Dr Emily Cooper

Fat Science

#13 in Medicine · 🇮🇪 #28 in Medicine · 🇬🇧

About the show

Fat Science is a podcast on a mission to explain where our fat really comes from and why it won’t go (and stay!) away. In each episode, we share little-known facts and personal experiences to dispel misconceptions, reduce stigma, and instill hope. Fat Science is committed to creating a world where people are empowered with accurate information about metabolism and recognize that fat isn’t a failure. This podcast is for informational purposes only and is not intended to replace professional medical advice.

Newest episodes

Mailbag: Navigating GLP-1 Tapers, Alcohol Cravings, and Insulin

Nov 9, 2026 41 min

What actually happens to your body when you space out GLP-1 doses, stop tracking food, or cut calories to fuel workouts? Dr. Emily Cooper, Mark Wright, and Andrea Taylor answer listener questions from the mailbag. A Seattle fitness trainer asks how to support clients without promoting under-fueling, while a patient navigating the loss of insurance asks about evidence-based ways to taper or space out tirzepatide doses. The team evaluates ongoing clinical trials regarding GLP-1 medications and alcohol use disorder, explaining how regular mechanical fueling helps stabilize alcohol cravings. The conversation also tackles the anxiety of abandoning daily food tracking, the limitations of self-reported registries, and why insulin is an essential hormone rather than a metabolic enemy. Key Takeaways Fitness professionals can support client health by establishing that proper nourishment is required to prevent injury and see genuine progress. Gradual dose tapering while maintaining weekly consistency helps avoid the metabolic highs and lows caused by stretching injection intervals too far. Alcohol acts as an immediate fuel source that bypasses insulin; regular mechanical eating can dramatically reduce alcohol cravings caused by energy deficits. Transitioning away from scales and calorie apps requires establishing mechanical eating patterns with balanced food groups at predictable intervals. Insulin and glucose are vital bodily lifelines; extreme carbohydrate restriction can cause diet backlash and lean tissue loss over time. Connect with Us Podcast Home:fatsciencepodcast.com Cooper Center for Metabolism:coopermetabolic.com Diabesity Institute: diabesityinstitute.org Join Our Community:patreon.com/cw/FatSciencePodcast Submit Your Question: questions@fatsciencepodcast.com or dr.c@fatsciencepodcast.com Fat Science is supported by the Diabesity Institute, a nonprofit dedicated to increasing access to effective, science-based metabolic care. This podcast is for informational purpos...

Maybe You Don’t Need a GLP-1

Nov 2, 2026 48 min

Taking a GLP-1 medication when your body does not need it can actually harm your health. Dr. Emily Cooper breaks down who these drugs are truly for. Dr. Emily Cooper, Mark Wright, and Andrea Taylor tackle the cultural assumption that everyone needs to be on a GLP-1 medication. They examine how marketing and social media trends have pushed these clinical tools into the realm of casual quick fixes, overlooking the biology of how they actually function inside the body. The discussion centers on the medical reality that a high body weight alone does not automatically mean a person is metabolically unhealthy. Dr. Cooper explains the expanded health indications for these medications, why severe calorie restriction while taking them causes lean mass loss, and what objective health markers actually justify pharmacologic treatment. Fat Science, Dr. Cooper, and the Diabesity Institute have no financial relationship with any pharmaceutical company. This conversation focuses on separating individualized metabolic care from commercial pressure, exploring alternative treatments like metformin, and understanding why a lack of response to these drugs is never the patient's fault. Key Takeaways GLP-1 medications are designed for specific metabolic dysfunctions, not for casual use or minor weight changes. A higher body weight does not automatically indicate poor metabolic health, and up to 25% of individuals with normal weight have underlying metabolic comorbidities. Severe calorie restriction on a GLP-1 leads to significant loss of lean muscle mass rather than healthy metabolic stabilization. Alternative medications like metformin, Contrave, or SGLT2 inhibitors may target individual root issues more effectively than GLP-1s alone. If a medication does not produce results, it reflects the limitations of current medical therapies rather than personal failure. Resources Mentioned Cooper Center for Metabolism Diabesity Institute Connect with Us Podcast Home:fatsciencepodcast.com Cooper C...

