How a PCOS Diagnosis Fueled One Founder’s Mission to Disrupt Women’s Health

For most of her teenage years, Ali Chappell, PhD, RD, Co-Founder and CEO of Lilli Health, struggled with her weight, disordered eating, irregular periods and severe acne, unrecognized symptoms until her diagnosis of polycystic ovary syndrome (PCOS) at age 21. That turning point set Chappell on a new path, not just as a clinician, but eventually as a company founder.

“I was about to finish my undergraduate degree in nutrition and on my way to being a dietitian and never heard of PCOS and never heard of any connection between your diet and ovaries,” said Chappell.

When her provider told her PCOS is connected to weight gain, which can exacerbate symptoms, Chappell decided to conduct a deep dive into how diet plays a part. However, while pursuing a master’s degree in nutrition and metabolism, she realized there were few opportunities to study PCOS.

What began as a personal health crisis evolved into a rigorous line of research, multiple clinical trials, and ultimately creating a company aiming to become “a dietitian in your pocket” for millions of women underserved by traditional care.

Securing Funding to Study Low Insulin Lifestyle

As Chappell continued on with her doctorate degree, she learned that the metabolism of women with PCOS is different, with insulin resistance affecting up to 95 percent of those with PCOS.

Knowing this, she began developing the idea for a Low Insulin Lifestyle. In 2010, she secured funding from the Laura W. Bush Institute for Women’s Health to kick off her first study on the impacts of a Low Insulin Lifestyle for the treatment of women with PCOS.

“Usually when you’re a doctoral student, you just do the research that your doctoral supervisor carves out, but I came in and said I want to do this study…and [my PhD mentor] told me to get funding and find someone who would refer patients to the study,” said Chappell. “Getting funding from the Laura Bush Institute was a big deal.”

The study results showed that participants following a Low Insulin Lifestyle achieved a 52.9 percent reduction in insulin levels and averaged 19 pounds of weight loss over eight weeks. The results led to several peer-reviewed publications after Chappell completed an NIH postdoctoral fellowship in women’s health nutrition. The results were later replicated in a large, randomized controlled trial comparing a Low Insulin Lifestyle to metformin and standard of care in 2018.

“Then after that, we got the National Science Foundation grant, and that’s when I was [convinced that] ‘I need to launch this as a company’,” said Chappell.

Lilli Health Launched to Improve Lives of Those with PCOS

Chappell credits the National Science Foundation grant for the launch of Lilli Health.

“They allow you into this program with people from all over the country who have science-backed products who they feel have true potential for societal change,” she said.

She was matched with mentors from Cornell University who helped her follow through on 100 interviews with providers and patients across the globe to identify the problem and the solution she intended to provide.

She concluded that some providers don’t have enough time to fully understand insulin’s role in PCOS and that patients are frustrated with finding a solution.

“The program is really what helped me go from scientist to CEO,” Chappell said.

In 2022, she launched Lilli Health with the help of her husband Johnny Chappell, Co-Founder and COO, who left his job as vice president for a small oil and gas company.

“He left his career to help support this dream and so we are learning together to make something special,” said Chappell.

The company’s foundational principal is to educate people on a low insulin lifestyle.

“If we’re only using a glucose-centric model, we’re missing the most important piece of PCOS, which is insulin,” said Chappell.

The company offers a kit that tests markers of metabolic health.

“The vast majority of primary care physicians are not testing insulin. They are testing A1C, so the kit is testing your A1C as well as your insulin and all these other markers for metabolic health,” said Chappell. “You can do it in your PJs instead of driving to the lab and having to be there fasting waiting in line.”

Lilli also offers an app that provides meal planning, tracking of symptoms, and monitoring of menstrual cycle.

“We really think of this as a one stop place because previously you had several tracking devices--calorie tracking apps, and mood tracking apps, and recipe apps but nothing specifically focused precisely on what is driving their symptoms in one place so they can have a full picture,” Chappell said.

FDA Clearance Proves Biggest Challenge

Chappell says intellectual property is hard to secure for lifestyle change products and she plans to eventually patent elements within the Lilli App. However, the biggest challenge she faces is getting FDA approval.

“I’ve been communicating with the FDA for the last year and a half trying to get this therapeutic FDA cleared but insulin resistance isn’t yet as well accepted as a condition by the FDA,” she said. “It is a precursor to other conditions but it is not a disease in of itself.”

She is hopeful that as more research is conducted about the benefits of an insulin-centric approach to PCOS, more providers will embrace it and eventually it will get FDA approval.

While some competition exists regarding wellness and nutrition apps, she said none specifically related to PCOS with a targeted approach towards insulin resistance. Telehealth medicine platforms are also competitors but they focus on provider-patient interactions.

“We’re trying to be that dietitian in your pocket,” said Chappell.

Up to this point, funding hasn’t posed a problem. The Chappells first turned to friends and family with success. Since both are members of the Aggie Angel Network, they have received support from the community.

“We are excited to grow the company to have valuation as high as we can have it before we actually go for funding those first rounds. That’s where we’re at right now,” said Chappell.

Practicing patience is a big lesson she learned along the way.

“I had no idea how long it was going to take to build the dream app that I wanted. I had a vision and been through other PR teams and thought we were ready to go but it took more time,” she said. “I had to move to another company and then had to rebuild, which took time. I learned a lot in that whole process.”

Giving Back to Her Younger Self and All Women with PCOS

With her PCOS symptoms under control and as a mother to two children, Chappell feels for her teen self who thought neither would be possible.

“If I would have known in my darkest days that I wouldn’t be living with frustration, pain, and a terrible eating disorder and fear that I wouldn’t ever have children, and if knew that one day not only would I not suffer from all that but I would be doing something to help other people on that journey, [it would have been] a light on that journey,” she said.

Part of her mission with Lilli Health is to give back by supporting other research.

“We just gave our first Lilli research grant,” Chappell said.

She plans for Lilli Health to continue conducting research and expanding outside of PCOS into areas related to perimenopause and menopause.

“This is an area where there should be a focus on insulin and insulin resistance,” said Chappell. “I want insulin lowering to be a standard of care for lifestyle intervention.”