Medvi, a Los Angeles-based telehealth startup, is on track to rake in $1.8 billion in sales this year — all with just two employees. The secret? Artificial intelligence doing the heavy lifting behind the scenes.

The Rise of Medvi: A Startup Like No Other

Matthew Gallagher’s Medvi is shaking up the telehealth industry. In 2025, its first full year, the company pulled in $401 million in sales, mostly from offering GLP-1 weight-loss medications. Now, just a year later, Medvi is forecasted to hit $1.8 billion in revenue. What’s wild is that the entire operation runs with only Matthew and his brother, Elliot.

That’s right — two guys. No massive staff, no sprawling office floors, just a lean duo backed by powerful AI tools to handle everything from software coding to customer service. It sounds almost unbelievable.

Matthew admits he outsources certain functions that AI can’t fully manage yet. He partners with companies like CareValidate and OpenLoop Health to navigate the complex worlds of medical licensing, pharmacy distribution, regulatory compliance, and shipping logistics.

But the core business, from marketing to customer engagement, relies heavily on artificial intelligence.

Elliot joined recently, stepping in mainly to ease communication and let Matthew zero in on what matters most. "I just helped take a lot of the weight off of him," Elliot said in an interview.

Their combined hustle, plus AI’s muscle, has turned Medvi into a powerhouse.

AI’s Role in Building a Billion-Dollar Business

Sam Altman, the CEO of OpenAI, predicted back in 2024 that AI would soon give rise to a new breed of companies — ones that could start small, even as one-person operations, and scale to billion-dollar valuations. Medvi proves his forecast wasn’t far off, even if it took two employees instead of one.

Matthew Gallagher’s approach puts AI at the center of every aspect of his business. He used AI platforms like Midjourney and Runway to generate the images and videos featured on Medvi’s website and ads. AI also helped write the website’s copy and power customer service chatbots. Even the software at the heart of Medvi’s operation was coded with AI assistance.

That kind of efficiency means Medvi can keep overhead shockingly low. No need to hire hundreds of employees when AI can automate routine tasks or even create marketing materials. The company’s revenue per employee ratio is astronomical — a clear sign AI is transforming how startups scale.

But There’s a Catch: Controversies and Legal Hurdles

Here’s the thing — Medvi’s meteoric rise hasn’t come without controversy. The company faces serious allegations around its marketing tactics. Some watchdogs and media outlets have flagged the use of AI-generated deepfake images in before-and-after weight-loss ads. Those photos, critics say, aren’t real people but AI creations designed to look eerily convincing.

Futurism reported in 2025 that Medvi’s website is filled with images that seem generated from scratch by AI, using tools that manipulate faces to produce dramatic transformations. That kind of advertising raises ethical questions about transparency and consumer trust.

On top of that, Medvi has drawn a warning letter from the FDA, which is keeping a close eye on how the company markets prescription drugs online. There’s also a class action lawsuit alleging misleading advertising practices. Those legal troubles could slow Medvi’s momentum or force changes in how it runs its business.

Matthew Gallagher has acknowledged using AI to generate much of Medvi’s digital content but defends the company’s practices as innovative and forward-looking. Still, regulators and consumer advocates are watching closely.

What Medvi’s Story Means for the Future of Business

Medvi embodies a new wave of startups that lean heavily on AI to punch above their weight. Being a two-person company with billion-dollar sales was almost unimaginable before AI tools became so advanced and accessible.

But the questions raised by Medvi’s strategy are real. Can AI-driven marketing cross ethical lines?

Will regulators crack down on companies that blur the line between real and fabricated content? And how sustainable is this model when legal and reputational risks pile up?

Matthew Gallagher’s gamble on AI shows how tech can turbocharge growth — but it also reveals potential pitfalls. His story is a proof point that AI won’t just change how companies start; it’ll change what they look like and how they operate.

As other entrepreneurs look to AI for their own startups, they’ll have to weigh the benefits against the risks. The Medvi saga may be just the beginning of a debate about AI’s role in business ethics and regulation.

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