Mailbag: Why Restriction Stalls Metabolic Health

Oct 26, 2026 41 min

When your body holds onto weight or reacts to exercise with fatigue and headaches, restriction is rarely the fix. Fueling consistently comes first. Dr. Emily Cooper, Mark Wright, and Andrea Taylor answer listener questions from around the world. The conversation addresses standard metabolic screenings, the risks of using weight loss medications during active eating disorders, and why disproportionate lower body fat may point to conditions like lipedema. The team also examines HbA1c test variability, adult-onset autoimmune diabetes genetics, and why severe restriction causes the brain to raise metabolic defenses. Finally, Dr. Cooper breaks down how intense exercise acts as a physiological stressor and why adequate recovery matters more than pushing through burnout. Key Takeaways Fasting insulin is often excluded from routine panels despite providing early insight into cardiovascular and metabolic risk. Active eating disorders disrupt metabolic hormones and require specialized treatment before metabolic health can be evaluated. Disproportionate lower extremity fat storage that resists lifestyle interventions may signal lipedema rather than standard adipose tissue. HbA1c tests can fluctuate by up to 0.2 points, making long-term patterns and mixed meal tolerance tests far more informative. Exercise elevates stress hormones, and working out while sleep-deprived or under-fueled breaks the body down instead of strengthening it. Resources Mentioned Diabesity Foundations Course Mechanical Eating Guide on Patreon Connect with Us Podcast Home:fatsciencepodcast.com Cooper Center for Metabolism:coopermetabolic.com Diabesity Institute: diabesityinstitute.org Resources from Dr. Cooper:coopermetabolic.com/resources Join Our Community:patreon.com/cw/FatSciencePodcast Submit Your Question: questions@fatsciencepodcast.com or dr.c@fatsciencepodcast.com Fat Science is supported by the Diabesity Institute, a nonprofit dedicated to increasing access to effective, science-based metabolic c...

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All episodes

Mailbag: Navigating GLP-1 Tapers, Alcohol Cravings, and Insulin

Nov 9, 2026 41 min

Maybe You Don’t Need a GLP-1

Nov 2, 2026 48 min

Mailbag: Why Restriction Stalls Metabolic Health

Oct 26, 2026 41 min

Understanding New Metabolic Medications and How They Work

Oct 18, 2026 55 min

Metabolic medications work by mimicking natural gut hormones and brain signals, not just by slowing down the digestive tract. Dr. Emily Cooper, Mark Wright, and Andrea Taylor break down the rapidly evolving landscape of metabolic therapies. From oral options to high-dose formulations and pipeline molecules, the conversation cuts through public confusion to focus on biological mechanisms. The discussion explores how these therapies interact with complex melanocortin and hormonal pathways in the brain. Rather than relying on rigid protocols or escalating doses prematurely, effective metabolic care focuses on individual biological response and measurable health parameters. Key Takeaways Modern metabolic therapies are designed to mimic native hormones like GLP-1, GIP, and amylin rather than simply slowing gastric emptying. Clinical trial dosing sequences are designed for regulatory approval, while individualized clinical practice prioritizes symptom stability and health markers over reaching maximum doses. Health improvements such as blood pressure regulation, cholesterol shifts, and liver markers often occur independently of scale changes. Resources Mentioned Diabesity Institute Foundations Course Cooper Center for Metabolism Connect with Us Podcast Home:fatsciencepodcast.com Cooper Center for Metabolism:coopermetabolic.com Diabesity Institute: diabesityinstitute.org Resources from Dr. Cooper:coopermetabolic.com/resources Join Our Community:patreon.com/cw/FatSciencePodcast Submit Your Question: questions@fatsciencepodcast.com or dr.c@fatsciencepodcast.com Fat Science is supported by the Diabesity Institute, a nonprofit dedicated to increasing access to effective, science-based metabolic care. This podcast is for informational purposes only and is not intended as medical advice. Please consult with a qualified healthcare provider for personalized recommendations. Produced by: Podcast Impact Studio https://podcastimpactstudio.com

