WW International Inc (WW) 2023 Q2 法說會逐字稿

Good afternoon, and welcome to the WW International Second Quarter 2023 Earnings Conference Call. (Operator Instructions) Please note this event is being recorded.

I would now like to turn the conference over to Corey Kinger of Investor Relations. Please go ahead.

Thank you, everyone, for joining us today for WW International's Second Quarter 2023 Conference Call. At about 04:05 p.m. Eastern Time today, we issued a press release reporting our second quarter 2023 results. The purpose of this call is to provide investors with some further details regarding the company's financial results as well as to provide a general update on the company's progress.

The press release is available on the company's corporate website located at corporate.ww.com. Supplemental investor materials are also available on the company's corporate website in the Investors section under Presentations and Events. Reconciliations of non-GAAP measures disclosed on this conference call to the most directly comparable GAAP financial measures are also available as part of the press release.

Before we begin, let me remind everyone that this call will contain forward-looking statements. Investors should be aware that any forward-looking statements are subject to various risks and uncertainties that could cause actual results to differ materially from those discussed here today.

These risk factors are explained in detail in the company's filings with the Securities and Exchange Commission. Please refer to these filings for a more detailed discussion of forward-looking statements and the risks and uncertainties of such statements.

All forward-looking statements are made as of today, and except as required by law, the company undertakes no obligation to publicly update or revise any forward-looking statements, whether as a result of new information, future events or otherwise. Joining today's call are Sima Sistani, CEO; and Heather Stark, CFO.

I will now turn the call over to Sima.

Thanks, Corey. Good afternoon, everyone, and thank you for joining us today. 2023 continues to be a pivotal and transformative year for WeightWatchers, a year where we return our core business to subscriber growth and catalyze our entry into the nascent, but significant, clinical category. Our second quarter results only give me further confidence that we are on the right trajectory.

We are focused on executing a narrow list of priorities that will deliver great impact across not only our business, but also global health outcomes. To reiterate, across the organization, we are focused on 4 key areas; one, reinvigorating our core business and hitting our raised end-of-period subscriber targets for the year, including continuing year-over-year sign up growth in the second half of the year.

2, compounding our head start in the clinical space by continuing to drive efficient member acquisition to Sequence, increasing brand awareness, and expanding member retention.

3, being the partner of choice for health providers, payers and employers by leveraging our expertise, relationships, and a step program engagement model that delivers cost-effective end-to-end behavioral and clinical weight management solutions, setting a new standard-of-care in this space.

And 4, building community experiences, both in real life and digital that will broaden our reach and increase engagement and satisfaction for both behavioral and clinical pathways. We are also committed to doing our part to increase education and access to the weight health spectrum for communities in need.

Now, turning to our Q2 results. We ended Q2 with 4.1 million subscribers, including approximately 37,000 clinical subscribers. Notably, in our WeightWatchers business, we ended Q2 with more subscribers than we did in Q1 with clinical only adding further to our subscriber base. This is the first time in our company's reporting history that we have achieved an in-year quarter-over-quarter total subscriber step-up.

Q2 sign -ups or gross subscriber additions for our WeightWatchers business, excluding clinical, were both above our expectations and up year-over-year for the first year-over-year increase since Q4 of 2020, delivering our return to sign-up growth 1 quarter earlier than our previously provided forecast. Notably, we achieved this without increasing our marketing spend year-over-year.

While as anticipated, revenue was down year-over-year due to headwinds from 2022's ending subscriber base, our actions to optimize our real estate footprint and organizational structure drove a record high adjusted gross margin. Additionally, our activation rate, a metric defined by a member's engagement and progress during their first 30 days on the program, continue to increase and trend in the right direction, with Q2 up approximately 10% year-over-year compared to Q1, which was approximately 6% year-over-year.

As a reminder, activation rate matters because activated members attrition rate is roughly half of a non-activated member and are more successful on WeightWatchers over the long-term. Similarly, our engagement rate, which is measured across our entire membership base beyond those in the first 30 days, also continued to trend positively with Q2 up approximately 12% year-over-year.

These results are further evidence that we are reinvigorating our core business and that our evergreen approach to innovation along with our data-informed approach to product improvements and performance marketing are taking hold, setting us up for a return to profitable growth.

Let's take a step back for a moment, as I want to share more on our mission as the global leader in weight health. As you will recall from our last earnings, we introduced this term to reframe the conversation around weight management in order to destigmatize obesity and make evidence-based solutions achievable and accessible to those in need.

