Felicia DellaFortuna
Analyst · Morgan Stanley
Thanks, Jon. Our first quarter financial performance demonstrates the solid financial foundation we've built following our successful 2025 reorganization. We are pleased to report that during Q1, we were able to advance short- and long-term business priorities simultaneously. We maintained a near-record adjusted gross margin and drove continued increases in ARPU. At the same time, we made strategic forward-looking investments and built a liquidity position to support our previously announced $37 million of cash utilization to pay down our term loan in Q2. Additionally, we are reaffirming our previously provided 2026 financial guidance for revenue and adjusted EBITDA, and we expect to generate cash in 2026. Starting with Q1 financial details. While end-of-period Behavioral subscribers were 2.5 million at the end of Q1 2026, reflecting a 25% year-over-year decline, we are encouraged with Core+ trends, which represented 537,000 subscribers and grew 6% year-over-year. While Core continues to face secular headwinds and saw incremental pressure in Q1 2026, this was due in part to our strategic decision to prioritize awareness for a Med+ tier, also coinciding with the Wegovy Pill launch. Due in large part to these efforts, end-of-period Clinical subscribers were 197,000, which grew 51% sequentially. Additionally, we are seeing members shift from Core to our Core+ and Med+ tiers, a trend that we expect to continue, demonstrating how our integrated weight health approach can drive higher ARPU and lifetime value. As a result, Q1 ARPU increased 13% year-over-year to $20.59. Clinical ARPU remained over 4x higher than Behavioral ARPU in Q1. Within the Behavioral business, Core+ had an ARPU of nearly 2x higher than that of our Core subscriber. Revenue in Q1 was $168 million, down 10% year-over-year, reflecting the subscriber dynamics between our subscription tiers, which resulted in 32% growth in Clinical subscription revenue and a 17% decline in Behavioral subscription revenue. Foreign exchange provided a $4 million benefit in the quarter, while fiscal Q1 2026 included one less day compared to fiscal Q1 2025. Adjusted gross margin was 73.6%, which remains near record highs despite an accelerating mix shift towards Clinical as we significantly improved the margin profiles within both Behavioral and Clinical through structural actions and operational efficiencies. While Clinical carries a higher cost of service and Behavioral primarily due to clinician staffing, Clinical gross margins have expanded meaningfully since our acquisition of Sequence in 2023. Marketing expense in Q1 2026 was $93 million, reflecting front-loaded investment in Q1 to drive awareness of our Med+ positioning, also coinciding with the Wegovy Pill launch. Adjusted SG&A was 15% of revenue, slightly lower as a percent of revenue than Q4 2025, reflecting the exit from our corporate headquarters lease and continued expense discipline. Adjusted product development expense in Q1, which primarily includes personnel costs for engineering, product design and data teams was 5% of revenue. As is typical for the business, Q1 represents our peak marketing investment period ahead of revenue that is recognized across the remainder of the year. Adjusted EBITDA for Q1 was a loss of $1.8 million, and we expect adjusted EBITDA to improve in the remaining quarters of 2026. Our profitability remains supported by the structural cost actions we have taken in recent years, which, along with the financial restructuring, have allowed us to fund strategic growth initiatives while maintaining a disciplined margin profile. Now shifting to cash on the balance sheet. We ended Q1 with $121 million in cash and cash equivalents compared to $160 million at the end of Q4. The sequential change primarily reflects Q1 2026 adjusted EBITDA, quarterly interest on our term loan of $12 million, capital expenditures of $6 million and the timing of marketing payments. Our liquidity position supports our previously announced debt paydown actions, including our voluntary solicitation, which was fully subscribed to 68.5% of par that we expect to take place in Q2. As a result, in Q2, we expect to utilize $37 million in cash to reduce the aggregate principal amount of our term loan by $42 million. The $37 million payment is made up of $27 million from our annual cash sweep and $10 million as part of the voluntary solicitation. Based on the interest rate in effect for this term loan, as of March 31, 2026, of 10.5%, we expect the debt paydown to reduce our annualized interest expense by approximately $4 million. Now shifting to our 2026 outlook. We are reaffirming our previously provided 2026 guidance for revenue to be $620 million to $635 million and adjusted EBITDA to be $105 million to $115 million. While we expect sequential Clinical subscriber growth in the remaining quarters of the year, we expect sequential net adds to be lower than Q1, reflecting seasonal normalization, lower levels of marketing spend and a more balanced allocation of that spend. We are expecting Clinical subscription revenue to grow to be approximately 25% to 30% of 2026 revenue, up from 16% of 2025 revenue. Within our Behavioral business, we are encouraged with the growth we are seeing within Core+, and we expect to grow Core+ subscribers in 2026. We remain focused on driving efficiencies within gross margin through workflow automation, technology enablement and cost discipline, in particular, as we scale our Clinical business. While we expect modest injected gross margin declines in 2026 versus 2025, we expect to remain above 72%. Now turning to operating expenses. We continue to expect 2026 marketing expense as a percentage of revenue to increase modestly compared to 2025. On product development expenses, we expect to remain at a similar quarterly run rate as Q1 2026 as we continue to execute on our multiyear technology roadmap. On SG&A, we continue to expect modest savings in 2026, primarily driven by the exit from our corporate headquarters lease and ongoing operational discipline. As is typical for the business, Q1 represents our peak cash usage quarter. We expect to generate cash through the remainder of the year, and we'll continue to manage liquidity and capital allocation with a focus on durable cash generation. The main drivers of adjusted EBITDA for our cash generation are interest, CapEx and cash tax. We expect approximately $45 million to $50 million of interest costs, which reflects slightly lower quarterly interest compared to Q1 2026 following the debt repayments from the cash sweep and voluntary solicitation offer mentioned earlier. We expect 2026 quarterly capital expenditures to remain at a similar run rate as Q1 2026, and we expect 2026 cash taxes to be between $5 million and $10 million. As we look to the future, we continue to feel confident in our financial footing and the immense opportunity before us. Our first quarter results demonstrate the increasing share of our growing Clinical and Core+ businesses as a percent of total end-of-period subscribers and revenue, which supports 2026 as an important step in a multiyear transformation. I will now turn it over to the operator to open it up for Q&A.