Mailbag: Why Calorie Deficits Stall Metabolism

Oct 12, 2026 52 min

Wondering why weight stalls on treatment? Dr. Emily Cooper explains how the brain defends set points and why eating less stops progress. Dr. Emily Cooper, Mark Wright, and Andrea Taylor answer listener letters from around the world. The conversation addresses why athletic men with a BMI of 27 can still show high visceral fat on a DEXA scan, how medications defend metabolic set points, and why intentional undereating triggers starvation responses. The team also examines global access to metabolic treatments, dual incretin agonists versus single agonists, artificial sweeteners, and how to interpret two-hour insulin and glucose tolerance curves. Key Takeaways Rapid weight reduction without adequate nutrition can cause lean mass loss and trigger metabolic defense mechanisms.Dual incretin therapies stimulate GIP receptors far more than GLP-1 receptors compared to natural human hormones, creating different patient responses.Intentional calorie restriction reduces natural incretin production and can impair metabolic signaling, making mechanical fueling essential.Fasting insulin suppression combined with pre-diabetes indicators can reflect the brain pulling glucose during periods of low carbohydrate intake.Resources Mentioned Diabesity Foundations Course Cooper Center for Metabolism Diabesity Institute Connect with Us Podcast Home:fatsciencepodcast.com Cooper Center for Metabolism:coopermetabolic.com Diabesity Institute: diabesityinstitute.org Resources from Dr. Cooper:coopermetabolic.com/resources Join Our Community:patreon.com/cw/FatSciencePodcast Submit Your Question: questions@fatsciencepodcast.com or dr.c@fatsciencepodcast.com Fat Science is supported by the Diabesity Institute, a nonprofit dedicated to increasing access to effective, science-based metabolic care. This podcast is for informational purposes only and is not intended as medical advice. Please consult with a qualified healthcare provider for personalized recommendations. Produced by: Podcast Impact Studio...

Breaking Drug News: Combination GLP-1s, Treatment for Kids, and Lp(a)

Oct 5, 2026 47 min

What do new drug reports really mean for your treatment? Explore groundbreaking updates on potential diabetes and weight-loss drugs from Novo Nordisk and Eli Lilly. Dr. Emily Cooper dives into top-line results, explaining what these findings mean for those struggling with metabolic issues. KEY TAKEAWAYS Understanding the difference between efficacy estimand and treatment policy estimand. Cagrisema’s potential in aiding weight loss compared to Mounjaro in patients with type 2 diabetes. Semaglutide's effectiveness in children and its implications. NOTABLE QUOTE "Many of our patients with metabolic dysfunction have increased cardiometabolic risk." — Dr. Emily Cooper LINKS & RESOURCES Learn more about Diabesity Foundations: learn.diabesityinstitute.org Podcast Home: fatsciencepodcast.com Cooper Center for Metabolism: coopermetabolic.com Diabesity Institute: diabesityinstitute.org Resources from Dr. Cooper: coopermetabolic.com/resources Join Our Community: patreon.com/cw/FatSciencePodcast Submit Your Question: questions@fatsciencepodcast.com or dr.c@fatsciencepodcast.com Fat Science is supported by the Diabesity Institute, a nonprofit dedicated to increasing access to effective, science-based metabolic care. This podcast is for informational purposes only and is not intended as medical advice. Please consult with a qualified healthcare provider for personalized recommendations.

The Fat Science Origin Story

Sep 28, 2026 1 hr 22 min

Have you ever felt that diets don't work for you? Mark Wright, Andrea Taylor, and Dr. Emily Cooper dive deep into the science of metabolism, challenging the myths surrounding diets and weight gain. With personal stories and expert insights, they explore how metabolic function and genetics play vital roles in our health. KEY TAKEAWAYS Diets often don't address underlying metabolic issues. Metabolic syndrome involves multiple health systems and requires comprehensive care. GLP-1 medications have changed the treatment landscape for metabolic dysfunction. NOTABLE QUOTE "It's not your fault... you were dealt not the best hand genetically." — Dr. Emily Cooper Links & Resources Podcast Home: fatsciencepodcast.com Cooper Center for Metabolism: coopermetabolic.com Resources from Dr. Cooper: coopermetabolic.com/resources Join Our Community: patreon.com/cw/FatSciencePodcast Submit Your Question: questions@fatsciencepodcast.com or dr.c@fatsciencepodcast.com Fat Science is supported by the Diabesity Institute, a nonprofit dedicated to increasing access to effective, science-based metabolic care. This podcast is for informational purposes only and is not intended as medical advice. Please consult with a qualified healthcare provider for personalized recommendations.

