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Innovating Health Coaching To Reverse Pre-Diabetes – Exclusive Interview With Dr. Mahadeva Cadwell

Dr. Mahadeva Cadwell is a thought leader in health and lifestyle as medicine with a focus on reversing pre-diabetes and insulin resistance. As an Internist, Palliative Care physician, and Integrative Nutrition Health Coach, she was inspired by her decade-long work with patients as well as her own family history. With a penchant for technical innovation, she was inspired to take on the challenge of leveraging AI to develop a tailored approach to optimizing health, making health and wellness more accessible for all.


She is the founder of Vivo, Ltd., a health coaching company that seeks to realize that vision. Her mission: live healthy longer at your most vital.


photo of Dr. Mahadeva Cadwell

Dr. Mahadeva Cadwell, MD, Integrative Nutrition Health Coach


Introduce yourself! Please tell us about you and your life, so we can get to know you better!


“Get up, the wall is down!” My dad shook me awake on a Thursday morning. I turned a sleepy head and grumbled, “Ugh, you just want me to get out of bed…five more minutes…”. “It’s not a joke. Listen!” The radio clicked on, and words started floating to my consciousness I never thought I would hear: “Last night, our leaders decided to open the wall…” The fall of the Berlin wall, half a kilometer from my home in central Berlin, turned my life from black-and-white to technicolor in a snap. Already an avid Trekkie, I dreamed big to boldly go into the world and leave my mark. Suddenly, the possibilities had become endless. 


Who am I today? I’m a physician with twenty years in clinical practice, Internist and Palliative Care specialist, who has practiced in two countries, in urban and rural hospitals, taught resident physicians for seven years in a rural track Family Medicine training program, I’m a graduate of Stanford Lead Graduate School of Business, and founder of Vivo, Ltd. Ok, those are my resume highlights – accomplishments I’m extremely proud of. But that’s not all that I am. I am also a dreamer and a doer. 


“To boldly go where no man has gone before.” Those words had stirred a drive inside of me, because those words were always meant for all of us and anyone who was willing to “boldly go.” And those three friends, Kirk and Spock and McCoy, as best they could through all of their over-dramatized strengths and flaws, were there to show us how to boldly go.


And I always did. I studied ballet for 25 years and when I was told I should dedicate my life to dance, I said no. I wanted to boldly go into the unknown and see what more I could do. The world was open to me after all, and I was going to take a chance on the world! I studied languages French, Italian, English – and traveled as much as I could on a shoestring budget. I was ecstatic that I was able to communicate with the people I encountered. Then I decided to study medicine. My family was confused and at times outright furious with my decision. I had broken a mold of expectations, but no amount of coaxing and cajoling to do something “reasonable” would convince me otherwise. So I boldly stepped into a world where my family only understood marginally how grueling but rewarding the life of a doctor would be. 


When it was time for my medical residency, I decided to do so in the high desert town of Reno, Nevada. I’m a dreamer, right? I was fascinated by ‘Bonanza’ as a kid and thought Lake Tahoe (and Adam Cartwright) was the most beautiful thing I’d ever seen! I wanted to start practicing medicine close to Lake Tahoe, but my family and friends had me in some Star Trek like tractor beam linked to a power generator fueled on fear of the unknown and the anxiety of leaving the familiarity of family and friends only to be found in Berlin. But I was going to make the trip happen despite my own anxiety, and waded through the murkiness of said unknown to come out on the other side…


Landing at the airport in San Fransico, I was breaking down and freaking out. I ran to the public bathroom where I cried in a toilet stall through most of the layover to Reno. At some point I gripped the edges of the sink hard enough to crack porcelain and I visualized Spock and Kirk and McCoy in my mind as I began saying the words, “Boldly go. Boldly go. Boldy go.” Then I made my connecting flight with renewed resolve.


The Reno area has been my ‘charging station’ ever since, my chosen and cherished home, a place from where I feel like I can do anything. I married, had a wonderful daughter who I am immensely proud of for the strength and kind thoughtfulness she exhibits, and lived through some phenomenal ups and downs. My first marriage did not last and ended in a painful and difficult divorce. Now a long time ago, it was the darkest point in my life when I almost ceased to exist. I grappled with loneliness, a punishing work schedule, and a life that was in shambles. I had turned to sleeping pills at that time, but the universe has miraculous ways to re-affirm life for me. I found recovery with a wonderful counselor Murray Brooks, you’ll always be my hero! – and a wonderful group of people with similar stories. Leaders, doctors, nurses, pharmacists – people like me that walked a path of growth and showed me the way. This time I boldly went where many had gone before. My soul bloomed again, I healed, and rediscovered my inner well of dreaming big and making my dreams happen! 


