Marketing Plan For U.S. Launch of New Weight Loss Modality.

1. Ketofast Marketing Plan
Discussion – March 2013

2. I. Market Situation
A. Summary
B. Key Issues
II. Communications Platform
A. Objectives
B. Strategies
C. Targets and Potential Messages
III. Communications Program and Tactics
IV. Budget Allocation
Contents

3. Market Situation
A. Summary
• Healthcare spending represented 17.9% of GDP in 2010 and is
expected to reach 20 percent by 2020. Source: National Health Expenditure
Projections 2010-2020. Baltimore, MD: U.S. Centers for Medicare and Medicaid Services, April 2012
• Healthcare spending is expected to increase 7.5% in 2014 . Source:
PWC
• Pharma revenues were $320B in U.S. and $956B globally in 2011.
IMS Health
• More than 25M Americans have type 2 diabetes (360M WW), 27M
have chronic heart disease, 68M hypertension, 50M arthritis and
795,000 suffer strokes each year, with 1 in 3 deaths from cancer
(approximately 190,650) related to obesity, poor nutrition or physical
inactivity. Source:
http://healthyamericans.org/assets/files/2012_f_as_in_fat_FINAL%20ES%209-22-12.pdf
• Diabetes care continues to grow and is a big business (Winthrop
building an $80M research center)
• $20B is the annual revenue of the U.S. weight-loss industry,
including diet books, drugs and weight-loss surgeries. (It expands to
$62B when including health clubs, diet sodas and diet foods, etc.)
Source: Marketdata
• Pharma is highly protective of revenue (Amgen has 74 lobbyists in

4. Market Situation
A. Summary
• #1 cause of preventable death in U.S. today is obesity. It was
smoking.
• 78M Americans over the age of 20 are classified obese
http://www.cdc.gov/nchs/data/databriefs/db82.pdf.
• 220,000 people with morbid obesity in the U.S. had bariatric
surgery in 2009. Sources: John LaRosa of MarketData; National Weight Control
Registry; American Society for Metabolic and Bariatric Surgery
• Bariatric surgeries are trending down. Source: Winthrop, Sparcs
• $11,500 to $26,000 is the average cost of bariatric surgery.
Source: LaRosa, Op Cit.
• Estimated medical cost of adult obesity in U.S. ranges from
$147B to nearly $210B per year. Medicare and Medicaid are
responsible for $61.8B.
• Non-surgical medically managed group weight loss centers are
a growth business. One chain, CMWL has grown from 60
centers in 2007 to more than 450 currently.
• There are 108 Million people on diets in the United States with
dieters typically making four to five attempts per year. (85%

5. B. Key Issues
• U.S. ranks 24th out of 30 nations in terms of life expectancy.
We spend only 3 percent of health care dollars on preventing
diseases (as opposed to treating them), when 75 percent of
our health care costs are related to preventable conditions.
Source: American Public health Association, Center For Health Policy, Issue
Brief, June 2012
• Dieting is huge business in US, yet most believe they do not
work.
• Patient surveys indicate that less than one-half of obese (BMI
30) individuals are advised by their physicians to lose weight.
• Physician surveys confirm doctors are reluctant to address
weight management issues, especially among the extremely
overweight.
• The KE Diet, picked up by the U.S. media as the Bride’s Diet,
earned millions in publicity, much of it negative.
• 99% of the morbidly obese in U.S. are not getting bariatric
surgery.
Market Situation

6. B. Key Issues
• The poor are underserved and index high for obesity.
• Cost of surgery is preventing many severely obese from treatment.
• Ketofast is currently not covered by insurance.
• Weight regain is the biggest concern in all of weight loss
• Ketogenic diets are gaining traction in weight loss and weight mgmt.
circles.
• Approx. 60% of the 4,900 U.S. community hospitals offer some form of
weight loss program.
• The top 4 weight loss advertisers spent $475M on advertising the first 9
months of 2012. Source: Kantar Media
• Ketofast was the 8th most searched diet of 2012 according to Google.
http://www.gymra.com/blog/most-searched-diets-of-2012/
• Obesity rates in US adults are projected to increase nationwide by
2030, exceeding 50% in 39 states and adding up to $66 billion to the
price tag of treating obesity-related diseases.