Listener Spotlight: Alessio’s Metabolic Wake-Up Call

Sep 21, 2026 53 min

Can metabolic dysfunction be the cause of anxiety? Join Dr. Emily Cooper, Andrea Taylor, and guest Alessio De Martis as they explore the fascinating intersection of metabolic health, anxiety, and the struggle with traditional diet advice. Learn how under-fueling can exacerbate metabolic issues and what that means for your overall health. KEY TAKEAWAYS Alessio's experience highlights the struggle of self-managing metabolic health in Europe.Under-fueling can worsen metabolic dysfunction, disrupting body stability.The body's response to hypoglycemia can mirror symptoms of anxiety. NOTABLE QUOTE "If you have a history of hypoglycemia, you're gonna have a lot less tolerance than other people." — Dr. Emily Cooper GUEST BIO Alessio De Martis is a 41-year-old listener from Rome, Italy, who shares his experiences with metabolic dysfunction, hypoglycemia, and anxiety. His journey represents the challenges faced by many in understanding their metabolic health. Links & Resources Podcast Home: fatsciencepodcast.com Cooper Center for Metabolism: coopermetabolic.com Resources from Dr. Cooper: coopermetabolic.com/resources Join Our Community: patreon.com/cw/FatSciencePodcast Submit Your Question: questions@fatsciencepodcast.com or dr.c@fatsciencepodcast.com Fat Science is supported by the Diabesity Institute, a nonprofit dedicated to increasing access to effective, science-based metabolic care. This podcast is for informational purposes only and is not intended as medical advice. Please consult with a qualified healthcare provider for personalized recommendations.

Back to School Metabolism Tips for the Whole Family

Sep 14, 2026 51 min

What's the back-to-school metabolism shift all about? The return to a school routine can have surprising impacts on metabolic health. Dr. Emily Cooper explains how sleep, nutrition, and scheduling affect metabolism, and offers practical advice for parents managing these transitions. KEY TAKEAWAYS Sleep quality is crucial for kids' and parents' metabolic health. Proper fueling before, during, and after exercise is essential for kids. Maintaining a consistent schedule can help manage stress and metabolism. NOTABLE QUOTE "Fueling the workout enhances our fitness basically, and reduces our stress hormones and strengthens our metabolism." — Dr. Emily Cooper LINKS & RESOURCES Studies on sleep and insulin resistance Podcast Home: fatsciencepodcast.com Cooper Center for Metabolism: coopermetabolic.com Diabesity Institute: diabesityinstitute.org Resources from Dr. Cooper: coopermetabolic.com/resources Join Our Community: patreon.com/cw/FatSciencePodcast Submit Your Question: questions@fatsciencepodcast.com or dr.c@fatsciencepodcast.com Fat Science is supported by the Diabesity Institute, a nonprofit dedicated to increasing access to effective, science-based metabolic care. This podcast is for informational purposes only and is not intended as medical advice. Please consult with a qualified healthcare provider for personalized recommendations.

Mailbag: Navigating Menopause and Metabolic Health

Sep 7, 2026 47 min

Is menopause impacting your weight and health in unexpected ways? In this episode, the hosts tackle an assortment of listener questions about weight loss, metabolic health, and menopause. They delve into the intricacies of medication tolerance, the ethics of unregulated weight loss drugs, and the physiological changes that can affect women during menopause. KEY TAKEAWAYS Understanding metabolic and hormonal impacts during menopause is crucial.Unregulated weight loss drugs pose significant risks and ethical concerns.Medication tolerance and side effects can vary greatly among individuals. NOTABLE QUOTE "It's not your fault." — Dr. Emily Cooper Links & Resources Podcast Home: fatsciencepodcast.com Cooper Center for Metabolism: coopermetabolic.com Resources from Dr. Cooper: coopermetabolic.com/resources Join Our Community: patreon.com/cw/FatSciencePodcast Submit Your Question: questions@fatsciencepodcast.com or dr.c@fatsciencepodcast.com Fat Science is supported by the Diabesity Institute, a nonprofit dedicated to increasing access to effective, science-based metabolic care. This podcast is for informational purposes only and is not intended as medical advice. Please consult with a qualified healthcare provider for personalized recommendations.

