Where We Stand: CYH vs the Market (Aug 2026)

The one-line version

We are approaching a ~$10M annual revenue run rate (roughly $900k per month gross, $750k net), with healthy gross margins and positive contribution even after all marketing spend, run by **10 full-timers and ~25 people all in** (about 13 to 14 full-time-equivalents). On revenue per person we are already in the same league as companies 100x our size and funding. We out-earn the app-only alcohol players and stand toe to toe with our closest direct competitor, in a harder, medical-grade model, and our unit economics already work.

Us, counted honestly

Full-time (~10): CEO, COO, Jamieson, Gui, Gustavo, Nicole, Ashley, Hazel, plus Adam and Danielle running coaching.

Part-time / contract / advisor (~12+): Lucas (marketing), Liz (PR), Steffanie (advisor), Dr. Montville (naltrexone), Dr. Levasseur (GLP-1), Dr. Sanchez, Kristi, Alison, Nici (sync consults), Jessy and Stephanie (coaching), and Marissa and Lee (alcohol groups).

• Total headcount: ~24 to 26 people
• Full-time-equivalents (FTE): ~13 to 14
• Revenue per FTE: ~$750k
• Revenue per raw head: ~$400k

For context, a typical startup runs $100k to $300k of revenue per employee. We are well above that, and we are doing it with margins that already carry the business at the contribution line.

The scoreboard

Three weight classes, and where we sit

1. The titans (proof the market is enormous). Hims ($2.35B revenue, public), Whoop ($1.1B revenue, $10.1B valuation), Noom (~$1B revenue), and Ro ($7B valuation, over $1B raised) show the ceiling. People pay for at-home, medication-assisted health at massive scale. The GLP-1 and behavioral-health waves we are riding are the same ones minting these outcomes. The size of the prize is measured in billions.

2. The category peers (behavioral alcohol apps). Reframe ($13M revenue, 78 people, $19M raised) and Sunnyside (37 people, $14.6M raised) are the app-first alcohol players. We are already at or above Reframe's revenue with a leaner team, and unlike them we deliver actual medical care (prescriptions, clinicians), not just habit coaching. On revenue per person we are running roughly 4x a peer like Reframe.

3. The direct competitor (Oar Health). Oar is the closest mirror: naltrexone for alcohol, virtual, profitable, doubling revenue, past 50,000 patients, run by ~13 employees plus ~30 contract clinicians. That structure is almost identical to ours (small core team plus part-time prescribers). We are structurally competitive with our biggest competitor, and broader in scope: naltrexone plus GLP-1 plus coaching plus groups, where Oar is naltrexone-first.

The punchline

We are not a scrappy also-ran a few tiers below the real companies. We are an earlier, leaner version of billion-dollar businesses, built in a harder regulated domain, already out-earning the app-only players and matching our most direct competitor, doing it at a revenue-per-person figure ($750k per FTE) that rivals Whoop ($750k) and Noom (~$845k) on a rounding error of their capital, and with unit economics that already work.

The titans prove the ceiling is enormous. Our efficiency proves we can climb toward it without burning nine figures to do it. That efficiency is the superpower to protect as we add the people and capital that turn "impressive for our size" into "impossible to catch."

Sky is the limit.

Strengths and weaknesses vs the set

Strengths

• Multi-modal care under one roof. We combine real medical treatment (naltrexone and GLP-1) with coaching, groups, and an app. App-only peers (Reframe, Sunnyside) cannot prescribe; single-modality players (Oar is naltrexone-first, Whoop is hardware) cannot match the breadth. That breadth is a cross-sell and retention advantage.
• A diagnostics engine none of them have. Through our sister company Choose Health (a growing at-home testing business) we already ship liver kits, and that barely scratches the surface. No one in this set (Whoop, Noom, Hims, Ro, Reframe, Sunnyside, Oar) has a captive, growing at-home testing arm. It lets us convert a sobriety sign-up into a long-term health-monitoring relationship, which is both a moat and an LTV engine.
• Elite efficiency with real unit economics. ~$750k revenue per FTE and positive contribution after marketing, against a category history of heavy cash burn (Noom). We do not need nine figures of funding to compete.
• Fastest growth in the set (see below).
• Speed. A small team turns strategy into shipped product in days, not quarters.

Weaknesses and risks

• Single-franchise reliance (and rising). The large majority of revenue today comes from our naltrexone (alcohol) franchise; GLP-1 and coaching are still small, and we are winding down ketamine, which concentrates us further. This is our biggest strategic risk, and it makes diversification through new adjacent categories more urgent, not less.
• Cash-pay only (for now). Every dollar today is out-of-pocket, which caps who we can reach to those willing and able to self-pay. Our IOP move into insurance (see The expansion, below) is the fix, and a large one.
• Regulatory exposure. Telehealth prescribing rules and compounded GLP-1 crackdowns can each move a chunk of revenue quickly, and we are more exposed here than app-only peers. Exiting ketamine removes one controlled-substance risk, but the trade-off is deeper naltrexone concentration.
• Paid-channel dependency. Growth leans on paid acquisition (Google, Meta), and our contribution margin, while positive, is thin. A CAC spike or ad-policy change squeezes us fast. Organic, brand, and content are the hedge.
• Competitor entry from above. The titans have the balance sheets to enter alcohol any time (Hims and Ro already sell adjacent categories), and Oar is scaling with national TV. We win on speed and breadth today, but the window rewards moving fast.
• Team fragility. Two engineers gate everything. This is the first place growth capital should go.