The scientific community's understanding of obesity is advancing rapidly. Weight health is a spectrum and there is a large and growing population that due to genetic, environmental, and biological factors cannot lose or maintain weight loss through diet and exercise alone. This is a watershed moment in the treatment of obesity, and we're prepared to challenge long-held misperceptions of weight. And more importantly, we're prepared to help our members understand their options so they can get the treatment they need.

But let me be clear, this does not discount the importance of lifestyle intervention. The advancements in clinical medications on the market to- date do not replace lifestyle change. They help it become more possible for people living with obesity to adhere to lifestyle change. And that's where our solution sets us apart.

WeightWatchers is the gold standard for lifestyle change and Sequence provides much more than a prescription. WeightWatchers have been ranked as the #1 best diet for weight loss on U.S. News and World Report for the last 13 years. We are the #1 doctor-recommended program. We have a clinically proven diabetes tailored program, and we have over 60 years of experience and over 150 peer-reviewed studies, including more than 35 randomized trials.

With Sequence, members are supported by a team of board-certified clinicians, registered dietitians, fitness coaches and a care team, plus access to WeightWatchers' behavior change program. Today, we are posting a brief presentation about the Sequence experience on our Investor website to help investors better understand our clinical offering.

We now have a portfolio of science-backed solutions that improve weight health. The WeightWatchers Lifestyle program; Sequence, our virtual clinic; and our B2B program for health providers, payers, and employers, WW Health Solutions. We are uniquely positioned to pair with the evolving clinical solutions to cover the entire weight health spectrum. Our work will be at the forefront of the emerging science of overweight and obesity and the leading voice in Weight Health.

Turning to our digital-first product road map focused on the 3 pillars of coaching, accountability and community. As discussed previously, we are in beta testing of our new member chat feature and improved peer-to-peer user experience for connection and support.

From the beginning, the community and social experience of WeightWatchers is what makes our program work. We believe chat will be foundational for enriching our digital community, allowing members to create relationships, thereby driving engagement, which then increases retention and LTV. We recently launched our new coach platform in North America, a dashboard for our coaches to improve engagement and precision with members, both digitally and in real life.

Coaches are the touch point to our members, providing an important source of motivation and support, and this platform will help them manage relationships at scale.

We also completed the integration with Abbott's FreeStyle Libre, continuous glucose monitor. Now in one place, members living with diabetes can learn how food activity directly impacts their glucose levels. We remain on track to deliver more feature improvements on our road map later in Q3 and in Q4 with a what-to-eat tab to support eating decisions and progress on trends to more easily track and monitor a member's weight health journey, all of which are expected to drive the continued improvement in our member's success with the program, which ultimately leads to better engagement, retention and LTV.

As we build our digital-first product to support all member journeys, we continue to look into the most effective ways to bring the in-person human connection found in our workshops to new life. We are not walking away from workshops, quite the opposite. We know that connecting our members in real life will be -- to be an impactful part of the WeightWatchers experience and that we have an opportunity to bring more of that impact to our entire community of members.

We believe the combination of a digital experience with an in-person one is a powerful, differentiated and highly effective solution for those on a weight loss journey. Rather, we're adjusting to the realities of a primarily digital-first community by optimizing our workshop real estate footprint.

We are exploring avenues to reinvent what in-person experiences could look like in the years ahead. I'm confident in our ability to unlock more ways where our members can come together in real life as well as digitally to create lasting communities.

Shifting to our clinical business. We're learning rapidly and are pleased with Q2 results, which ended the quarter with 37,000 subscribers, up nearly 40% since the closing of the acquisition on April 10. We have started to see that the incredible demand for these medications has outpaced supply with shortages reported for Ozempic, Wegovy, Mounjaro and even Saxenda.

While these supply issues will have a revenue impact, which you will hear more from Heather about, please keep in mind that access to these medications is still at a very early stage, but we expect it will grow exponentially in the years ahead.

Of course, as with any new industry, there are fits and starts, such as we are seeing with the current supply capacity of all GLP-1 medication. Our clinicians and care team are helping members navigate the current environment by being transparent on the situation and when appropriate, prescribing alternatives across a wide formulary. We see this time as an opportunity where we can utilize this window to scale up operations and increase readiness ahead of the return of supply as well as ahead of our peak season.

In short, this is a near-term speed bump, and we remain bullish on the long-term potential for our clinical offering. Additionally, during this time, we are focused on 3 things. One, clarifying misinformation and driving awareness and education about clinical pathways.

