At REMUS, we have a special knack for finding rebels.
It’s what we do. We look for contrarians who are unafraid to challenge the conventions that constrain creativity and impede progress. We believe these free-thinkers have the audacity needed to build the world’s most exciting, most innovative, and most transformative companies.
But what defines a “rebel”? Are rebels born, or are they made? What does life look like for them?
In this series, we’re speaking with some of the boldest, most passionate, status quo-upturning rebels we know to answer these questions and more.
Today, we’re speaking with Shantanu Gaur, founder and CEO of Allurion Technologies: a rebel in the medical device space. Allurion is the creator of the Elipse gastric balloon, which helps patients lose weight thanks to an outpatient procedure that requires no surgery, endoscopy, or anesthesia. Allurion’s contrarian view of obesity treatment has catapulted the company to success. By keeping patient needs and interests at the center of its strategy, Allurion has touched thousands of lives around the world.
In his leadership position at Allurion and throughout his life, Shantanu has valued contrarian thinking. Here’s what being a rebel means to him.
How do you define “rebel”?
A rebel is a contrarian, someone who has the courage to hold an opposite view. In entrepreneurship, rebels abound. Good entrepreneurs often hold views that are contrarian, that aren’t obvious, and which require time and effort to validate.
The Sioux Indian tribe has a concept they call the heyoka, a person dedicated to contrarianism within the tribe. The heyoka is part jester, but s/he also forces the rest of the tribe to question the boundaries and customs they’ve created. That concept—to never shut the door on a contrarian viewpoint—resonates strongly with me. Often the greatest ideas, the greatest inventions, the greatest paths to progress in our society are plowed by those individuals who hold that contrarian view.
What makes you a rebel?
Certainly my role as an entrepreneur makes me a rebel, as does my work in obesity, which has often been viewed as the ugly stepchild of the healthcare space. Obesity is a problem that everyone faces but no one really wants to talk about. It takes courage to enter a space like that with something innovative and novel, to stare at all of the failures that have come before us, and to have the courage to move forward with our somewhat rebellious view of how the world should view obesity.
I think it takes several different characteristics to be a rebel as an entrepreneur. You have to be audacious. You have to think big. But you also have to have the grit to see it through. In her book Grit, Angela Duckworth says “enthusiasm is common; endurance is rare.” There are so many would-be rebels who have the enthusiasm, the energy, and the passion to think differently. There are very few who have the endurance to see it through.
How do you cultivate that endurance? Or do you think it’s innate?
Like all skills, I think it’s a combination. Some are born with grit, some have it beaten into them, and some are just more likely to be successful in a difficult environment.
As an entrepreneur, one thing that really helps is to surround yourself with gritty people. That’s something we’ve done intentionally at Allurion. We want people who can stare failure in the face, accept it, move on, and build from it. It’s much easier to be a rebel when you’re surrounded by other rebels. When your energy levels and enthusiasm are down, there’s nothing better than to have them picked back up by people around you who are gritty and deeply rebellious.
Who are some rebels who have surrounded you in your life?
It starts with my parents, who were immigrants to the United States. I think people who drop everything and move entire families to start a new life are some of the greatest risk-takers out there.
Growing up, I heard stories of how my parents were able to succeed in a very resource-scarce environment. I heard stories of how they got out of that environment and into the promised land, where they built a family and had meaningful careers. That built grit in me as a kid. It taught me that the cloth I was cut from is a really tough one.
And certainly going through the experience of starting a business and seeing all the ups and downs along the way taught me to be gritty. When you start a business, you learn to endure. You learn that no problem is unsolvable. Periodically reflecting on problems you’ve solved builds those muscles that allow you to move forward, even though times may remain difficult.
Can you talk about what you might consider a defining challenge from your life or your business?
When we started Allurion back in 2009, my cofounder Sammy and I were medical students. At the end of medical school, we had a very tough decision to make: should we go full-time into Allurion and see it through, or should we continue on our journeys to become physicians?
I remember sitting down with my father, who’s a mathematician and a brilliant guy. As a rebel himself, he gave me very good advice. He assumed that as a doctor I would treat 10 patients a day for 5 days a week. That’s about 50 patients per week, 200 patients per month, 2400 patients per year. If I were to practice for 20-30 years, I would probably touch the lives of tens of thousands of people. That’s incredibly fulfilling, and not many people can say that.
If I pursued Allurion, however, I could potentially impact billions of people, because that’s how many people around the world are struggling to lose weight. Or I could impact no one, because businesses do fail.