When to add people (using revenue per employee)

We run ~$750k of revenue per FTE. A healthy growth-stage digital-health company sits closer to $400k to $500k per FTE. Being well above that is not a trophy; it means the team is stretched and we are likely leaving growth on the table.

• At today's ~$10M run rate, a healthy ratio would support roughly 20 to 25 FTE (we are at ~13 to 14). That is headroom for about 6 to 10 more full-time hires before efficiency would even look average.
• Hire now, not later. We are contribution-positive and growing ~180% a year; adding ahead of the constraint is affordable and arguably overdue.
• Sequence: (1) engineering first, since the two-person team is the binding constraint on the insights work and everything else; (2) a data/analytics hire to take load off Gui; (3) clinical and ops capacity to protect fulfillment quality as volume climbs.
• Re-trigger: each time growth pushes revenue per FTE back above ~$650k to $700k, add the next hire.

Growth vs the set (last ~12 months)

We are the fastest-growing company in this comparison, running roughly 2.8x year over year (about +180%), with recent months near triple the same months a year prior.

• Choose Your Horizon: ~+180% YoY (off a smaller base)
• Oar Health: ~+108% YoY
• Whoop: ~+103%
• Hims & Hers: ~+59%
• Reframe: ~+50%
• Noom: mature core, with growth concentrated in its newer GLP line

The honest caveat is base size: it is far easier to grow fast from ~$10M than from $1B. But growing faster than every company in the set while staying contribution-positive is exactly the profile that earns the right to scale.

Top priorities for the next 6 months

Each of these presses a strength or attacks a weakness above.

1. Retention through the Upward Spiral insights project. The cheapest growth is the churn we prevent. Making tracking pay off in visible, personalized insights lifts LTV across every product. Highest-leverage bet, and already in motion.
2. A paid app-only tier (no meds). Lower CAC, higher margin, and a way to monetize the large group who want help but are not ready for medication. It diversifies us away from prescription reliance and competes with Reframe and Sunnyside on their turf, with our stronger content and coaching.
3. More self-guided content. Content is the engine of both the app-only tier and the Learn step of the flywheel. Low marginal cost, builds organic and brand (hedging paid-channel dependency), and improves retention. A compounding asset.
4. Diversify the product line. With ketamine winding down, this is more urgent, not less: grow GLP-1 deliberately and test tangential, high-intent categories (sleep is already in motion for Q1 2027, then weight management, focus and energy). It is the direct answer to single-franchise reliance, and each new line is a cross-sell into an audience that already trusts us. The IOP and sleep moves below are the first concrete steps.
5. Turn testing into a long-tail LTV engine (Choose Health). We have barely tapped the sister-company partnership. Expand beyond liver kits into broader at-home health monitoring, so a customer who came to get sober stays for years of ongoing health tracking. This deepens LTV, strengthens retention, and is a differentiator no competitor in the set can easily copy. It also pairs naturally with the insights project: more testing means more data, means richer insights.

Supporting all five: add engineering capacity (see timing above), because every priority here is gated by the same two-person team.

The expansion already underway (the ceiling is higher than the numbers)

Two moves in flight widen the market well beyond where the numbers sit today.

1. Insurance, via the IOP program (the big one). We are building an Intensive Outpatient Program for AUD. It matters on three axes at once:

• New payer model. Our naltrexone business is 100% cash pay. IOP is our move into the insurance world (out-of-network first). Cash pay limits us to people who will self-pay; insurance opens the majority of the market. This is the single largest market expansion on our roadmap.
• New patient network. IOP plugs us into a different population of AUD patients seeking outpatient therapy, an acquisition channel beyond our paid funnels.
• New modality, with a bridge to ours. IOP is therapy-led and not medication-assisted today, but it can be combined with naltrexone and/or GLP-1 later, turning a therapy relationship into a full medical one and vice versa. Cross-sell in both directions.

Net effect: IOP diversifies us on the two axes where we are most concentrated, product/modality and payer, at the same time.

2. A sleep vertical (Q1 2027). Rob is building a sleep protocol, and Dr. Montville has already identified a physician to lead it, targeted for Q1 2027. This is the first concrete step on the tangential-category priority: a new therapeutic line that cross-sells into an audience that already trusts us. Poor sleep and alcohol are tightly linked, so it is a natural adjacency, not a random bolt-on.

Together these say the ceiling is higher than a ~$10M naltrexone run rate implies: we are adding a payer model that multiplies the addressable market and new clinical verticals that multiply LTV.

Caveats (so we quote it straight)

• Competitor revenue and headcount are third-party estimates (GetLatka, Sacra, Crunchbase, stockanalysis, press) unless the company is public; treat them as directional.
• Our top-line is a run rate; the deeper proof of durability is retention and net profitability over time. Our contribution margin after marketing is already positive, which is the hard part, but this is a run rate, not audited annual results.
• Employee counts are not apples to apples: Hims, Ro, and Oar all use contract clinicians who are not in their headcount, similar to our part-time docs. We show both FTE and raw-head views for that reason.

Sources

• Whoop: GetLatka, Series G $575M at $10.1B (Yahoo Finance), Sacra
• Noom: GetLatka, Sacra
• Hims & Hers: Revenue (stockanalysis), Employees (stockanalysis)
• Ro: Sacra, PitchBook
• Reframe: GetLatka, Crunchbase
• Sunnyside: Series A $11.5M (TechCrunch)
• Oar Health: Digital care milestone, 50k patients (Xtalks)