2, introducing a dedicated lifestyle program for members on medication. There are different needs for someone on a clinical pathway. Medications do not replace the benefits of behavior change, but instead allow those benefits to be possible. We are using our expertise to develop a tailored lifestyle program that addresses those needs such as prioritizing a nutrient-dense diet and protecting lean muscle mass. We expect a rollout to the market, including to our Sequence subscribers to occur prior to our upcoming peak season.

And 3, integrating the Sequence and WeightWatchers platforms for holistic solutions as members go through different phases of their weight loss journeys. WeightWatchers and Sequence are highly complementary to one another, and we now have a portfolio of solutions to meet the broad and evolving needs of members.

In addition to direct-to-consumer with Sequence, there is also our B2B business. Given our robust portfolio of solutions, I believe WW Health Solution will be the partner of choice for health providers, payers and employers alike. The emergence of this new class of chronic weight management medications, while highly effective, are posing challenges for payers.

We are hearing from employers that they want to enable access, especially as their employees advocate for coverage, but they are looking for guidance as to how to manage costs. In addition, consistent feedback from employers is that they're coming to us because they need their solution to be science- backed with a track record and proven results, all of which WeightWatchers delivers.

WW Health Solutions has over 500 clients and an experienced service model and infrastructure to meet enterprise needs. And now it also has a best-in-class program to provide cost -effective pathways to clinicians and medication, along with necessary behavior change support, while managing costs and delivering value-based care to their employee population.

In summary, I'm encouraged by our results halfway through 2023, which only reinforces my view that we are focused in on the right areas and confident about the future.

I will now turn the call over to Heather to discuss our Q2 financial results and outlook.

Thanks, Sima. Turning to our second quarter results. As previously announced, we closed the acquisition of Sequence on April 10, and results are now reflected in our financials as well as certain metrics are included in the clinical line of business. We ended Q2 with 4.1 million subscribers, including approximately 37,000 clinical subscribers with both sign-ups and cancels outperforming our forecast in the quarter.

As Sima mentioned, this is the first time in our history of reporting subscribers that Q2 ended with a higher subscriber base than Q1. This is an additional proof point that the actions we are taking to stabilize and grow the business are working.

Revenue totaled $227 million, which is down 16% year-over-year, both on a reported and constant currency basis, primarily due to the lower subscriber base entering the year, coupled with the planned reductions in our Consumer Products business as we rationalized product SKUs in North America and continue the wind down of this line of business in our international markets.

Clinical contributed $8 million in revenue as a partial offset. Adjusted gross margin of 63.4% for the quarter was a record high and up 150 basis points from the prior year, primarily due to actions to reduce our fixed cost base with our workshop real estate restructuring.

Marketing expenses of $51 million were down 1% year-over-year and were below our planned spend. With our improved performance marketing capabilities and nimbleness adjusting to trends, we were able to increase efficiency and achieve both sign-ups and CLTV above plan.

Adjusted G&A of $59 million was up 4% year-over-year. Restructuring savings and expense controls were offset by the inclusion of $4.5 million in clinical G&A expenses, including approximately $2 million in intangible amortization from purchase price accounting considerations. Adjusted operating income was $34 million.

Restructuring charges totaled $3 million in the quarter. We continued to further streamline and centralize our organizational structure and rationalize certain non-strategic business lines. We largely completed the rebalancing of our studio real estate portfolio by reducing our fixed lease studio count and shifting workshop delivery to flexible third-party or studio at locations, which helped drive our record high adjusted gross margins in Q2. And we are on track to deliver $30 million of anticipated 2023 savings from our actions.

Related to the accounting for the Sequence transaction, we incurred approximately $5 million of non-recurring acquisition transaction costs for Sequence employee stock-based compensation attributable to post-combination vesting and other transaction costs. These charges are not included within adjusted operating income are non-cash and do not impact our net debt to adjusted EBITDAS leverage ratio.

Income tax was a benefit of $48 million in the quarter, which, consistent with last quarter, reflects the impact of an unusually high negative annual effective tax rate, driven by evaluation allowance and small pretax loss reflected in the company's full year fiscal 2023 guidance.

GAAP EPS was $0.65, which incorporates the net positive impact of $0.69 of items impacting comparability, including the valuation allowance, net restructuring charges and the $5 million of acquisition transaction costs mentioned earlier.

Turning to Sequence and our clinical line of business. We are pleased with the early performance and ongoing integration efforts from Sequence. Q2 end-of-period subscribers were approximately 37,000 members, which is up from 27,000 at closing on April 10. Q2 gross margins were north of 40%. And after excluding acquisition-related expenses, we expect to generate modest operating income and cash flow in 2023.

