The Future of Consumer Wearables
A Conversation Between Brooks and Sonal
We set out to find a way to collaborate on an article on trends and investable concepts in consumer wearables. We had a discussion on Zoom, transcribed the call with Granola, and had ChatGPT o1 clean up our transcript.
Key One-liners for Consumer Wearables Start-ups:
Start with a niche!
New, continuous measures of health may be on the horizon
Form factor matters
Consider privacy concerns
Success requires both deep technical expertise and consumer marketing savvy
Marketing & brand are crucial
Conversation Below
Sonal:
“It looks like we’re both really interested in this space of consumer wearables. There’s so much happening—new companies, new technologies, and evolving markets. I thought we could kick off a discussion about what we’re seeing out there, how we think the market will shape up, and what a ‘company of the future’ might bring to the table. Maybe I’ll start by asking you: in your view, what kind of technologies exist right now in consumer wearables?”
Brooks:
“There are so many ways to slice it. One framework I like is to look at what sort of sensing the device is doing. First, there’s physiologic sensing—heart rate, temperature, respiration, oxygen saturation. That’s the most common and widely distributed. You see it in smart watches, rings, and bands using existing technology packaged into a wearable.
Next is molecular sensing, where you’re looking at proteins or small molecules like metabolites in different biofluids—blood, interstitial fluid, sweat, even potentially urine, though that’s less convenient for a ‘wearable.’ Within that category, you might have hormone sensing, which can measure things like cortisol or other biomarkers indicative of stress or reproductive health. All of these land in a few broad buckets: physiology, metabolism, and hormones.
Sonal:
“It’s super interesting that you bring up the possibility of integrating all those elements. My ideal vision for wearables is having one sleek device—maybe a ring or a band—that tracks my physiological changes, my hormones, and delivers predictive analytics about stress or mood. That kind of all-in-one wearable is the dream.
But each technology has trade-offs. We’ve been doing a lot of diligence on aptamer-based sensors, for example. As you said, they can measure physiological and hormonal biomarkers. The question is: how many different markers can you measure before you’re forced to expand into a larger form factor or develop multiple layers of sensing? That’s often the bottleneck—fitting many complex assays into one tiny ring or band.”
Brooks:
“Aptamers—or even antibody-based approaches—run into the challenge of binding affinity and turnover. If you engineer an aptamer or antibody to be super specific for, say, beta-hydroxybutyrate (a ketone), it might bind that molecule so tightly that once it’s bound, it doesn’t ‘un-bind’ easily. You end up saturating your sensor. That’s not ideal for continuous monitoring.
On the other hand, if the binding is too weak, you might get cross-reactivity with other molecules. It’s a tricky balance between specificity and the practical reality of continuous sensing. I’ve seen some companies—like Persperion—try to do sweat-based sensing. But sweat itself can be unreliable unless you force sweat production through something like iontophoresis or exercise. Their method requires pressing a fingertip on a sensor for thirty seconds, saturating that sensor, and then re-testing. So, it’s not strictly continuous.
One big question is whether these devices need to be fully continuous 24/7. Maybe you only need repeated tests throughout the day to get actionable insights. Where do you think the market stands on the need for truly continuous versus intermittent monitoring?”
Sonal:
“You bring up a really good point, and that’s where market segmentation comes into play. Let’s take two different examples. If you have a chronic condition like PCOS, it could be super valuable to see perpetual hormone readouts—how your levels fluctuate throughout the day or month, and how diet or medication might help. But do I need a minute-by-minute update? Probably not. Checking daily or hourly might be sufficient. On the other hand, for a heart failure patient, minute-by-minute readings might be critical to predict cardiac events.
This suggests that maybe you start with conditions or markets where extremely high-frequency data isn’t necessary—where having data every few hours or once a day is still a game-changer. Then, as your technology matures, you move into more demanding indications. That approach also dovetails nicely with how to choose a beachhead market: start somewhere you can deliver real value with the technology you currently have, then expand outward.