Top Metabolism Killers Revealed

Aug 31, 2026 43 min

What are the top causes of metabolic disruption? In this informative episode, Dr. Emily Cooper dives into the factors that quietly sabotage metabolic health. From the intricacies of sleep to the surprising connection between love and metabolism, listeners will learn what enhances or damages their metabolic system. KEY TAKEAWAYS Sleep is crucial for metabolic and hormonal balance. Weight cycling severely impacts metabolic health. Underlying stress and emotional wellbeing affect metabolism. NOTABLE QUOTE "Everyone has strengths and limitations, let's put it that way." — Dr. Emily Cooper LINKS & RESOURCES Mechanical Eating Handout: Available on our Patreon page. Links & Resources Podcast Home: fatsciencepodcast.com Cooper Center for Metabolism: coopermetabolic.com Resources from Dr. Cooper: coopermetabolic.com/resources Join Our Community: patreon.com/cw/FatSciencePodcast Submit Your Question: questions@fatsciencepodcast.com or dr.c@fatsciencepodcast.com Fat Science is supported by the Diabesity Institute, a nonprofit dedicated to increasing access to effective, science-based metabolic care. This podcast is for informational purposes only and is not intended as medical advice. Please consult with a qualified healthcare provider for personalized recommendations.

Mailbag: GLP-1 Injection Reactions

Aug 24, 2026 38 min

Do you ever wonder how medications like Wegovy and Mounjaro influence your metabolic health? Dr. Emily Cooper, along with Andrea Taylor and Mark Wright, dives into listener questions about maintaining metabolic health when medication coverage is lost, understanding the role of leptin after weight loss, and the effects of medications like Mounjaro. They also explore the injection site reactions and the complex interplay between thyroid, exercise, and inflammation. KEY TAKEAWAYS Loss of medication insurance coverage can significantly impact treatment, but alternative options like pills may be available. Leptin levels differ by gender; they're naturally lower in men due to different body composition. Fasting can disrupt hunger signals and glucose regulation, particularly following intermittent fasting. Injection site reactions are common but switching medications or techniques might alleviate symptoms. NOTABLE QUOTE "Obesity is a physical sign of underlying metabolic dysfunction." — Dr. Emily Cooper LINKS & RESOURCES To register for course: https://learn.diabesityinstitute.org/products/live_events/live-virtual-update-event Links & Resources Podcast Home: fatsciencepodcast.com Cooper Center for Metabolism: coopermetabolic.com Resources from Dr. Cooper: coopermetabolic.com/resources Join Our Community: patreon.com/cw/FatSciencePodcast Submit Your Question: questions@fatsciencepodcast.com or dr.c@fatsciencepodcast.com Fat Science is supported by the Diabesity Institute, a nonprofit dedicated to increasing access to effective, science-based metabolic care. This podcast is for informational purposes only and is not intended as medical advice. Please consult with a qualified healthcare provider for personalized recommendations.

How Wildfire Smoke Affects Metabolism

Aug 17, 2026 38 min

Is wildfire smoke affecting more than just your lungs? Poor air quality affects not only respiratory health but also metabolic functions. Wildfire smoke can trigger inflammation, oxidative stress, and hormone release, leading to metabolic disturbances. KEY TAKEAWAYS Wildfire smoke can impact metabolism, leading to insulin resistance. Stress hormones released during smoke exposure can raise blood sugar levels. Air pollution is linked to increased risk of metabolic syndrome components. NOTABLE QUOTE "When there were wildfire events, within days, the admissions for diabetes increased." — Dr. Emily Cooper Links & Resources Podcast Home: fatsciencepodcast.com Cooper Center for Metabolism: coopermetabolic.com Resources from Dr. Cooper: coopermetabolic.com/resources Join Our Community: patreon.com/cw/FatSciencePodcast Submit Your Question: questions@fatsciencepodcast.com or dr.c@fatsciencepodcast.com Fat Science is supported by the Diabesity Institute, a nonprofit dedicated to increasing access to effective, science-based metabolic care. This podcast is for informational purposes only and is not intended as medical advice. Please consult with a qualified healthcare provider for personalized recommendations.

