91导航

Maya聽Ajmera, President & CEO of 91导航 and Executive Publisher of Science News, sat down with Shantanu Gaur, Founder and CEO of聽Allurion聽Technologies, who created an FDA approved medical device for the treatment of obesity. Gaur is聽an alumnus聽of the 2003 and 2004 International Science and Engineering Fair (ISEF), a program of 91导航. A graduate of Harvard College with an M.D. from Harvard Medical School, Gaur has more than 40 patents. Gaur also serves on the Society鈥檚 National Leadership Council.

You competed at ISEF in 2003 and 2004. What impact did that have on you and your career?聽

Twenty years later, two things still聽stick out聽to me. One, ISEF was the first time I had an opportunity to see what exceptional science and engineering really looks like. I grew up in a small town in southwestern Pennsylvania, and suddenly I was standing alongside students from all over the world doing genuinely聽cutting-edge聽work. It was eye-opening. I could see a level of talent I聽hadn鈥檛聽encountered聽before, and it motivated me. It also gave me a sense of community. I聽had aspirations聽to become a scientist, and for the first time I felt like I聽wasn鈥檛聽alone in that. I was surrounded by people who shared the same drive.

For my junior year ISEF project, I studied a rare genetic mutation in the Afro-Caribbean population of Trinidad and Tobago that raises the risk of prostate cancer. We investigated whether screening for that mutation could help to ensure that the limited resources in Trinidad and Tobago could go to those patients at highest risk. During my senior year, I worked with chicken embryos on a protein involved in retinal development. It was my first time doing wet-lab work with a live specimen. In my senior year project, I learned about the power of negative results to advance a field and so much about the joys and challenges of wet lab science.

You聽founded聽Allurion聽while you were still in medical school. What made you choose that path, and what did the people around you think?聽

Allurion聽started as a weekend project鈥夆�斺�塻omething my classmate Sammy and I found interesting outside of class. As we got encouragement from faculty, I eventually had to decide whether to finish my residency or leave to build the company. I went to my dad,听who鈥檚聽a math professor, for advice. And he laid it out in stark, quantitative terms: As a physician, you have one pair of hands.聽You鈥檒l聽see patients for decades and touch the lives of聽maybe 100,000聽or 200,000 people, and聽that鈥檚聽a meaningful, fulfilling career. But if you build a company around a real problem, you have the potential to touch the lives of millions. There is a risk, however, that if your business never gets off the ground, you聽may聽touch no one鈥檚 life. He asked me a simple question: Do you want to maximize your life for impact or not?

That question is what pushed me toward聽Allurion聽and has shaped everything else in my life since. My advice is to take the risk and work on big problems because the potential聽payoff,听in聽lives changed,听can be enormous.

Obesity is one of the most complex and stigmatized conditions in medicine. What convinced you it was the problem worth solving?聽

Two billion people worldwide are overweight, and a聽billion聽have obesity. More people die every year from obesity-related disease than died from COVID-19 at the height of the pandemic.聽It鈥檚聽the health issue of our generation, and like other chronic diseases,听it鈥檚聽not going to have one miracle-pill solution.聽聽As a second-year medical student, one of the patients I met was a young woman聽who鈥檇聽had bariatric surgery. She spent weeks in intensive care afterward and ultimately recovered, but seeing how physically and emotionally invasive that experience was, my classmate and I kept thinking: There聽has to聽be a better way.

How does the聽Allurion聽balloon work?聽

The whole concept behind聽Allurion聽is this: Could we develop a non-surgical way of getting a device inside the stomach so that it can start helping people feel full? We know that bariatric surgery works because it reduces the volume of the stomach. Why not put something inside the stomach instead and avoid聽the surgery?