7. Market Situation
B. Key Attitudinal Issues - Physicians
• 71% of physicians believe their patients affected by obesity
"want the easy way out." Source: Foster GD, Obes Ress. 2003; 11:1168-
77
• 56% of physicians believe they are qualified to treat obesity"
Source: Jay M, BMC Health Serv. Res. 2009; 9:106-16
• More than 50% of physicians viewed obese patients as
awkward, unattractive, ugly, and noncompliant.
• The treatment of obesity was rated as significantly less effective
therapies for 9 of 10 chronic conditions (only drug addiction
worse).
• 75% respondents agreed that a 10% reduction in weight is
sufficient to improve obesity-related health complications and
viewed a 14% weight loss as an acceptable treatment outcome.
• More than one-half (54%) would spend more time working on
weight management issues if reimbursed appropriately.

8. Market Situation
B. Key Attitudinal Issues - Physicians
• Evidence of skepticism about Ketofast among physicians and
administrators.
• Physicians are leery of the NG tube, insurance and liability
but seem intrigued by the game-changing nature.

9. Market Situation
B. Key Attitudinal Issues – Consumers
• A majority of both men and women indicated support for laws
to prohibit weight discrimination in the workplace, but only
32% of woman and 27% of men indicated support for laws to
insure disability coverage.
• About half of people think their weight is just about right, and
only 12% of parents think their child is overweight. That's
even though government figures show two-thirds of U.S.
adults, and one-third of children and teens, are either
overweight or obese. Source: AP-NORC
• The U.S. public considers obesity second only to cancer as
the most serious health issue, with conditions closely related
to obesity—diabetes and heart disease—tied for third. NORC
• Face-to-face presentations close the deal (After Dr. Alan
Geiss’s presentations, the phone rings off the hook. After
Ramada Whitehall too.)

10. B. Key Attitudinal Issues - Deep Dive
Why are only 1% of the potential eligible population getting bariatric
surgery? Source: Bruce M. Wolfe, M.D. Dept. of Surgery, Oregon Health and Science
University, SORD, Sept,./Oct 12012
Limited access
• Provider capacity
• Insurance coverage (50% of insurance carrier cover, esp. large companies)
Information gaps
• Patients
• Physicians/providers
Fear of Complications
• Patients
• Physician/providers
• Bias directed towards persons with obesity

11. Communications Platform
A. Objectives:
• Increase awareness of Ketofast among all members of the
medical community.
• Sign up 500 Ketofast program participants in ‘13 (physicians,
GPS, admins.)
• Increase consideration of Ketofast as an alternative to bariatric
surgery.
• Increase awareness of Ketofast as reducing the rate of obesity
comorbidities.
• Raise awareness among bariatric physicians that the size of
the obesity marketing is 99X that of the surgery market.
• Increase awareness of Ketofast among morbidly obese and
caregivers.
• Convince patients to discuss Ketofast with their doctors.
• Increase Ketofast’s share of discussion on weight loss on the
web.
• Generate positive opinion among lawmakers and insurance

12. B. Strategies
• Use a pull strategy. Target patients and get them to ask their
physicians about the program. (Cover patients in science and
give them the tools to convince their doc.)
• Create a consumer brand steeped in science.
• Create an active presence on the web and in social media to
drive the new modality conversation.
• Test market in a state with high density of obesity.
• Use an almost “cause related” posture in messaging strategy.
• Target the morbidly obese and enlist them to help one
another.
• Identify and recruit key medical advocates for Ketofast.
• Position as a safe and high-impact alternative to surgery.
• Highlight and celebrate the wellness successes of patients,
not the weight lost.
Communications Platform

13. B. Strategies
• Create two 6 week test market programs in cities indexing
cities for Morbid obesity, e.g. New Orleans, Montgomery, AL.
• Educate our way to success, don’t sell. The need exists,
comfort and address the need with humanity.
• Do not compare to diets, position as a contolled, supervised
fast.
• Communicate the science (ketosis, enteral, 24 hours) so it is
understandable and believeable.
• Create a connection between the Ketofast process and the
After Ketofast protein options. A brand linkage.
• Detail the physicians, after some awareness aircover.
• Balance use of the web with real live events. Many poor don’t
have web access.
Communications Platform

14. Communications Platform
C. Targets and Potential Messages
Dr. Skeptical Do no harm is the Hippocratic oath.
And when it comes to rapid weight
doctors agree most programs are
dangerous. For those with patients at
the end of their health rope the best
route has always been surgery, but
with it comes risks. As much as
physicians would love a fool-proof 10
day program for patients, they are
skeptical.
“I heard about Ketofast and thought it was a gimmick until I
read the studies and listened to peers and patients.
Controlled fasting with an NG tube and pump will never be
OTC, but it can help my severely obese patients.”