What are your thoughts on consumer wearables that claim they can do it all—target athletes, patients, and general wellness? Do you think it’s better to start narrow or broad?”
Brooks:
“That’s such a key question: depth versus breadth. In healthcare, you could go the route of tackling a very specific disease state—diabetes, for example, where you focus on continuous glucose monitoring. Or heart failure. Or a particular hormone imbalance. You do one thing really well, and that’s enough to drive adoption in that population.
By contrast, the purely consumer side can focus more on lifestyle. For instance, Oura staked out ‘sleep optimization’ as its core. Whoop targeted the elite athlete. But functionally, Oura and Whoop measure extremely similar things: PPG-based heart rate, SpO2, HRV, etc. The difference is brand and marketing. Oura says, ‘We own sleep;’ Whoop says, ‘We’re for athletes trying to optimize performance.’ It’s about how you position yourself to the consumer.
You asked about starting narrow or broad. I lean toward starting narrow—like you said, picking a very precise group such as people training for their first half-marathon. Offer them a device with a tailored approach: a specific set of biomarkers, real-time or near real-time feedback, and advice that’s unique to that journey. You earn trust, collect meaningful data, and then expand. I think the same logic applies in a clinical context: pick a single chronic condition (e.g., heart failure or PCOS), prove your value, and then add new indications over time.”
Sonal:
“Yes! I completely agree. A company we were recently looking at decided to start with heart failure. I love that approach. They’ll develop the technology and hone in on that patient group first, then expand outwards as their technology gets more sophisticated. You also highlighted something important: form factor. I have an Oura ring; most of my female friends do as well. Meanwhile, most of my male friends use Whoop. There’s definitely a gender or style dynamic to this. If you’re targeting PCOS, you probably want a sleek, subtle ring that doesn’t scream ‘medical device.’ If you’re targeting hardcore athletes, maybe a big wristband is acceptable—it can even look cool, like a badge of honor. So yes, there’s a big brand and design aspect that can’t be overlooked.”
Brooks:
“Exactly. And I like how you framed that half-marathon example. It’s so precise that the group feels special and recognized. That’s a proven startup playbook: serve a niche deeply, then expand.
Another thing I’m thinking about is how we’re still measuring mostly existing clinical biomarkers. There’s an exciting possibility, though, to develop new, more holistic biomarkers—ones that aren’t just about diagnosing disease but measure how close you are to your optimal health state. Right now, so many biomarkers are binary: normal or abnormal. But for those hovering on the borderline, we don’t have a lot of nuanced guidance beyond ‘exercise more, eat fewer sweets, sleep better, drink less.’
In an ideal world, we could track continuous markers that reflect a range—like, instead of just labeling you ‘healthy’ vs. ‘pre-diabetic,’ we’d say, ‘You’re at a 4.7 out of 10 on your metabolic resilience scale. Here are the specific interventions to push that to a 6.0 or beyond.’ That prescriptive element could be huge. But developing novel biomarkers means educating the market, and that’s a big lift.”
Sonal:
“Exactly. We’re in the era of first measuring the basics. But as consumer datasets grow, we can start building that deeper, more personalized analysis. Some groups are already feeding Apple’s internal health data—heart rate, motion data from AirPods, even iPads or iPhones—into large-scale studies. The long-term goal is discovering novel biomarkers for mental health conditions, or for overall wellness. That’s the best-case scenario, where large-scale consumer data leads to real breakthroughs.
But there’s an ethical dimension. Apple (and other tech giants) can gather all this data, like they’re doing with their new health study, but how do we trust them to use it only for health innovation versus, say, ad targeting or differential pricing? It’s a sticky situation. Part of me loves that consumer data could drive new diagnostic markers. Another part worries we’re giving giant companies the keys to deeply personal health data.”
Brooks:
“That’s the core tension. In traditional pharma, there’s a clear incentive to keep patients on medication—chronic conditions are a revenue driver. On the consumer side, big tech’s business models often revolve around advertising or data monetization. Neither scenario is purely altruistic.