We developed a capsule with a balloon inside it that is attached to a thin tube, about the width of a piece of cooked spaghetti. A patient swallows the capsule in a doctor鈥檚 office. Once聽it鈥檚聽in the stomach, we attach a bag of water to the tube and fill the internal balloon over about five minutes, with no anesthesia or sedation. Once the balloon is filled鈥夆�斺�塧bout half a liter, weighing around a pound and a quarter鈥夆�斺�墂e withdraw the tube and the patient goes home with what amounts to an implanted meal sitting in their stomach. The human stomach is聽roughly the聽same size in every adult regardless of height or weight, so one size fits聽nearly everyone. The balloon stays in place for four months and is there to give patients time to build new habits, without invasive surgery or taking medications.

Were there moments you almost gave up?聽

Constantly.聽There鈥檚聽a line from Angela Duckworth鈥檚 book聽Grit: The Power of Passion and Perseverance聽that captures it for me: 鈥淓nthusiasm is common, endurance is rare.鈥� Every startup begins with excitement about聽the science听补苍诲听the vision, and then you actually have to build it.聽That鈥檚聽when you realize that if building a company were easy, everyone would be doing it.

When we were raising our first round of financing, we went to a hundred investors and got a hundred nos. We were medical students with no business or engineering background, trying to fund a device聽we鈥檇聽only聽demonstrated聽by filming a prototype pushing against the walls of an animal鈥檚 stomach. After our savings ran dry, we聽scraped together聽$25,000 and $50,000 at a time from family,听friends聽and professors to fund our first real animal and human studies.

Even today, some investors still doubt there鈥檚 room for a technology like ours, especially with GLP-1 drugs on the market. The lesson is that there will always be more people who doubt you than believe in you. The job of an entrepreneur is just to keep聽enduring, because聽changing minds takes years.

What role does AI play at聽Allurion, and where do you see it going in medical devices more broadly?聽

We聽don鈥檛聽use AI in the balloon itself, but聽it鈥檚聽central to our digital platform. Managing any chronic disease鈥夆�斺�塷besity, diabetes, hypertension鈥夆�斺�塽ltimately comes聽down to changing daily habits, and there simply聽aren鈥檛聽enough dietitians and coaches in the world to support the two billion people who want to lose weight. Our app includes a conversational AI coach, Iris, that looks at a patient鈥檚 data and nudges them accordingly鈥夆�斺�塺eminding them to weigh in or serving up content on sleep if聽that鈥檚聽where聽they鈥檙e聽struggling.

Beyond the patient experience, AI is changing how we run the company: we use it to analyze product complaints, track lot聽history听补苍诲听monitor聽regulatory changes across the more than 80 countries where聽we鈥檙e聽approved. I聽don鈥檛聽think AI will change what a medical device physically is, but聽it鈥檚聽already changing how devices are developed,听personalized聽and supported over time.

What鈥檚聽next for聽Allurion?聽

We have an exciting pipeline at聽Allurion. We are working on a version of the balloon that stays in the stomach for a full year instead of four months and one that could function as a platform鈥夆�斺�塻lowly releasing a GLP-1 medication, vitamins or something that supports the gut microbiome rather than just occupying space. With 2 billion people around the world in need, even after all these years, we have only just begun.

What books did you love as a child and what are you reading now?聽聽

I loved historical fiction as a child, with the Civil War trilogy聽Gods and Generals,听The Killer聽Angels听补苍诲听The Last Full Measure聽at the top of the list. Now, I am working my way through聽The Obstacle is the Way, a must-read for any scientist or entrepreneur!

What worries keep you up at night?

I worry that in a world of abundance, fueled by the technological advances made possible by AI, that knowledge and power聽becomes聽more鈥夆�斺�塶ot less鈥夆�斺�塩oncentrated.聽I want my children and their children to live in a world where knowledge is abundant and聽accessible聽and anyone has an opportunity to advance a world-changing idea.

What gives you hope for the future?

Entrepreneurs give me hope for the future. Every problem has a solution, and I take comfort in the fact that humans will inevitably find聽the solutions聽to any problems that imperil our future.