Inside the GLP-1 Secret Shopper Study

Aug 10, 2026 49 min

Is it really a good idea to get medical care from online pharmacies posing as clinics? This week on Fat Science, Dr. Emily Cooper, Mark Wright, and Andrea Taylor dig into a Yale secret shopper study that tested 49 websites selling GLP-1 medications online. The websites look and market like medical clinics, but the study found that most patients never spoke to a clinician at all before getting a prescription. Dr. Cooper, Mark, and Andrea unpack what real medical care requires, why these platforms skip it, and what that means for anyone considering this route. KEY TAKEAWAY Two-thirds of the sites in the study issued a prescription with no clinician contact of any kind — despite marketing themselves as medical clinics. Fewer than 40% asked for any clinical measurement (blood pressure, labs, etc.), and only 18% asked whether the patient even had a primary care doctor. Many of these sites are financially connected to compounding pharmacies and use leading questions to push add-ons that create untested drug combinations. Real medical care means a full history, objective labs, and ongoing monitoring — not a five-minute questionnaire and an automatic credit card charge. NOTABLE QUOTE "The marketing appears to be a medical clinic or a medical company, when in fact it's really just a sale of a drug." Dr. Emily Cooper LINKS & RESOURCES Study published in JAMA on the secret shopper findings Links & Resources Podcast Home: fatsciencepodcast.com Cooper Center for Metabolism: coopermetabolic.com Resources from Dr. Cooper: coopermetabolic.com/resources Join Our Community: patreon.com/cw/FatSciencePodcast Submit Your Question: questions@fatsciencepodcast.com or dr.c@fatsciencepodcast.com Fat Science is supported by the Diabesity Institute, a nonprofit dedicated to increasing access to effective, science-based metabolic care. This podcast is for informational purposes only and is not intended as medical advice. Please consult with a qualified healthcare provider for personalized reco...

The Truth About Exercise and Metabolism

Aug 3, 2026 46 min

Does exercise really boost metabolism, or is there a hidden truth? In this episode, Dr. Emily Cooper uncovers the science behind why exercise isn’t just about burning calories. Dive into the fascinating world of myokines, the chemical messengers released by muscles that impact everything from mood to inflammation. Discover why it's not your fault if exercise alone isn't solving your metabolic issues. KEY TAKEAWAYS Exercise impacts more than calorie burn; it's a signaling system for the body. Myokines, released during exercise, affect organs like the brain and liver. Muscle contractions broadcast vital signals affecting overall health. NOTABLE QUOTE "Exercise is more than burning energy; it's communication throughout the body." — Dr. Emily Cooper LINKS & RESOURCES Cooper Center for Metabolism: coopermetabolic.com Resources from Dr. Cooper: coopermetabolic.com/resources To register for course: https://learn.diabesityinstitute.org/products/live_events/live-virtual-update-event Links & Resources Podcast Home: fatsciencepodcast.com Cooper Center for Metabolism: coopermetabolic.com Resources from Dr. Cooper: coopermetabolic.com/resources Join Our Community: patreon.com/cw/FatSciencePodcast Submit Your Question: questions@fatsciencepodcast.com or dr.c@fatsciencepodcast.com Fat Science is supported by the Diabesity Institute, a nonprofit dedicated to increasing access to effective, science-based metabolic care. This podcast is for informational purposes only and is not intended as medical advice. Please consult with a qualified healthcare provider for personalized recommendations.

Mailbag: Understanding Body Dysmorphia

Jul 27, 2026 40 min

How does biology affect our perception of body size? Dr. Emily Cooper answers listener questions about body dysmorphia and metabolic dysfunction. Mark and Andrea discuss the challenges with compounded medications and the implications of insurance-driven diet requirements. KEY TAKEAWAYS Body dysmorphia can have biological components related to metabolic dysfunction. Compounded medications may lack the testing and safety guarantees of brand names. Insurance requirements often lack a medical basis and can hinder proper treatment. NOTABLE QUOTE "The altered body image perception may be linked to metabolic signals." — Dr. Emily Cooper LINKS & RESOURCES None mentioned. Links & Resources Podcast Home: fatsciencepodcast.com Cooper Center for Metabolism: coopermetabolic.com Resources from Dr. Cooper: coopermetabolic.com/resources Join Our Community: patreon.com/cw/FatSciencePodcast Submit Your Question: questions@fatsciencepodcast.com or dr.c@fatsciencepodcast.com Fat Science is supported by the Diabesity Institute, a nonprofit dedicated to increasing access to effective, science-based metabolic care. This podcast is for informational purposes only and is not intended as medical advice. Please consult with a qualified healthcare provider for personalized recommendations.