But, like you said, we can still drive positive change. If we can encourage biomarkers of health—rather than disease—companies might compete on getting people to a better state of well-being instead of just labeling them as ‘sick.’ The question is how we reorient the system away from normal vs. abnormal, and toward a continuum where each person can see progress and strive for improvement.
In truth, we have a mismatch between the concept of ‘normal’ (usually population averages) and what’s actually healthy or optimal for an individual. We might not want to be ‘average’ if the average population is in poor metabolic shape. So maybe these new wearables and biomarkers can define a better standard than the standard reference ranges we see in clinics. Still, that’s a big challenge—like you said, it requires large datasets and careful framing.”
Sonal:
“And I wonder if that’s where we come full circle: going after specific market segments—like half-marathon runners in training—can help. They become the reference group for each other, not the general population. Same goes for a PCOS community, or for an older adult population focusing on cardiovascular health. Once you build enough data, you can define new ‘healthy ranges’ for those more precise segments instead of defaulting to broad references tied to age and BMI.”
The technology side is crucial, but so is market focus—the right customer, the right set of biomarkers, and eventually the creation of novel, aspirational health metrics. All of that leads me to a final question: Who are the right teams to build these companies? I’ve seen amazing technologies that never get traction because they’re missing the marketing and consumer-savvy piece. Oura and Whoop are as much lifestyle brands as they are health-tracking devices. The ‘coolness’ factor is part of why people buy them, not just the sensor specs.
So you really need a team that’s deeply technical and deeply consumer-aware. That’s not easy to find. Sometimes the founder is a PhD who’s never launched a brand. Other times it’s a marketing genius who struggles with sensor engineering. Striking that balance is going to be vital.”
Brooks:
“I agree 100%. If you look at how some consumer wearables have succeeded, they often have a brilliant marketing approach right from the start. Consider companies that tout their waitlists of tens of thousands of eager users—often, it’s not because those users understand the ins and outs of the tech, but because the company told a compelling story about what this device could do for them. Then you look at Oura’s pitch at Slush from 2017—where they literally had a magician on stage! That’s the level of showmanship it takes to stand out as a consumer brand.
For purely pharma-focused solutions, you can have a more clinical, data-driven pitch. But for general consumer wearables, you often have to be showy, emotional, or aspirational to spark interest. Technical brilliance alone isn’t enough.”
Sonal:
“Completely agree. That’s such an important insight. Marketing, distribution, brand positioning—those can make or break a consumer health startup. Anyway, this has been a wonderful conversation, Brooks. Hopefully, we’ll find something interesting to invest in or even build together.”
Brooks:
“Absolutely. Thanks so much, Sonal. Looking forward to seeing how all of this develops.”
(End of Conversation)
Key Takeaways
1. Segments & Niche Use-Cases
• Start with a tightly defined user base (e.g., half-marathoners, PCOS patients, or heart failure patients). Prove out the device’s value and data quality in that market, then scale outward.
2. Biomarkers Beyond Disease
• Moving from traditional clinical ‘normal vs. abnormal’ lab values toward new, continuous measures of health could transform how we track and improve wellness.
3. Form Factor Matters
• Rings, wristbands, patches—each appeal to different demographics. Design must align with both comfort and consumer identity (fashion, lifestyle, medical discretion, etc.).
4. Ethical & Data Considerations
• Large-scale consumer data can unlock novel biomarkers and major health insights, but also raises privacy concerns when held by big tech.
5. Team Composition
• Success requires both deep technical expertise and consumer marketing savvy. A purely technical founding team may struggle with brand-building; a purely marketing-focused team may not execute the R&D effectively.
6. Marketing & Brand Are Crucial
• Wearables are lifestyle products as much as health monitors. Companies like Oura and Whoop differentiate themselves less on the science and more on how they position their product in consumers’ lives.
Thanks for reading! If you enjoyed this discussion, feel free to share your thoughts in the comments or reach out with any questions. We’re excited to see where consumer wearables go next—from enabling healthier lifestyles to potentially revolutionizing chronic condition management.
—Brooks & Sonal
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