As Sima mentioned, while there are shorter-term supply constraints due to overwhelming demand, we strongly believe the multi-year growth opportunity is significant and are utilizing this time to increase our scaling readiness.

Shifting to our outlook. We are encouraged by the subscriber trends we are seeing in our core WeightWatchers business and expect them to continue for the balance of the year as we execute on our data informed approach to member acquisition, benefit from the increased operating efficiency and deliver an enhanced member experience with our product road map.

We expect to end the year with total subscribers of 3.7 million, up from our prior guidance of approaching 3.6 million. Within this, we expect WeightWatchers subscribers, excluding clinical, to be above 3.6 million at the end of the year, up from 3.5 million at the end of 2022. For the clinical business, as Sima mentioned, we are assuming near-term medication supply challenges continue, thereby lowering our clinical subscriber expectations for the remainder of 2023.

As a reminder, the seasonality trends in our business mean that Q1 is traditionally our annual peak and end-of-period subscribers sloping to a Q4 trough. Our outlook of ending the year at 3.7 million subscribers would represent one of the best seasonal slopes seen since we've been reporting total subscribers.

With the near-term supply constraints in our clinical business, coupled with the subscriber mix shift, we expect full year revenue to be in the range of $890 million to $910 million compared to prior guidance of $910 million to $930 million. We expect clinical revenues to be $30 million for Q2 to Q4 in aggregate, down from our previous guidance of $45 million, reflecting lower subscriber expectations due to medication shortages.

While we have reduced our 2023 revenue expectations, given our anticipated increasing subscriber levels year-over-year and including the addition of clinical, for the first time since entering 2020, we expect we will have a modest subscription revenue tailwind into next year.

Shifting to Consumer Products and other. As we prioritize the actions and initiatives that matter most to member success and will drive our return to growth, we have made the decision to sunset our e-commerce and consumer products offerings. As we've previously communicated, we began scaling back on the business, but an exit in the U.S. will allow us to further streamline our operations and better allocate resources. Products will be sold until quantities run out with a planned completion by the end of 2023.

While we expect Consumer Products and other revenues to be in line with prior guidance and contribute roughly $65 million in revenues during 2023, approximately $50 million will not recur and will be a revenue headwind into 2024. Importantly, however, we expect this to be roughly neutral to operating income. We still plan to continue our high-margin licensing business.

Adjusted gross margin is expected to be in the range of 62% to 63% for the full year, up from 61% to 62% previously. As we are seeing a higher mix shift to our digital business, and we will have continued read-through of the benefit of having reduced our fixed cost base by optimizing our real estate footprint.

We continue to expect full year marketing spend to be flat with 2022 at approximately $245 million. As highlighted in prior calls, we continue to focus on high-value member acquisitions and plan to redeploy our first half marketing savings, primarily into Q3, where we can maximize LTV to CAC efficiency. We are confident these actions will drive a second consecutive quarter of year-over-year sign-up growth in Q3.

Adjusted G&A expense is expected to be approximately $235 million for the year, lower than the previous guide of $245 million due to incremental restructuring and organizational savings. Despite the back half revenue impact from clinical supply shortages previously mentioned and mix shift in our WeightWatchers business, we expect adjusted operating income to be towards the high end of the previously provided guidance range of $80 million to $85 million as we benefit from improved margins and expense control.

As mentioned earlier, we incurred acquisition transaction costs that are now excluded from adjusted operating income, including approximately $4 million of costs previously included in Q1 adjusted operating income. However, equally offsetting this change in presentation is the inclusion of $4 million of intangible amortization from purchase price accounting considerations, which do not impact EBITDAS or net debt to adjusted EBITDAS leverage.

We estimate that remaining charges related to the 2023 restructuring plan will be up to $10 million. For the full year, excluding the impact of restructuring and acquisition transaction costs, we expect income tax expense to be approximately $15 million to $20 million, largely driven by the full year impact of the valuation allowance discussed earlier.

As we highlighted last quarter, given the seasonal nature of our business, the outsized Q1 income tax expense was largely expected to reverse in the remaining quarters of fiscal 2023, when we expect to earn pretax income, which started to happen in Q2, as mentioned earlier. Excluding the impact of the valuation allowance, we expect an income tax benefit of up to $5 million for the full year, consistent with our expectations from last quarter.

