Early in her career Brooke Boyarsky Pratt (MBA 2013) enjoyed considerable success in roles at McKinsey and Berkadia, a Berkshire Hathaway portfolio company. But a routine visit to the doctor in 2020, where she experienced weight stigma yet again, led her to address the problem of obesity care. Boyarsky Pratt had struggled with her weight since she was young. So when she started knownwell, an integrated weight and primary care provider that was designed to support people with obesity, it was a huge step for her both personally and professionally. In the spring of 2023, knownwell opened its first weight-inclusive clinic in the Boston area. But Boyarsky Pratt had to make a fundamental decision on how she wanted to grow the company. Should she grow slowly and build a small footprint of clinics in the Boston area over the next few years? Or should she scale fast to potentially help millions of people across the U.S.?