15. Communications Platform
C. Targets and Potential Messages
Helplessly Obese The helplessly obese are morbidly
obese that don’t have a lot of support.
They may be impoverished, are often
without insurance and do not have a
great support structure. Likely they
have not gone to college and have
grown up with poor nutritional habits.
They tend to have other health issues
and stay away from doctors until
really sick.
“I heard about a new program available through doctors where you
don’t eat anything for 10 days and get all your food through a tube
that goes through the nose and into your stomach. It’s not a diet. It
is inexpensive and will not only take off 10% of my fat, but will
clear up a lot of other health problems.”

16. Communications Platform
C. Targets and Potential Messages
Weight Challenged Weight Challenged is a segment of the
morbidly obese population with higher
than average IQs. They are well
educated in obesity and understand its
health repercussions yet still over eat.
They don’t like to be lectured, are
articulate about their disorder and know
it can’t go on. They are embarrassed
and often think about surgery. They
spend a good amount of time online are
motivated to help others and worry
about their kids.
“I read about Ketofast and have even dreamt something like it.
Imagine doing a treatment that in 10 days almost creates a
new lighter person. It seems drastic measure, but not when
measured against the benefits.”

17. Communications Platform
C. Targets and Potential Messages
Conflicted The Conflicted are family caregivers
who live with the morbidly obese and
see the hurt it is causing. They are
conflicted because they don’t like talk
about overeating, secret eating,
portion control and the likelihood a
loved one is eating themselves to
death. But if they don’t who will?
Hopefully the doctor. What to do or
not to do, is always the question.
“I heard about a doctor-supervised controlled fast that helps
patients lose 10% of their body weight in 10 days. It’s a
tough program using a feeding tube and ketosis, but is non-surgical,
works and has good regain results.”

18. Communications Platform
C. Targets and Potential Messages
Healthcare Reformists Healthcare reformists are people
from the president on down who
care about healthcare justice for
all. They support improved patient
outcomes, patient quality of life,
increased dignity and fair, equitable
payment for healthcare service.
The Ketofast program offers a way to get the obesity epidemic under
control, while reducing the incidence and seriousness of Type 2
diabetes, stroke, hypertension, heart disease and cancer –
conditions that are putting unbelievable stress on healthcare and the
economy. What company or lobbyist could possibly argue against
Ketofast?

19. A. Dr. Skeptical
Communications
Programs and Tactics
Advertising
Trade Journal Launch – Use the top two trade journals in
each key practice area for 4 straight months. SORD, JAMA or
New England Journal of Medicine.
Radio – Use National Public Radio in top 10 US cities, with a
2 month introductory flight – offering research. Do 2
additional 6 week flights throughout the year. Buy drive time.
Online – Purchase display ads an sites indexing high for
bariatric physicians. Offer the Ketofast research. Websites
TBD.
Direct Response
Bariatric Surgery Complication Mailer – Purchase 500 of the
ASMBS bariatric surgery complications poster and print on
the back of the poster the one complications associated with
Ketofast, aspiration pneumonia. Drive physicians to our
website for video overview of the program and sign up page.

20. A. Dr. Skeptical
Communications
Programs and Tactics
Events
Dinners -Sponsor limited seating dinner event at a good
restaurants in key markets to introduce Ketofast to bariatric
physicians and recruit an advisory board. Promote via mail,
outbound telemarketing and limited radio (NPR). Plumb
attendees for referrals and provide incentives for referral or
advisory board members. Position as “Round Table Taking
Aim at Obesity.” First stop Geisinger Health System?
Prof. Cappello Live Online – Conduct an online presentation
of Dr. Cappello’s findings and latest Ketofast development
from his office in Rome. Use Google Hangout. Do Q&A via
chat.