As a reminder, given the small pretax loss reflected in the company's full year fiscal 2023 guidance, any updates to the expected pretax loss or income tax expense can result in significant impacts in quarterly income tax results.

Turning to our capital structure and cash flows. We ended Q2 with approximately $91 million of cash after paying $40 million in cash for the purchase of Sequence completed earlier in Q2, plus an undrawn revolver. With our cash position plus our revolving credit facility, we have more than sufficient liquidity for our working capital needs, including near cash outlays related to our restructuring actions and servicing our debt. We continue to expect that cash from operations will be a modest use of cash for the full year due to the approximately $40 million in expected restructuring cash payments.

At quarter end, our net debt to adjusted EBITDAS leverage ratio was 7.7x. We expect our trailing 12-month leverage ratio to further increase in 2023 due to lower EBITDAS levels through most of this transformative year. We are committed to improving our leverage ratio as we return the business to profitable growth.

We still expect full year interest expense to be approximately $95 million. As a reminder, we have a $500 million hedged through Q1 2024 to protect against rising interest rates on our variable rate term loan of $945 million and our $500 million notes are fixed rate. Therefore, only 31% of our total debt is floating. We are currently exploring options for forward starting swaps for when the current hedges expire. Of note, effective June 30, we transitioned the reference rate for our debt instruments and swaps away from LIBOR.

Our new reference rate is 1 month term SOFR plus a credit spread adjustment to largely remove any direct economic impact from the transition. As such, there is a limited impact on our interest expense. CapEx, which is primarily due to capitalized software is expected to be in the $45 million range. Depreciation and amortization is expected to be in the $50 million range, slightly higher than prior guidance of $45 million to reflect the intangible amortization from the Sequence acquisition mentioned above.

In summary, we are executing well against our strategy and meeting and, in some cases, exceeding our 2023 objectives. Encouraging subscriber trends, record gross margins, and improved cost structure position us well for profitable growth.

I will now return the call back to Sima.

Thanks, Heather. Our team's hard work and innovative thinking are paying off. We are turning the corner and getting WeightWatchers back on a subscriber growth trajectory while setting the foundation for our next chapter with a portfolio of solutions to serve the full spectrum of weight health.

To reiterate, our WeightWatchers business has returned to sign-up growth, without increasing our marketing budget, fueling our return to subscriber growth in the back half and driving a subscription revenue tailwind going into next year. We drove a nearly 40% increase in clinical subscribers, primarily from positive word of mouth since the close of the acquisition and are scaling up our operations, increasing readiness and developing a dedicated lifestyle program for members on medications.

We have increased our activation and engagement rates by advancing our digital first product road map, focused on coaching, accountability, and community. We are managing the business prudently, reducing our cost structure and driving record high adjusted gross margins. And we are focused on returning the company to profitable growth and are committed to reducing our leverage.

Before we turn to Q&A, I would like to highlight the 3 new members of our Board of Directors since our last earnings call. Tracy Brown, EVP and President of Retail and U.S. Chief Customer Officer at Walgreens and the former CEO of the American Diabetes Association. Tara Comonte, former Chief Executive Officer and current Board member of TMRW Life Sciences and a Board member of Strava, the leading subscription platform for Connected Fitness. Dr. William Shrank, Venture Partner, Bio and Health at Andreessen Horowitz, and a former Chief Medical Officer at Humana.

With these additions, we are further extending our thought leadership to cover the entire weight health spectrum, something completely aligned with our vision as the global leader in weight health.

Thank you for joining us. We are now happy to take your questions.

(Operator Instructions) The first question will come from Jason English of Goldman Sachs.

Congrats on the uptick in base business subscribers. It's a welcome surprise. I'm a little surprised though that you're cutting the revenue forecast. Like, I get the $15 million trim on new clinical because of the capacity constraints in our drugs, but still, with the uptick on subs and the cut being more than just the $15 million, it suggests a decent drop in revenue per subscriber. What's driving that?

Jason, yes, as you know, the majority of the revenue adjustment that we're making is driven by the external factors of medication supply on clinical. The balance of it really is about the mix shift that we're seeing between clinical core and workshop. So we're seeing more folks signing up for the digital business versus the workshop business, which is a higher margin business as well. So, we're seeing that shift impact total revenue and also driving some of our improvement in gross margin.

And I should -- like to add there too, hey Jason, is that part of that is consistent with the broader economic story. So, we're seeing some of our lapsed workshop members who are coming back in Q2 and choosing digital. And so that feels in line with what we're seeing from a macro perspective. But, NPS has remained really stable versus February of '23 earlier this year, and in fact, is up 22 points year-over-year.