Everything that came after has sprung from that well my recovery and personal growth journey opened. The most noteworthy part? As I became kinder towards myself, my empathy for others amplified as well. It was an immeasurable gift I had been given and I wanted to take that gift and spread it throughout the world. If I had such a remarkable healing journey, coupled with my reborn strength, I wanted others to experience the same. That is when the seeds for my company were sown, to erupt into the light of day years later. 


My origins have always remained close to my heart to remind me that going forward boldly is worth it no matter what. Autographed framed photographs of Kirk and Spock are still on my mantle place. When my friend recently visited us, she looked at them gesturing in a wide arc, “Ah, I see. Mom and Dad?” Her smile told the whole story. 


What inspired you to start Vivo Health Coaching, and what is the main mission of your business?


When I was agonizing over a design project during my lead time at Stanford, I was looking for ways to address common frustrations with patient support for their chronic illnesses. Quickly into my brainstorming I discovered something: I realized the most common question I ask is, “When did this all start?”. I had a lightbulb moment! Why not go back far enough into people’s lives before they get sick? Medicine is very reactive instead of proactive despite emerging efforts to shift that approach. I wanted to create something that would help people steer their health towards wellbeing when they had early warning signs of illness and were at risk of losing their youthful, energetic selves.


Fast forward to October 2023 – I founded Vivo, Ltd, a health coaching company that focuses on helping executives and founders reverse pre-diabetes. Through my own journey of health discovery, recovery, and personal growth, I have learned so much about health and wellbeing. As a European, combining ancient wisdom with modern approaches to health and habits also appealed to me. Dan Buettner’s amazing research into the Blue Zones resonated with me on a deep level. In the Blue Zone research I had found something powerful I wanted to bring to others, to experience that balance and joy in life I had rediscovered after years of grueling work schedules and so-so health. The principles formulated in this research have flowed into my approach to helping my clients make simple shifts in their daily routines to move the needle towards becoming their old healthy selves.


I zeroed in on pre-diabetes by applying my physician – filter, since diabetes and insulin resistance are common illnesses, racking up phenomenal lifetime expenses. More people than ever before are affected. Applying my solution to the precursor of this devastating illness (think cardiovascular morbidity and mortality, high cost, lost earnings, poor quality of life), I had an entry point for people to embark on a healthier lifestyle journey with direction and clarity.


As a business owner and entrepreneur with a busy life and a big vision myself, and after talking with hundreds of patients who lead or work in executive business roles, preserving health is akin to preserving value. The high cost of illness was evident in the frustration and anguish of my patients who were unable to run their business because of grueling health issues that had them laid up in the hospital. 


Vivo's mission is to bring this life-affirming solution to business leaders with prediabetes, to preserve their most valuable asset – their health. Imagine you beat pre-diabetes, so you never have to deal with diabetic complications, have time and energy to follow your passion and build your vision well into old age (think Warren Buffet!).


Can you describe the range of services and programs that Vivo Health Coaching offers, and how they cater to different client needs?


Vivo offers a personal coaching and mentoring program called the Timeless Health Method. I combine principles of a balanced life with modern strategies to create a simple but effective plan that is custom-tailored to you. Everyone starts at a different point in their lives, so I meet you where you are, and we work from there. You get a full range of consulting, coaching, and mentorship. The consulting part is your opportunity to tap into my doctor brain, and while I don’t function as your doctor, I provide clarity and information for you about your health and coach you on how to have the most effective working relationship with your doctor. We teach our doctors how to engage in shared decision-making (the official term for this!), but we do not train our patients how to do this well. 


This is also a program of empowerment. Many of us rely heavily on technology and data these days to tell us what to do, which is a bit of a double-edged sword. Health data is very valuable and when integrated well into decision-making, it is a vital cornerstone. But if you over-rely on data, it can keep you from trusting your own body. I help you find the confidence to trust yourself, the empowered voice to harness your body’s wisdom, not fight it. 


How do you tailor your health coaching services to meet the unique goals and challenges of individual clients?


When you enroll, we sit down and have a close look at your goals, your vision, and what is important to you for your health in particular and your life in general. Health is a big part of your life – the biggest in fact. Being healthy will mean the freedom to live your life as you want. Looking at your goals, we brainstorm together what steps make the most sense for you at that moment, and how those steps can best be adapted into your life. It’s like a design session! That way, you build your new health habits around your life, not trying to upend your schedule while trying to follow a strict protocol. Upending your life works short-term but is one of the greatest predictors for failure long-term. 