21. A. Dr. Skeptical
Events (continued)
Communications
Programs and Tactics
High Power Dinner – Invite high profile weight loss
executives and physicians to a gather and share ideas about
better nutrition. “What should Kathleen Sebelius do? might
be the topic. Consider holding it in Washington, DC. Invite
high profile guest politicians such as Michael Bloomberg or
Newark mayor Cory Booker.
Promotion
Trade Show and Annual Conference Event Presence , e.g.,
Obesity Week 2013, American Diabetes Association's 73rd
Scientific Sessions in Chicago, etc.

22. B. Helplessly Obese
Communications
Programs and Tactics
Public Relations
Story Placement – Seek out writers who cover health and
wellness and pitch stories about how underserved the obese
community is. Share how few tools there are to help them.
Food deserts, (not desserts) Medicare coverage, etc.
Advertise
Create a single infomercial-like 5 minutes program that runs
for free on the Ketofast website and on a Ketofast YouTube
Channel. Promote with paid display ads.
Online:
Live Chat -- Provide real time live with Ketofast participants
so as to answer any and all question about the program.
E.g., “Do you get diarrhea? How is sleeping with the NG
tube?”

23. B. Helplessly Obese
Communications
Programs and Tactics
Documentary
Over the course of 10 days, film a documentary following Obese
patients undergoing the Ketofast treatment. At a single locations
attempt to truly understand the obesity psyche. Sign up 10
participants. Record the sessions on video, planned events, and
discussions. Target obese Posters, e.g., Melting Mama,
BoogieDown500, and likeminds. Include listen and learn
sessions with psychologists, dietitians, nutritionists and other
guest speakers. Consider a field trip to watch how the general
population responds to the obese in various settings. Call it The
Truth About Obesity.
Promise panelists edit and final approval power of shared
communications. Make this a long form documentary, with
editable chunks for lessons, and promo videos, etc. Interview
community members, family, caregivers, etc. Search for pathos,
humor, an attempt to de-stigmatize the condition.

24. C. Weight Challenged
Communications
Programs and Tactics
Advertise
Digital - On Huff Post Healthy Living Section and Yahoo’s
“Reluctantly Healthy.”
Print – New York Times Health Section – Tuesdays
Web
10 step program – Create one audio, video, event per day
(for 10 days) with special “speakers” to help patients focus on
actionable behaviors to keep weight off. Create resolve, not
lessons.
Enterall Forum -- On this forum, in this community, we preach
“Don’t ever, ever be afraid to hit Enter.“
How to Shop at the Grocery Store video – Stay away from the
middle of the store (the aisles). Use a nutritionist and a chef.
Use humor.

25. D. Conflicted
Communications
Programs and Tactics
Online
Taking Aim at Enabling Obesity Sitelet-- Create a content area
on the Ketofast website specifically to address caregivers and
healthy family members with obese loved ones. Challenge the to
share about enabling behaviors they feel contribute to obesity.
Also share positive behaviors caregivers can display. Interview
community members, family, caregivers, etc.
Advertising
Digital - Promote Participation in the Online forums via display
ads on site that index high for caregivers.

26. E. Healthcare Reformists
Communications
Programs and Tactics
Advertising
Op-Ed Campaign – Conduct a thought leadership campaign on the
politics of obesity, in the New York Times. LA Times and
Washington Post. Maybe CG Roll-Call. Tacking issues like HFCS
(high fructose corn syrup), marketing to children, food deserts,
education.
Email campaign – Sponsor email blast sponsored by SMART Briefs
and CQ Roll Call Daily Briefing.
Events
March in Selma Alabama. Borrowing from Dr. King’s march, revive
the concept in support of raising awareness about obesity and it’s
perils in the black and poor communities.

27. IV. Budget Allocation
Est. $4,350,000

28. Brand Strategy
KetoFast Controlled Fast takes aim at
Obesity.
Physician
Controlled
• Physicians are
the hero, not
drugs.
• Non-surgical.
• Educate our way
to weight
reduction.
• KetoFast website,
physician
monitored and
designed.
Fast Weight Loss
• 6-9% of body
weight in 10
days.
• Separated cycles
keep body
healthy.
• Fat stores first.
• Preserves lean
body mass and
organ mass.
Fast Attacks
Hunger
• Ketosis, no carbs,
controlled
appetite, teaches
the body restraint
• Regain metrics.
• Special KEN
Protein mix.