So, we feel really good that people are staying connected to the brand and still seeing it as a must-have and just choosing the digital option as their way of staying connected to the program.

Understood. And one more follow-up for me on the clinical side. I think -- and sorry, I was distracted. I think I heard you say you're going to launch this more aggressively later this year before the New Year's resolution sort of uptick or enrollment cycle. Correct me if I'm wrong on that. But if so, what gives you confidence that the drug supply will be adequate enough?

And secondly, where do you stand on clinician capacity? Because I understand -- I've always viewed this as a twin potential bottleneck. One is the clinicians, do you have enough of them to operate the telehealth side? And the other is, do you have enough drugs to actually prescribe? So updates on both of those and the timing would be really helpful.

Yes. No, so just to clarify what we had said there was that we are scaling up to be ready for when supply comes back. And on the lifestyle program itself, the one that is specific for people on the GLP-1 journey that, that is going to be available ahead of peak season.

And yes, I think this is a real opportunity. Look, we're already 4x the number of clinicians since the Sequence acquisition, and we even have a wait list of onboarding on additional clinicians. And so this -- the shortage is obviously, we don't like this for our members and their experience and their needs, but in the meantime, what it's allowing us to do is scaling up to be ready for when the supply comes back on.

The next question comes from Lauren Schenk of Morgan Stanley.

It's Nathan Feather, on for Lauren. Congrats on the strong core performance. I want to dig in a little bit on the lower expected Sequence revenue for the year, interest in mechanics behind that. I mean, what's the kind of key driver between the lower revenue? Is it lower gross add demand, higher churn if people can get access to supply? Or is there kind of a revenue per subscriber dynamic? And would you potentially not charge subscribers or would they pause if they can't find supply? Just trying to think through dynamics and how it impacts your sub-base as we exit the year?

Thanks, Nathan. Yes. So, look, it's really early days, and certainly, we didn't acquire Sequence for 2023, and we're confident that supply issues are not going to be a barrier to our long-term outlook. Obviously, there are more medications within the pipeline and lots of investments being made by manufacturers to get this right. And as you can imagine, we're in touch with them in doing top-to-tops and understanding when and how we can expect that supply to come back on.

And so, yes, what ends up happening, understandably, is this is a month-to-month program. And if we are unable to get somebody the medication, then that does impact churn. But more importantly, we're just not going out -- let me take a step back and say we offer a wide formulary.

So in a lot of cases, we're able to mitigate that by finding the -- through our customer, through our care portal, finding the pharmacy that does have supply and/or getting people started on a different medication while they're waiting for one of their other dosages or brands.

In the meantime, though, what it really means is, we're not pushing our top of funnel activity as you even noticed in your recent report, you haven't seen us do much cross-selling, and that is purposeful. We don't want to impact NPS by driving a lot of people into the funnel who then have a poor experience because of supply issues.

So this ends up being, as I mentioned, an opportunity for us to spend this time thinking through scaling, making sure the current members are having a really great experience and increasing our readiness overall.

The next question comes from Linda Bolton-Weiser of D.A. Davidson.

So it seems like on the drug shortage issue that we had seen some news articles and developments about Novo Nordisk actually starting to file suit against compounders. And my understanding, without being a drug analyst, my understanding is that when that happens, it's like a sign that their supply is ramping up adequately because when they start to crack down on these compounders.

So, I guess then I'm surprised to hear this about the shortages when it seems like actually the news was to the contrary that there would be increased supply. So can you just comment on that?

Yes. No, look I mean, Novo has been public in saying that they're still seeing Wegovy at 0.25, 0.5, 1 shortages through September. They've also said that Saxenda also, so just through the end of 2023 and beyond. Your guess is as good as mine, I think, in terms of what they're -- them kind of going after compounder set. But, frankly, my perspective on it is, there's a lot of misinformation.

There are a lot of bad actors, and when people have poor results on the compounded substances, they then use the brand names, or "weigh loss medication" out in the market as to explain their side effects and their issues, and it actually has nothing to do with their products. So, I think it's a sound strategy on their part. But we can confirm that the shortages are still very much being felt in the market, and I'm happy that there is a broader strategy to reel in the bad actors.

Okay. And can I also ask just about your trend of return to member growth? Are you able to say like which months it turned positive year-over-year? And is there any trend of acceleration of year-over-year growth or is it just steady or is it kind of just variable month-to-month? Is there any way you can tell us how the trend is going?

