After Nearly Dying From an Eating Disorder, She Raised $75 Million for a Startup to Make Evidence-Based Treatment Affordable for Everyone Kristina Saffran spent years in the nonprofit world figuring out the most evidence-based treatments, and then built a company on that knowledge.

Kristina Saffran nearly died during her freshman year of high school. She had anorexia nervosa, considered one of the most fatal mental health disorders, and was in and out of the hospital as doctors struggled to find a solution. It was a family-based outpatient treatment that finally helped her recover.

She was so grateful that, at age 15, she started a nonprofit to make this treatment available to others who couldn't afford it. But by the time she was 27, she wanted to make a larger impact and started thinking about a telehealth startup specifically for eating disorders, based on the same model of care.

When she met with Martin Rosenzweig, chief medical officer for Optum Behavioral Health Solutions, part of UnitedHealth Group, and described her vision for the program, he told her, "If you build it, we will come," offering to provide guidance into making it scalable and workable with most people's insurance. That was major. Still, it was such a complicated industry. How would she tackle it with what little experience she had?

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That was in 2019. Today she's raised $75 million, and her startup, Equip, employs 350 people. Here's what she's learned:

Lesson 1: You don't need to know it all.

Saffran thought she knew her blind spot. She didn't have a Ph.D. and was entering a clinical field. So she brought on a clinical cofounder: Erin Parks, Ph.D., former director of outreach and admissions at UC San Diego Eating Disorders Center for Treatment and Research.

But as they raised money and started hiring engineers, Saffran floundered. She'd accepted that she wasn't the medical expert on the team, but now she realized she didn't really get the tech side — and thought she had to. "I just felt so much imposter syndrome," she recalls. "Then a mentor said to me, 'You are very smart. You can understand technology, and if you don't, that is because the person reporting to you is not explaining it clearly.'"

Saffran leaned into that. She hired good tech communicators and realized her job was not to know everything — instead, it was to know enough to figure out who to trust.

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Lesson 2: Delegate almost everything.

In the early days of a startup, everyone does a little of everything — especially the founder. That suited Saffran just fine. She oversaw marketing, handled customers' issues, and personally signed on Optum, as well as insurance providers Aetna and Anthem, among others. But in early 2021, as the team grew past 50 members, Equip needed to become a more formal organization. Saffran hired a human resources specialist to recruit, but she wasn't ready to give up all her roles — especially business development. "This is an area I'm good at and like doing," she'd say.

But slowly, she started handing tasks off to others — and the big shift came last year, when Equip hired a chief commercial officer. Saffran had come to realize she can only be successful if she delegates 85% of the decisions that must be made. "It's been a big learning of, it's really my job to think 12 to 18 months ahead, get leaders in place, and then trust them and delegate," she says.

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Lesson 3: Track what matters, not what doesn't.

Equip started by serving ages 6 to 24, and this summer it's expanding into older adults. But it isn't without risk.

"The thing that keeps me up at night," says Saffran, "is the tension between maintaining our strong clinical quality and needing to grow really rapidly to serve everybody." But this is a familiar tightrope, and Saffran knows how to keep her balance: by focusing on patient outcomes. If they ever slip, she says, Equip — which is already on a path to profitability — will pull back. "Patient success will always be our North Star."