Challenges are expected and they are valuable indicators that there is a learning opportunity. Sometimes clients get frustrated because something isn’t going the way they expected, or they don’t see results fast enough. This is an opportunity to slow down, recap, and look at the challenge from a different perspective. We dig deeper, explore and reflect, and it may just uncover limiting beliefs that have been holding you in a repetitive pattern of behavior. This gives you the chance to move past that. On the other hand, we focus on your bright spots as well. What’s working well and why is that? Can we replicate it for other areas in your life to reach your goals? 


What are your future plans for Vivo Health Coaching, and how do you see the business evolving in the next few years?


The core service right now is the Timeless Health Mastermind that gives you the foundation for how to optimize your health and your old energetic You back as time goes by. Over time, we will offer different tiers to meet different level needs for business leaders set on reversing pre-diabetes. We will also be launching an app in the coming months so that your ‘coach’ goes with you wherever you are for your meal planning, shopping lists, label deciphering, and selecting your preferred options from any restaurant menu – clarity on the go so to speak! 


Down the road we really want to expand services to include an AI-algorithm for point-of-care coaching, so you don’t have to wait to connect with me, but you can work through your questions with the AI. The working name I gave this idea back at Stanford is “Sebastian”, and so far, it has stuck! Maybe we’ll keep it that way, so you’ll recognize it once it’s out! 


Eventually we want to connect your health data with your coaching plan. This is a long-term vision to work towards a client-centered health hub that integrates your data and helps make recommendations for your most effective individualized approach. In a sense, it will be your supercharged personal health guide!


I’m really excited to follow the developments in the area of data security and decentralized secure data storage. Kyral Health is one of those trailblazers developing this path of patient-centered security and I’m thinking this could really be a gamechanger in how you can interact with and access your personalized health plan and have an informed “coach” ready to go.


If you could change one thing about your industry, what would it be and why?


If I were to wave a magic wand, I would walk into a healthcare world tomorrow that has adopted a “Yes, and…” attitude in favor of its current “Yes, but…”. There are a lot of challenges we face in healthcare today. Our greatest challenge, as I see it, lies in the pace of adapting our tool kit to provide effective and efficient care to patients in an equal and just manner, while transitioning from a reactive to a proactive approach to health. My biggest frustration is my experience of very risk averse healthcare leaders which makes it tough to challenge the status quo. It stunts innovation. But it is growth and innovation that is needed to meet the rapidly evolving and growing needs of our overburdened healthcare system through value-based care. There is a big effort in that direction, but we need to increase our efforts in many areas within the system, as value-based care implemented in one area can cause friction with the systems that are currently in place. We shouldn’t rush into a rosy-eyed ‘hope everything works out’ future, but thoughtful implementation of an innovative design process guided by a structured digital transformation is key. In order to achieve that, we need to articulate meaningful steps for action we can implement now to start moving the needle in the right direction. 


Tell us about a pivotal moment in your life that brought you to where you are today.


2020 was a year many of us would probably like to forget. For me it was the year my path changed to catapult me on today’s trajectory. Back then I was working as a hospitalist in a rural critical access hospital in Northern Nevada. I had been doing that kind of work for the past nine years. My life was uncomplicated, and I poured all my energy and focus into teaching our resident physicians. Things were great until Covid broke everything. My husband was a huge driving force to help me take a leap of faith into something new that otherwise I may not have taken. 


Covid was inevitably rolling into the little town with a bit of a delay after it had already ravaged thousands of communities in the country. Together with my fellow physicians, we met with the C-suite to plan for the upcoming first wave of Covid. Long story short, we had a great plan according to what was already working elsewhere. We tried to implement the plan but got pushback from the C-suite. I was not willing to betray everything that medicine and being a physician meant to me and this fight became a fight I could not win. We parted ways, as several other colleagues did a well. 


I felt defeated. My confidence as a doctor and in myself had dwindled to an all-time low. But to boldly go was foremost in my mind as my husband reminded me of who I was at heart, and what I had accomplished in life by tapping into that courage. 


I took a leap of faith, left my comfort zone, low self-confidence and all, and applied to Stanford Lead. Did I mention I was absolutely terrified when the program started, suddenly having to speak to total strangers on zoom?! Well, you wouldn’t know it now! The Lead program was and continues to be a fantastic source of inspiration and learning for me, and the connections and friends I have made over the years are as dear to me as my own family. They have inspired me, encouraged me, and believed in me when I doubted myself to move forward. 


I took on the “Yes, and…” attitude together with boldly going, moving ahead, building and creating along the way. The process is tedious, long, soaked in blood, sweat, and tears, and incredibly rewarding. Stepping out into the world was huge for me. Hiding and just dreaming would have been easier. But I don’t want easy. I want to create, I want to live my best life with no regrets, and I want to leave a legacy of my passion for helping and healing people, so you too can say “I live – Vivo.”


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