Linda, I think we're seeing continued improvement in our trends through the course of the year. I wouldn't want to pinpoint a specific moment in time. But recall, we had our solid step-up in subscribers out of Q4 2022 and into Q1. And again, now here in Q2, we're ending with a step-up out of Q1 for the first time in history. This is all pointing towards continued progress on the step change we're making towards growing our subscriber base. Hopefully, that helps.

And I'll just add, hey, what this is saying is the changes we're making are working. I've said it from the beginning, activation rate is a leading indicator, and that number continues to smile. So we are really excited about what's to come. We haven't even introduced our biggest features yet. And we've noted that the progress in trends on what-to-eat tab are coming in the fall. And so, this is us leading with a digital-first experience and really putting our data informed learnings to work.

The next question comes from Michael Lasser of UBS.

This is Isabel, Thompson on for Michael Lasser. Maybe just in the second quarter alone, there was only a modest increase in those clinical members since the acquisition closed. Were the supply constraints the only reason these subscribers haven't been ramping faster or were there other factors at play here? And how do you plan to put marketing behind the Sequence business moving forward?

Isabel, so I'll start by saying I disagree that 40% uptick since acquisition is modest. What I will note is that we also saw that traction in an environment of supply shortages. And that really, again, goes to reflecting our ability to help members through our wide formulary and through our customer, through our care program, the Sequence program.

And I want to emphasize that we have these really big synergies. We're able to provide solutions across the weight health spectrum, now combining both the lifestyle intervention of WeightWatchers with clinical care. On the tech side, we're combining billing, creating one identity through all channels.

And to your question regarding to marketing, that's also another important synergy, where we're going to have TAC efficiencies between our solutions. We have demonstrated ability to drive interest from people on our site to the clinical interventions and our initial tests in performance marketing.

And again, we're not spending here on top of funnel, because we want to ensure we protect the NPS during the supply shortages. But we've been testing and we can see that the combination of WeightWatchers alongside the Sequence brand has really improved ROIs. So, we expect to really do more of that when the macro environment has improved.

That's very helpful. And then maybe as a follow-up, are you doing any discounting of the core program to drive sign-ups higher there? And then separately, do you have a sense of how many new and existing members are currently taking GLP-1 prescriptions?

I'll speak first to the discounting question. So, we do have discounting activities going on, much like we always have. I would say it's not necessarily ramped up or differentiated approaches to discounting, and our approach is quite similar to other best-in-class subscription businesses where members joining pay less should they commit to longer-term plans.

So, we continue to operate with discounting such as that. And we're really pleased to see that the pricing and promotional activity that we're carrying out in 2023 is proving out to be both revenue and CLTV accretive, both in year and in the long-term. So, we're really pleased with the outcomes.

The next question comes from Brian Nagel of Oppenheimer.

This is William, on for Brian. So, I realize that you've touched on this topic quite a bit, but I just wanted to ask maybe a little bit differently. Just our question is on the step-up in the core membership in Q2 from Q1, and you mentioned reinvigorating your offering and other marketing efficiencies. Can you discuss further the step -- the drivers of this step-up? And also, any changes to the way that you would look upon the cadence of first half membership in your business going forward?

Sure. Hey, William. Look, the drivers are product improvement, better data-informed performance marketing and overall awareness and alignment with our new weight health approach. We're seeing a lot of continued momentum on our modern performance marketing. We underspent plan but drove better LTV and sign ups.

This is just a reflection of more nimble data informed decisions with in-house performance. We're moving cross channels, cross regions, thanks to the centralized global marketing organization. So that's been a part of it. As I mentioned on the awareness front, lots of media activity resonance with the work that we are doing and I think being more authentic and forthcoming in our messaging.

And finally, product improvement. We've said that activation is not just about the people we sign up today, but them doing better in their first 30 days, which is a signal that they're more engaged. And weight loss, let's be clear, this is a word-of-mouth product. And so when we drive up NPS, which we have, more people hear about it, talk about it, have success with it. And so not only does it help on the retention side, but it also has a positive impact on driving further organic sign-ups.

So, as we mentioned, the Q2 and a period excluding clinical is above Q1, and that is the first time in our company's reporting history, and -- but I think that achievement is a combination of all of those things that I just spoke about.

Excellent. Our next question is on the balance sheet. To the extent that you plan to de-lever somewhat, when would you look to do this? And then how would you carry it out?

