Noom sells psychology-driven weight loss — but former employees say they were unprepared for and overwhelmed by users' eating disorders, depression, and trauma
Tara Anand for Insider
Over one weekend last year, as the holidays approached, a user of the popular weight loss app Noom sent a series of alarming messages through the service's chat feature.
The user, in his mid-50s, described himself as a veteran with post-traumatic stress disorder and a father of three daughters, according to the Noom "goal specialist," or coach, assigned to him. He was expressing suicidal thoughts, which seemed to coincide with the coming holidays and pandemic-related isolation and stress. In one message, he wrote about "wanting to step off this ride."
The coach – whose job was to answer users' questions about Noom's program and send upbeat missives like "Stick with It!" – didn't see the messages until they logged in on Monday.
"When I didn't respond over the weekend, he asked why I had forsaken him," the coach, who has since left the company, told Insider. "I felt so awful that I couldn't do more, but I wasn't qualified to do anything but send a suicide hotline resource and encourage him to reach out to a therapist."
According to Noom's protocols, the case was passed on to a team that reviews whether users should be kicked off the platform, and the coach was told to direct the user to a suicide hotline and encourage him to talk to his psychiatrist. He replied that he was feeling more stable.
The man was allowed to remain on the app, though, and eventually, he stopped responding to messages. The coach never found out what happened to him and says the experience was intense and emotionally challenging.
The coach did not have access to the chat logs and Insider has no way of reaching the user or verifying the coach's account. But 13 former Noom coaches and coaching managers who spoke with Insider say the coach's story is consistent with their experiences working for the service. They described at least seven incidents where they or their colleagues flagged users threatening suicide. (The identities of coaches interviewed are known to Insider, but most of them asked to remain anonymous to protect their careers.)
'Easy access to a healthier life'
With its tagline, "Stop dieting. Get lifelong results," Noom frames itself as using psychology to address the root causes of weight gain, helping users lose weight, long-term, by reframing their thinking around food and eating habits.
"When it comes to losing weight, it's psychological," Noom says in one ad, which features a man who scrapes every morsel from his plate. The man is then transported back to the dining table of his childhood, across from a stern father figure, so he can connect the dots: "I've been conditioned to clean my plate since childhood!"
But it's not clear how Noom helps its users achieve breakthroughs, like linking a current behavior to childhood trauma, or how users can distinguish between unhealthy habits and, say, metabolic reasons for their appetites.
What is clear, according to interviews with more than 30 people, including former coaches, as well as other former employees, users and experts, is that Noom attracted users who appeared to be suffering from depression, eating disorders, and other acute mental health conditions, and understood Noom's "psychology-based" offerings to be something like therapy. While Noom doesn't advertise therapeutic services or eating disorder treatment, its emphasis on psychology and mental wellness can make it hard to tell the difference. Noom's coaches, who lacked the qualifications, preparation, and training to be psychological counselors, often found themselves working with clients who exhibited complex and sometimes frightening behaviors.
As the company's growth accelerated amid the COVID lockdowns of early 2020, a huge uptick in users put enormous pressure on Noom's coaching staff.
"Coaches may as well be therapists without licensure," one former coach and project manager told Insider. "It was like crowdsourced therapy."
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In response to a detailed list of questions from Insider about Noom's marketing, safety protocols, and training, a Noom spokesperson provided this statement:
"Noom has helped millions achieve their personal health and wellness goals using behavioral science techniques. It is incredibly important to us that every Noom user has a safe and rewarding experience as we continually evolve and improve our platform by incorporating user feedback and input from credentialed experts," the statement said. "We have robust processes and safeguards in place to protect the safety of our users, such as preventing at-risk people from joining the program and employing a team of clinical experts who are consulted upon signs of unhealthy behavior."
Noom was co-founded in 2008 by Saeju Jeong, an entrepreneur who studied electrical engineering, and Artem Petakov, a former Google software engineer. They spent a decade searching for a hit. A stationary bike digital interface (that might today bring the success of Peloton to mind) never caught on. A digital fitness tracker that included a step counter and food journal couldn't retain users and folded.
But the Noom Weight Loss app was a winner. In 2017, it became the first virtual program to be recognized by the CDC as an evidence-based program to help prevent diabetes, based on data that up to 64% of Noom users lost at least 5% of their body weight. By 2018, it was one of the most-searched diets, according to Google, after the low-carb keto diet and the celebrity Dubrow diet, and retained its top-10 spot through 2020.