My father told me he didn’t want me to say no to Allurion simply because I was afraid of failure. At the end of the day, he helped me realize that the question was whether I wanted my life to be more about maximizing impact and taking a bit of risk or taking a less risky path for a good amount of fulfillment.
And when you put it like that, who wouldn’t take the first option of taking the risk and maximizing your impact?
I imagine there must have been some mourning involved in moving on from the life you’d envisioned. What was that like?
In my life and my leadership, I value clarity over certainty. Once you make a clear decision, you need continue to move forward with that.
You may be uncertain about the trajectory. You may not even be right. But if you have clarity, you and your entire team can proceed together in lockstep.
That is what makes startups and growth-stage companies so exciting. You have this army of people who are all aligned with the same vision and goals. And that comes from valuing clarity over certainty.
At Allurion, has there been a time where you’ve gone against the grain professionally? What happened as a result of your making a rebellious or contrarian move in your role as operator or CEO?
Absolutely. Our path at Allurion is inherently rebellious and contrarian. When we started the company, we were two medical students in our 20s who had no business entering the medical device space. That’s a space dominated by executives who have cut their teeth at large companies, who understand how the entire healthcare ecosystem works. It’s not a space that is incredibly welcoming to outsiders—to rebels, so to speak.
That decision to enter a space where we had no experience, no real knowledge, where we weren’t seasoned executives could not have worked out better. What this space desperately needed was a fresh perspective and a departure from the old ways of thinking and executing. And that’s exactly what we brought to the table.
How have you continued that spirit of rebelliousness?
A more recent example stems from our understanding of how our customers were responding to our technology and our product. We’ve treated over 40K people, we’re commercial in over 40 countries, and we get a steady stream of feedback from our consumers and our providers. We kept hearing how much people loved our very basic smartphone app and our Bluetooth scale, which allowed them to share their weight loss journeys with their families, friends, and providers.
Last year, at the height of the pandemic, we launched our digital product team and have built something almost no medical device company would ever dream of building: an entirely digital consumer experience that is a far departure from a medical device company’s typical product.
Launching this team was a huge, rebellious risk, because we did so when businesses were shutting down. Most companies were advised to double-down on their core businesses and to scale back. We did the exact opposite, and it could not have turned out better. Twelve months later, we emerged with a virtual experience our customers and patients love, and it fits beautifully into this new world we’re living in, where everything is virtual.
What do you think is the biggest source of opportunity in your sector as a whole right now?
The same source that attracted us to the weight loss space to begin with: listening to the unmet needs of our consumers.
People who want to lose weight are incredibly complex consumers and incredibly nuanced in their desires. When you think about the different pivots we have made as a business—starting with a singular focus on a great medical device for weight loss, branching out into a great digital experience that complements that medical device, now tackling the nutritional and wellness space to further augment the weight loss experience—all of those moves were driven by feedback from our patients.
I will go to the grave listening to the good, the bad, and the ugly that our consumers have to say about our technology.
What keeps you personally going in the face of challenges?
We have a wall at Allurion that reads, “We Unlock Stories.” On that wall are photographs and stories from people who have enrolled in our weight loss program, lost weight, and changed their lives.
I’ve had the privilege of talking to hundreds if not thousands of Allurion customers, and I rarely hear from them the number of pounds they’ve lost. They always start by telling me all the things in their life that weight loss unlocked: they’re no longer afraid to be in family photos, no longer embarrassed when they board an airplane and have to ask for a seatbelt extender. They can now run after their kids or grandkids without losing breath. These are really emotionally-driven individuals who want to unlock new stories in their lives more than they want to see a smaller number on the scale.
Whenever there is a challenging time at Allurion—and of course, at any high-growth business there are several—you’ll often find me in our kitchen staring at that wall, because those stories are incredibly motivating. They’re a big part of why we get up in the morning and do what we do.
What advice would you give to an aspiring rebel?
Just go. Do it. Start it. Move. There are so many would-be rebels who like to think about starting something. The actual rebels just go. They take that contrarian view, they take the perspectives of all the people who are telling them no, and they move forward even faster.
So if you are a rebel out there, just go. Your time is valuable, and the time of the people you are going to serve with your invention and your product is also valuable. So get to market as soon as you can.
And remember that you’ll be in the arena every day. Being a rebel is not a one-day thing. It’s not a one-week thing or a one-year thing. It’s a career. It’s a lifestyle. It’s in your DNA. And as the founder, it’s your responsibility to inject that DNA into your company.