences that users cannot easily replicate elsewhere because the recommendations improve with more data over time. The competitive advantage lies not just in hardware sensors or data collection, but in AI interpretation layers that make complex health science actionable for everyday consumers through conversational interfaces and proactive guidance.

Physical-digital integration creates defensible barriers through hardware and experience complexity. Defensibility often comes not from brand, but from infrastructure complexity. Pure digital solutions face intense commoditisation because, as one investor put it, “With Lovable [LLMs], you can build what used to be defensible in just a few weeks.” By contrast, hardware-software platforms and hybrid care models create barriers that are expensive and slow to replicate. Eight Sleep anchors its smart mattresses with proprietary sleep algorithms, while Nix’s sweat analysis sensors require specialised manufacturing and IP. These integrations make switching costly and copycats less viable. The strongest companies use digital layers not to replace humans, but to enhance physical products and services, creating systems of care that are sticky by design.

The Tesla model dominates premium-to-mass market progression. Successful consumer health companies consistently follow premium positioning before democratisation: "Start with the top 5%, build brand and community, then scale down to mass market." Oura launched at $399 for biohackers before scaling to $199 for mainstream wellness, while Forward targets affluent consumers with $150/month memberships before expanding accessibility. This approach builds brand equity and validates product-market fit with less price-sensitive early adopters who become advocates for broader market expansion. As Cihat Cengiz of Dieter von Holtzbrinck Ventures notes, the Tesla model in consumer health also lets companies validate their science and build proprietary data assets with premium early adopters, creating the foundation for scale.

Coverage pathway evolution defines long-term sustainability. The most successful business models start consumer-paid to prove value, then move toward reimbursement integration. Spring Health progressed from B2C therapy through B2B2C workplace benefits toward insurance coverage, demonstrating scalable unit economics improvement over time. As investors note: "Long-term winners will aim for reimbursement / payer integration, but most will start as consumer-paid." Companies that cannot articulate clear paths to payer adoption face limited scalability potential.

7. Risks & challenges

The Wellness Trap: when science backing becomes make-or-break

The consumer health landscape has fundamentally shifted away from pure lifestyle brands toward scientifically-validated solutions, creating existential risk for companies without clinical backing. Companies that position themselves as wellness brands without scientific differentiation increasingly face commoditisation and become acquisition targets rather than achieving VC-scale exits. This "wellness trap" emerges because consumers now expect measurable outcomes and clinical validation, making feel-good marketing insufficient for sustainable competitive positioning. Increasingly, payers and regulators expect prospective outcome evidence - RCTs or robust real-world data—to validate claims, and companies that can’t demonstrate efficacy early will face limited reimbursement and consumer trust.

Regulatory Grey Zones: innovation at the edge of compliance

Consumer health companies often move faster than oversight. Most startups begin by operating in regulatory grey zones - making wellness-style claims, selling DTC, or framing diagnostic outputs as “insights”, allowing them to scale quickly but building in the risk of existential liability tomorrow if compliance requirements catch up faster than expected.

In the U.S., FDA rules on devices and software-as-a-medical-device, shifting policy on lab-developed tests (LDTs), and FTC scrutiny of health claims all constrain what companies can say or do. HIPAA and 42 CFR Part 2 add complexity around sensitive health data, especially in mental health or substance use. In Europe, the challenge is often greater. MDR and IVDR impose strict requirements, and notified-body bottlenecks can delay or derail startups entirely. While U.S. companies may operate in the grey zone for years before intervention, European startups face more immediate barriers: without certification, products cannot legally be marketed. This makes regulatory navigation not just a risk, but a go/no-go factor for entire categories.

Cultural healthcare expectations limit European addressable markets

European consumers demonstrate fundamental resistance to out-of-pocket health optimisation that constrains market opportunities compared to US dynamics. The cultural expectation that "I pay into the healthcare system already, why should I pay extra?" limits European consumer health markets to approximately the top 10% of affluent consumers willing to bypass state healthcare systems. This cultural barrier requires different market entry strategies, longer sales cycles, and premium positioning that many US-focused business models cannot easily adapt. European success demands regulatory validation and clinical outcome proof that justifies additional health spending beyond state-provided services.

Economic Downturn Vulnerability Through Premium Positioning

Consumer health companies face particular economic sensitivity because they position as lifestyle optimisation rather than medical necessity, making them vulnerable to discretionary spending cuts during economic stress. When consumers tighten budgets, health optimisation services experience immediate churn since users can defer wellness goals without immediate health consequences. This vulnerability affects companies across the spectrum—from premium services like personal training to consumer devices and subscription services—requiring strong unit economics and cash reserves to weather economic downturns that drive customer acquisition cost increases and retention challenges.

GLP-1 Market Presents Billion-Dollar Opportunity with Built-In Profitability Challenges

The GLP-1 ecosystem represents a massive opportunity for digital health founders, with Goldman Sachs analysts expect 15 million U.S. adults to be on anti-obesity drugs by 2030. However, several structural challenges threaten unit economics sustainability. Gross margin compression remains severe as GLP-1s cost roughly $1,000 per month before insurance and other rebates, while companies like Found offer compounded alternatives at $189 over a four-week dosage and competitors like Sesame provide compounded semaglutide for $249 a month. Prior authorisation friction creates significant patient acquisition challenges, with insurers deny 22% of GLP-1 PA requests on first submission. Supply volatility compounds these issues for companies as evidenced by shares of Hims & Hers, an online health and wellness company that sells compounded GLP-1 medications, plummeted 25% when FDA announced supply shortages.

8. Investment outlook: capitalising on the megatrend

The highest-return opportunities centre on companies bridging clinical science with consumer accessibility, particularly those targeting historically underserved demographics or creating novel biomarker measurement capabilities. Scientification leaders like AliveCor and Evvy demonstrate how FDA-approved devices and clinical-grade testing create defensible market positions, while companies serving neglected populations - men's health through Hims, menopause management through Midi Health - benefit from pent-up demand and limited competition. Community-first platforms building network effects around vulnerable health experiences offer the strongest competitive moats, particularly in taboo categories like fertility and mental health where peer support drives retention beyond product features. The most scalable models start with premium positioning with clear mass market pathways, targeting affluent early adopters who validate willingness to pay before democratisation through pricing reduction and social proof accumulation.

Geographic strategy requires understanding cultural health attitudes and regulatory arbitrage opportunities that create competitive advantages rather than viewing compliance as obstacles. US markets offer broader addressable populations with consumer willingness to pay for health optimisation, but face higher competitive intensity and marketing costs. European investments provide smaller but potentially higher-margin opportunities among affluent consumers seeking alternatives to state healthcare systems, with regulatory validation creating global trust signals and defensive barriers. Market timing follows predictable adoption patterns starting with biohackers/top 1% to gradually expanding to mass market - requiring stage-appropriate demographic targeting and sequential market entry strategies that build capabilities progressively while leveraging regulatory differences for competitive positioning.

Investment screening must prioritise founder capabilities, clinical validation, and business model defensibility over pure technology innovation. The ideal founder profile combines healthcare industry experience with consumer product expertise and demonstrated fundraising ability for sustained brand building, as technical differentiation can be quickly commoditised while execution becomes the primary competitive advantage. Due diligence requires real diagnostic capabilities and measurable health outcomes rather than wellness positioning, as the scientification trend makes clinical backing table stakes for sustainable market positioning. Portfolio construction should evaluate companies' paths toward reimbursement integration, community building potential that creates user retention beyond features, and data monetisation opportunities through pharmaceutical partnerships and clinical research collaborations that extend value beyond direct consumer revenue streams.