In September 2019, Noom announced that tennis great Serena Williams had invested in the app. "I'm a true believer that everyone should have easy access to a healthier life," she said in Noom's press release.
In an era of growing disillusionment with juice cleanses and low-fat everything, Noom's success seemed counterintuitive. By pitching itself as something different from a diet and promising that long-term weight loss and mental wellness could be within reach, Noom managed to benefit both from the backlash against diet culture and growing awareness about the benefits of therapy, which can cost hundreds of dollars an hour. For $60 a month — the price varies based on the length of a subscription — Noom promised breakthroughs at a relatively affordable price.
'How would you like to feel this month?'
Before joining Noom, users fill out a questionnaire asking about what diet programs or mental health apps they've used in the past. "What feelings are you hoping to achieve during your journey with Noom?", the app wants to know.
Noom's marketing suggests a customized program, but all users are given a standard set of tools. For the first 16 weeks, they're encouraged to follow Noom's curriculum and watch a brief video lesson every day. These range from goal setting to short explainers on thought distortions, patterns of exaggerated thinking that exacerbate stress and anxiety, and emotional eating. The app also includes a step counter and food tracker, which categorizes foods based on caloric density.
In the sign-up process, prospective users are asked if they have an "active diagnosis of an eating disorder." Answering "yes" brings up a box that reads, "Noom is not currently designed to support those with an active eating disorder." However, "yes" does not close users out of the signup process, and it's possible to change the answer to "no" and continue.
Noom's signature offering has been its goal specialists, or coaches — real people with expertise in fitness, nutrition, wellness, or psychology, who offer regular encouragement.
Coaches said they were given client rosters that fluctuated in size depending on the time of year, and they were expected to send a certain number of messages per hour via Noom's chat feature. At Noom's peak, coaches were juggling 300-400 users at a time, and 600 or more during the January high season.
Coaches would reach out to users to ask, "How would you like to feel this month?" or encouraging them to "Remember your big picture!" They also responded to messages from users that appeared in the chat. Noom gave coaches prompts for "motivational interviewing" — a series of questions to help guide a user toward the best course of action.
Many of the queries were simple, like questions about Noom's curriculum, former coaches said. But other messages could be deeply personal. Some users described the minutiae of their daily lives and shared intimate details about themselves.
Often, users treated the chat feature like instant messenger and seemed to expect immediate engagement and empathetic responses. There's no limit to the number of messages a user can send and messages could add up to pages of text. When users' free-flowing messaging styles were met with the robotic cadence of motivational interviewing, or didn't get a quick response, users would grow frustrated and lash out.
The parameters of client and coach interactions are laid out on Noom's FAQ page. But getting there requires users to click through to "Support" and then "My program." It says that coaches are there to help with accountability and to support users' specific needs. It also says that coaches will check in weekly, during standard business hours, and that it can take up to two business days to respond to a user. "Together, you can discuss the highs and lows of your week and adjust your goals if needed," the page reads.
Based on the number of Noom users who went on social media to complain about their interactions with coaches, the often generic tone and the wait time of responses came as a surprise to many users.
"I'm like being legit vulnerable to my coach, only to be met with some Disney Channel type of energy. Very overly optimistic and happy, doesn't acknowledge what I'm really saying," one Noom user wrote on Reddit. "What I wanted was some sort of validation, most of what I message is ignored."
Noom coaches said they struggled to set ground rules and expectations when they interacted with users — a process in therapy that's known as "setting scope."
Some faulted the app's marketing and interface and felt it distorted users' expectations, making it unclear what the service entailed. Noom's directive that employees express an "unconditional positive regard" for its users made it difficult to be direct or set appropriate boundaries with users, former coaches said.
"You're fat and you're ugly, how can you help me?", one coach was told by a user, according to that coach's former manager. (Coaches' pictures appeared on Noom's chat feature.)
"One of the growing pains was that they didn't standardize support," said the former manager, who worked at Noom from 2019 to May 2022. "It was a fast-paced environment. And, as it scaled up, instead of just dealing with one jerk, maybe you're dealing with 30 jerks."
