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How Truemed Is Incentivizing Americans to Invest in Prevention

a16z general partner Erik Torenberg speaks with Justin Mares, founder and CEO of Truemed. They discuss why American health outcomes are so poor compared to the rest of the developed world, how crop subsidies created a food system that "systematically outputs unhealthy people," and what it would take to treat the chronic disease crisis as a national security issue. Mares explains how Truemed allows people to spend tax-free HSA and FSA dollars on lifestyle interventions like gym memberships, sleep aids, and healthier food—and why he believes this could redirect hundreds of billions of dollars toward prevention. They also explore the case for psychedelics as mental health therapy and why peptides could disrupt the pharmaceutical industry. Timestamps: 00:00 — Introduction 0:44 — The Environment That Makes Us Sick 04:19 — What Went Wrong in the 1970s 6:10 — The Subsidy Problem 8:49 — Universal Ozempic Won't Save Us 12:21 — Building Truemed 15:59 — The Zoo Animal Theory of Human Health 18:33 — The Chronic Disease Crisis as National Security 27:52 — Psychedelics as Mental Health Therapy 35:49 — Why Peptides Will Disrupt Pharma Resources: Follow Justin Mares on X: https://x.com/jwmares Follow Truemed on X: https://x.com/truemed Stay Updated: If you enjoyed this episode, be sure to like, subscribe, and share with your friends! Find a16z on X: https://twitter.com/a16z Find a16z on LinkedIn: https://www.linkedin.com/company/a16z Listen to the a16z Podcast on Spotify: https://open.spotify.com/show/5bC65RDvs3oxnLyqqvkUYX Listen to the a16z Podcast on Apple Podcasts: https://podcasts.apple.com/us/podcast/a16z-podcast/id842818711 Follow our host: https://x.com/eriktorenberg Please note that the content here is for informational purposes only; should NOT be taken as legal, business, tax, or investment advice or be used to evaluate any investment or security; and is not directed at any investors or potential investors in any a16z fund. a16z and its affiliates may maintain investments in the companies discussed. For more details please see http://a16z.com/disclosures.

JMJustin MaresguestETErik Torenberghost

Feb 4, 2026·40m·Watch on YouTube ↗

📖 CHAPTERS

1. 1

   Health isn’t a personal failing—it’s a sickness-promoting environment

   Justin Mares argues that today’s default American environment makes people unhealthy: ultra-processed food, little time outdoors, and constant screen exposure. He frames chronic disease as a foundational societal problem that cascades into many other national issues.

2. 2

   How Justin got obsessed with prevention and lifestyle-driven health

   Justin describes discovering the “secret” that lifestyle and diet materially change health outcomes, and how that clashed with the trajectory of U.S. health statistics. This realization pushed him to study food systems, toxins, and root causes—and eventually build companies around the thesis.

3. 3

   Why it’s uniquely hard to be healthy now (and what the Amish illustrate)

   The conversation contrasts earlier generations—who didn’t need “biohacking” to stay well—with today’s need to actively avoid harmful defaults. The Amish are cited as a real-world counterexample: different food, movement, community, and tech exposure correlate with better outcomes.

4. 4

   What changed in the 1970s: shareholder food + ultra-processing at scale

   Justin locates a major inflection point in the 1970s, when processed food economics and corporate incentives accelerated ingredient substitution. Over decades, real ingredients were replaced with cheaper industrial alternatives, creating today’s ubiquitous ultra-processed diet.

5. 5

   The subsidy engine: corn/soy/wheat policy that makes America sicker

   Justin argues the most powerful (and politically difficult) lever is reforming crop subsidies that make industrial inputs artificially cheap. Those cheap inputs are then baked into most packaged foods, shaping population-level nutrition by default.

6. 6

   Why ‘universal Ozempic’ isn’t a cure-all (even if GLP-1s help)

   Justin sees GLP-1s as valuable for a population with high obesity rates, but rejects them as a singular solution. Appetite suppression without nutrition improvement can worsen micronutrient/protein deficits and doesn’t fix root causes in the food environment.

7. 7

   From Kettle & Fire to Truemed: making prevention financially rational

   Justin explains the insight that people want healthier products but are constrained by cost, while the healthcare system pays massively after disease occurs. Truemed targets that mismatch by letting eligible consumers use HSA/FSA dollars for lifestyle interventions via medical-necessity documentation.

8. 8

   The ‘zoo animal theory’: genes-environment mismatch drives chronic illness

   Justin frames humans like zoo animals: when removed from a species-appropriate environment, pathology rises (obesity, depression, abnormal behaviors). He argues the highest leverage is redesigning environments so healthy choices happen by default, not willpower.

9. 9

   Chronic disease as national security: policy levers beyond food

   Justin argues the scale of sickness should be treated like an existential threat; if caused by an adversary it would trigger emergency mobilization. He outlines major levers: prevention-first healthcare, EU-style chemical regulation, and stopping corporate capture in guidelines and institutions.

10. 10

    Why it’s hard to compete with Big Ag/Chem: lobbying and liability shields

    The discussion highlights how entrenched incumbents preserve advantage through lobbying, including efforts to limit legal exposure for harmful products. This dynamic makes it difficult for startups to challenge dominant chemical/agriculture players on a level playing field.

11. 11

    Reimagining ‘grocery as healthcare’ and community-level health models

    Justin argues grocery and food retail could evolve from passive sourcing to active health outcomes management using biomarkers and personalized guidance. He also suggests the next frontier is community-scale interventions—changing shared environments rather than optimizing individuals alone.

12. 12

    Psychedelics, metabolic psychiatry, and biology-first mental health

    Justin supports psychedelics (e.g., ketamine-assisted therapy) as effective tools for treatment-resistant depression and PTSD, especially for veterans. He also emphasizes that physical health (inflammation, gut, sleep) is tightly coupled to mental health, advocating more research in metabolic psychiatry.

13. 13

    Truemed today: partners, HSA/FSA rails, and scaling lifestyle coverage

    Justin describes Truemed’s product: an eligibility/medical-necessity flow and payments integration that lets people use pre-tax health dollars on approved lifestyle interventions. He positions this as infrastructure for chronic disease prevention at national scale.

14. 14

    Peptides and nutrition tribes: disruption, experimentation, and the ‘Peat’ counter-dogma

    Justin predicts peptides could disrupt pharma because many aren’t patentable and are geared toward ‘enhancement’ (energy, inflammation, libido) rather than just disease management—though he wants more research. He also critiques nutrition science incentives and promotes N-of-1 experimentation, highlighting Ray Peat’s pro-metabolism approach as a provocative alternative to caloric restriction dogma.