Thanks for the question, William. I don't think that I would be committing to anything in terms of actions or timing or scale or activity. I would say, though, if we did do something, our intention would be to act in a way that benefits all of our stakeholders, reducing our leverage is an absolute capital priority, Pleased with our strong liquidity and solid runway. But at this time, I wouldn't speak further. Thank you, though.

The next question is a follow-up from Jason English of Goldman Sachs.

Hey, again, thanks for slotting me back in one more time. So, I just couldn't help myself, I had to come back for more. You mentioned the lifestyle program for GLP-1 patients to come on later this year. I guess my question is around the viability of applying that to GLP patients who aren't coming through on Sequence. There's been some chatter out there around employers looking to make insurability conditional, potentially on some sort of behavior modification program such as your own.

And I know you've got a lot of deep-seated relationships with many of those potential employers. So, my question is very vague. I appreciate that. I'm kind of rambling now. But as we think about the forward, are you having discussions with these employers? And is there a viable solution or a future where they could be authorizing use of these but requiring participation on a program like yours? And given your relationship, what is the likelihood that they actually recommend you as the program of choice for that?

Jason, I love that you came back for more. So, and this is a great question. Look, we have a lot of enterprise experience. We've been running our B2B business for years. But in the past, it's been viewed more as a perk and now we are getting a lot of incoming requests from new employers as well as our existing employers and also payers who want to talk about a covered benefit.

And then the way that they need to manage and be able to provide these life-changing medications to their population is by figuring out the best way to recover the cost of the medication. And that means helping somebody such that it's a preventative tool for other chronic conditions, right? Heart disease, high cholesterol, hypertension, diabetes, some cancers.

So -- what ends up happening is that we can take in and account for their entire employee population and basically bucket people into where they fall on the spectrum of weight health needs, whether they need a lifestyle intervention, whether they need a lifestyle intervention plus clinical pathway, and then in which case, how do we de-escalate that over time and get them either off the medication if it's appropriate for -- medically appropriate for that patient and/or move them to a different lower cost medication.

And so this is work that we're doing right now in active discussions with. Also, by the way, on the science side, we are running trials. We're doing some, in partnership with the Cleveland Clinic and other academic institutions to show the efficacy of some of these plans. And so, just to say, yes, I mean, I think that we are really uniquely able to provide that because we have our intensive behavior therapy program, because it's been around for 60 years, because it is the most studied evidence-based solution that is out there and because we have the existing infrastructure across servicing enterprise clients. So that on the B2B side.

Now what I want to say about our lifestyle program and why that matters for not just Sequence members, but anybody who's getting these medications, whether or not they come to us from Sequence, is that you have to remember that less than 1% of medical providers have any sort of nutrition training or what we would say, American Board of Obesity Medicine certified. According to a 2021 survey of medical students in the U.S. and U.K., which -- this was published in the Journal of Human Nutrition and Dietetics, most students only receive an average of 11 hours of nutrition training throughout an entire medical program.

My brother is a doctor. He only had 1 nutrition class. And so, the reason I bring this up is that these medications and it's -- their ability to manage the side effects and get the outcomes that you're seeing about and hearing about in these trials has to do with having alongside of it lifestyle intervention and also being able to manage across the entire time that you are on this journey, titrating dosages up and down. And so, this is a really high support process. It's not just like other conditions where you might just take this one medication, whether it's a statin or an ACE inhibitor, et cetera, and then just -- that's it, you take it.

So anyways, all our clinicians -- just to say that twofold, one is why it makes our Sequence program so unique, because the clinicians who are on our Sequence program get this training through a 12-week specialized onboarding period. They get rigorous training, close oversight by the clinical leadership team and they're able to really guide our members with better empathy. I think that's an important differentiator of our current program, but it also says why our lifestyle program would be important for any provider who is trying to support their patients.

They can now recommend WeightWatchers and know that at least that, that patient will be getting ongoing guidance on nutrient density, how to build lean muscle mass, how to think about various symptoms that they may be facing, et cetera.

This concludes our question-and-answer session. I would like to turn the conference back over to Sima Sistani for any closing remarks.

I'm highly encouraged by the trends in our Q2 results, which are returning us to a subscriber growth trajectory. Not only will 2023 be an inflection point in our performance, but also be a year of dramatic improvement in our ability to help members achieve their goals through our portfolio of solutions to serve the full spectrum of weight health.

We look forward to speaking with many of you at upcoming conferences, including at Morgan Stanley and the Baird Healthcare Conferences in September. Thank you for joining us today, and we look forward to updating you on our progress.

The conference has now concluded. Thank you for attending today's presentation, and you may now disconnect.