Jeffrey Greenberg/UCG/Universal Images Group via Getty Images
In its job ads for coaches, Noom said candidates must be willing to "pilot experimental coaching protocols" and help "prevent or manage chronic conditions by facilitating healthful lifestyle modifications." The ads called for a bachelor's degree or an associate's degree with relevant experience.
Along with recent bachelor-of-science graduates in nutrition and exercise science, the coaching staff included counselors and dietitians with years of professional experience. According to interviews with former coaches and a salary sharing document compiled by employees and viewed by Insider, Noom coaches' pay started at $37,500 and varied widely, up to about $46,000.
The experience that coaches brought to the job could vary widely. That diversity of experience was sometimes seen as a strength, and former coaches said counted on co-workers to help them work through solutions for their clients. But the downside was inconsistency. A Noom user might be assigned to a veteran psychologist who was adept at working through unhealthy habits, or a green 20-something with far less work experience.
Coaches got some training at the start and supplemental training was offered on an ongoing basis. Some of the coaches Insider interviewed said they were interacting with Noom users within two weeks of starting. Within a month, they were mostly on their own with clients.
Depending on when a coach started — for example, pre-COVID or after — the substance of the training varied widely, as did the experience of the trainers, former coaches said. The consistent part of the training focused on Noom as a product. But coaches said their training left them ill-prepared to deal with the unpredictable sides of coaching, like signs of an eating disorder or serious depression.
Noom employs, in addition to coaches, experts with mental health credentials, including a chief of psychology. But coaches who spoke to Insider said it wasn't always clear how they could access those resources.
A former coach with a masters degree in counseling and clinical psychology experience said that her experience of the training was that it was "terribly orchestrated and terribly done."
"It still feels like the beginning stages of an idea and not super based in science," the former coach said.
Emotional bandwidth
Rachel Clair was hired as a Noom coach in 2018, at a time when the coaching staff grew from 60 to about 200. She had a PhD in health psychology. And, for a while, she said it was a great place to work.
The job allowed Clair to work remotely — a relative rarity prior to COVID — and she could choose her own hours. (Clair said she underwent treatment for cancer while working for Noom, and was able to get ample time off for her medical care without losing pay.)
Like other coaches Insider talked to, she became concerned that Noom users were hyper-focused "on the scale and calories" while Noom wasn't equipped to treat disordered eating.
Then came March 2020, and the COVID lockdowns. Suddenly, everything from work to school to therapy went online. For some, the lockdowns were an excuse to become a digital nomad, or a master sourdough baker.
For others, the combination of isolation, anxiety, and being cooped up with a stockpile of packaged foods made the pandemic uniquely triggering for disordered eating, according to experts. Anxiety and depression increased by 25% worldwide, according to the World Health Organization. Eating disorder diagnoses spiked by an alarming rate, and hospitalizations for eating disorders rose at nearly 10 times the pace of the previous two years among young adults, a recent study found.
Noom became a ubiquitous advertiser on a dizzying array of new podcasts (more than 300, according to Noom's website), offering simple solutions to the stress-eating and pandemic weight gain from the convenience of a single app. Along with companies like Peloton and TalkSpace, Noom garnered media buzz as a pandemic success story.
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Noom nearly doubled its revenue from $237 million to $400 million in 2020, according to Inc. It announced a $540 million investment from Silver Lake the following spring. According to TechCrunch, it had an estimated 45 million downloads across 100 countries. (Noom declined to disclose its user numbers.) Valued at more than $3 billion, the company was looking ahead to a hotly-anticipated IPO.
But while the pandemic accelerated Noom's growth, coaches said they were inundated with huge caseloads, forcing them to juggle hundreds of users, some of whose messages were increasingly weighted with grief, stress, and anxiety. "We had users who had loved ones dying during COVID, users have gotten cancer diagnoses," the former coach with a counseling degree said.
Meanwhile, they said they were under pressure to hit performance targets that included how many messages they sent per hour, how many users they interacted with daily, and their response times.
By January 2021, Clair had become a coaching manager, and she said that the coaches she supervised had "less than five minutes" a day to focus on each client. During that time, she was a supervisor on two cases involving suicidal ideation.
Noom's growth had both dramatically increased what coaches were asked to do, and stretched whatever support was available to help them.
"They seemed to stop caring about the coaches and started caring about the numbers, and that trickled down to the users," Clair said. "Coaches put their heart and soul into it but when they can't take care of themselves, they don't have the emotional bandwidth to help users."
Clair left the company in June 2021 and now works as a freelance ghostwriter. "I was burning out too. I couldn't do my job and I couldn't take the stress anymore," she said.
J. Conrad Williams Jr./Newsday via Getty Images
Another coach, a recent college graduate with a degree in community health, described a similar trajectory. When she started, in 2018, she appreciated Noom's energetic and flexible work culture, and felt she could do some good.
But soon her coaching job felt more akin to a therapist, trauma counselor, or nutritionist. She worried she might be doing more harm than good.
"A majority of my conversations would be with people clearly in a very unhealthy relationship with food and their bodies," she said.
Three years after starting at Noom, she took another job and left. She and several former coaches told Insider they pursued a career in nutrition counseling because they had previously dealt with disordered eating themselves.
In addition to feeling like she was falling short as a coach, she said she was increasingly triggered by her own issues with food and dieting.
STING: A safety net with holes
In a typical therapy or counseling scenario, a clinician meets with a client to determine their needs prior to enrolling them in a program. The clinician might determine that the client is not a good fit and refer to more specialized or intensive care. But Noom does minimal screening, and asks just one question during sign-up to flag for eating disorders. Instead, according to former employees and some critics, Noom largely puts the onus on its coaches.
According to company training documents seen by Insider, coaches who encountered high-risk users were told to refer those cases to STING — "Support for Those In Need of Guidance" — and there would be a follow-up via Zoom within 24 hours.
STING was designed to determine whether users should stay within the app, or should be removed for issues beyond the scope of what Noom is designed to handle, such as eating disorders, serious mental or physical health issues or what Noom documents call "off label" use of the app as a substitute for therapy. Removal was a "last resort," the documents said.
STING teams were made up of coaches who volunteered for the roles and weren't paid extra for the time, as well as a supervisor. Multiple ex-employees told Insider that their understanding was that taking on additional assignments like this was important if they wanted to get a raise or promotion.
Users who reported self-harm or domestic abuse were immediately referred to STING, and suspected disordered eating behaviors, substance abuse, or medical issues could also lead to STING involvement.
Once a case is flagged, the STING team would work with the coach to assess or de-escalating the situation. If it's determined that the user needs outside resources, like a suicide or eating disorder hotline, that can be provided. In most cases, though, the goal is to bring the user "back into scope."
As one former employee who worked with STING explained it, the coach would copy and paste the relevant messages into a chat, and the STING team would offer help to redirect the conversation back to Noom's curriculum. If this was successful, the Noom user was generally allowed to stay on the app.
That former employee recalled working on several cases where users had told their coaches about experiences with sexual violence, which they believed had led to dysfunctional eating habits. Even in those cases, STING's goal would be to get the user back within the scope of Noom's program. A typical response might be: "It can be difficult to parse emotions, past events, and the present. Would it be helpful if I provided resources on emotional eating?"
Coaches confronting disturbing messages from users might spend a tense period waiting on a response from STING. If something came up after normal working hours or over the weekend, the wait could stretch to three days. According to Noom's training documents, if certain risky behaviors were observed after 5 pm Eastern time, coaches should wait until the next business day to report them. "Active purging... and bulimia does require escalation but does not need to be escalated after hours," the document says, without further explanation.
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One coach, a registered dietitian, said that users could sometimes avoid being kicked off the app by going along with STING's prompts and walking back, or denying, whatever statements had been flagged.
The former employee who worked with STING said one reason she left Noom was concern that users the coach believed should have been kicked off the app had been allowed to stay. The coach recalled, for example, one user who seemed to present signs of dissociative personality disorder, and responded to messages with a childlike persona.
"It was an ethical issue," they said. "They decided to move forward with coaching and I didn't feel it was clinically appropriate."
Heather Clark, clinical director of eating disorder treatment at the nonprofit Rock Recovery, said that in her estimation Noom's processes don't measure up to established standards of care for counseling and eating disorder recovery, which she said is concerning even if Noom doesn't claim to provide those services.
"It's a murky space that they've put themselves in, where they're saying that they're psychology-based, not a diet," she said. "It's tricky because dieting is a risk factor for eating disorders. It doesn't matter if you call it a diet or not."
"Part of our responsibility [as counselors] is that if someone needs more help than we can provide, we need to be honest about our limitations," she said.
Instead, Clark says it appears that Noom "falsely advertises safety" and then leans on its coaches to "pick up the pieces."
Counting calories
Meanwhile, critics have also cataloged concerns about Noom's methods. Reports that Noom was recommending 1,200 calories a day for many users prompted criticism from dietitians and led Noom to raise the range in November 2021.
Former Noom coaches said they routinely had users log daily calories below a safe limit. One coach told Insider they had a client who refused to eat more than 1,000 calories a day, and often ate significantly less — a level of under-eating which could have dangerous side effects, according to dietitians. The coach said they were advised to "coach around" the issue.
Coaches said users who logged too few calories in a day should have received warnings from the app, but Noom didn't have a mechanism for that. Other weight-loss apps, such as MyFitnessPal, generate an automatic message if a user logs too few calories.
In a blog post updated July 2022, Noom discussed a new feature that prevents users from setting a calorie goal below a certain limit. The app's sign-up process was also updated to generate a suggested weight range, based on BMI, and prevent users from setting a goal weight that would categorize them as underweight. Former coaches said they previously had to manually calculate a user's body mass index (BMI) to prevent them from setting a goal that would be medically underweight, a process confirmed in a training document seen by Insider.
Noom cites an array of peer-reviewed studies on its research page in support of its methods based on a time frame from 16 weeks up to 18 months. A majority of those studies are co-authored by Noom employees or advisory board members.
While a healthy diet and vigorous physical activity is known to promote good health and relieve stress, those who lose weight through dieting often regain the weight over time. In addition, dieting is known to raise the risk of disordered eating, says Melainie Rogers, founder of BALANCE eating disorder treatment center.
"Repairing people's relationship with food and body image is about pushing away that thin ideal and working with people to become healthier where they are, Rogers said.
Noom "really hit it out of the ballpark with the marketing," Rogers said. "But are they selling something they can't provide?"
Downsizing
By mid-2022, Noom's fortunes had shifted. The company was facing "cash burn," including a $56 million settlement after users alleged they had been billed for subscriptions long after they'd tried to cancel them. Along with other pandemic-era success stories like Peloton, which laid off hundreds of employees in 2022, it appeared that Noom had grown too fast.
Noom staff are referred to as the "Noomily" (Noom Family) in emails and work messages. But former employees described Noom's culture as one of "toxic positivity," where they were expected to be unflappably upbeat and enthusiastic about the company, and said it had led to serious burnout.
A company representative, listed online as an external coach communications project coordinator, told employees in Slack to refrain from criticizing the company in a work environment survey for a third party, emphasizing that feedback should be kept internal, according to screenshots seen by Insider. Another company representative then walked it back by saying they wanted people to be honest on external surveys, according to the screenshots.
In late April, Noom laid off 495 coaches — 25% of its coaching staff.
According to a document produced a month earlier by Noom management, the goal of the layoffs was to quickly trim $40 million from the company's costs and lose lower-performing coaches.
"Costs are high," Noom management said in the document, which was seen by Insider. "Because we were not as rigorous as an organization, we have not allowed things to be performance managed. This is our preferred method of controlling costs."
Annette Riedl/picture alliance via Getty Images
In October, 500 more Noom coaches were abruptly called into a virtual meeting and laid off.
The move was explained as part of a pivot away from the coaching model, former employees familiar with the company's internal strategy told Insider.
"Our model is not sustainable," Dr. Andreas Michaelides, Noom's chief of psychology, said in a company meeting, a transcript of which was seen by Insider. "We are focused on experiments that are more premium coaching."
Many users were also shaken by the layoffs. The lively Noom community on Reddit was filled with posts from users expressing frustration with the abrupt loss of coaches with whom they'd built a strong connection.
"My coach was the only reason I used the app. She was so kind and compassionate," wrote one user.
Former employees said they were told that coaching would ultimately become an add-on service. One former product team member said that most users didn't engage with coaches and "don't like coaching."
It's not clear how the coaching model will change, or whether Noom will address some of the underlying issues that critics have raised, including Noom's screening process, the confusing points of its marketing, who it hires, and how it trains coaches.
"Working there truly hurt my mental and physical health, even though that's what the company preaches," said the former coach who joined the company right out of college.
"I felt like I could never relax, even when my work day was done, because all I could think about is the messages from people who desperately need support piling up."
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