Understanding Metabolism: Latest Scientific Insights

Jul 20, 2026 50 min

Why is your fat talking to you? In the latest solo episode, Dr. Emily Cooper, Andrea Taylor, and Mark Wright explore groundbreaking research into metabolic health. Learn why the scale doesn't always reflect metabolic risk, and discover the science behind fat's active role in the body. KEY TAKEAWAYS Metabolic dysfunction cannot be judged by scale weight alone. Visceral fat is a stronger predictor of heart failure than BMI. Hormonal environments profoundly affect fat storage and health risks. NOTABLE QUOTE "Your fat is talking to you." — Andrea Taylor LINKS & RESOURCES Obesity Reviews Paper Immunological Reviews Journal Article European Congress on Obesity Study Links & Resources Podcast Home: fatsciencepodcast.com Cooper Center for Metabolism: coopermetabolic.com Resources from Dr. Cooper: coopermetabolic.com/resources Join Our Community: patreon.com/cw/FatSciencePodcast Submit Your Question: questions@fatsciencepodcast.com or dr.c@fatsciencepodcast.com Fat Science is supported by the Diabesity Institute, a nonprofit dedicated to increasing access to effective, science-based metabolic care. This podcast is for informational purposes only and is not intended as medical advice. Please consult with a qualified healthcare provider for personalized recommendations.

Why Carbs Are Good For Your Brain

Jul 13, 2026 49 min

Is your brain starving for glucose? In this episode, Dr. Emily Cooper explores the critical role of the brain as a metabolic organ and its dependence on glucose and insulin. Listeners will learn why good sleep and a holistic lifestyle are vital for cognitive health. KEY TAKEAWAYS The brain uses about 20% of your body's energy at rest. Insulin plays a non-fuel role in brain function, supporting neural connections and mood. Sleep is essential for the brain's waste clearance system, the glymphatic system. Insulin resistance in the brain is linked to cognitive decline and dementia. Exercise, a balanced diet, and social engagement are key to brain health. NOTABLE QUOTE "The brain is the most metabolically active organ in our body." — Dr. Emily Cooper LINKS & RESOURCES JAMA: US POINTER Study on Cognitive Decline Novo Nordisk: EVOKE & EVOKE Plus Trials Links & Resources Podcast Home: fatsciencepodcast.com Cooper Center for Metabolism: coopermetabolic.com Resources from Dr. Cooper: coopermetabolic.com/resources Join Our Community: patreon.com/cw/FatSciencePodcast Submit Your Question: questions@fatsciencepodcast.com or dr.c@fatsciencepodcast.com Fat Science is supported by the Diabesity Institute, a nonprofit dedicated to increasing access to effective, science-based metabolic care. This podcast is for informational purposes only and is not intended as medical advice. Please consult with a qualified healthcare provider for personalized recommendations.

Mailbag: When Weight Loss Stalls on GLP-1s

Jul 6, 2026 45 min

Is it normal for GLP-1 medications to become less effective over time? Dr. Emily Cooper discusses listener questions about the nuances of metabolic health and the real reasons behind weight fluctuations and food cravings. With insights into GLP-1 medications, mechanical eating, and more, the episode aims to debunk myths and provide science-based encouragement. KEY TAKEAWAYS Trusting your body's hunger signals can prevent metabolic slowdown. Mechanical eating can help manage sugar cravings and maintain metabolic health. Navigating pediatric metabolic issues requires understanding genetic influences and appropriate medical intervention. NOTABLE QUOTE "It's not your fault. Trust your body and step up to the higher end of your metabolic flexibility." — Dr. Emily Cooper LINKS & RESOURCES American Board of Obesity Medicine: obesitymedicine.org Links & Resources Podcast Home: fatsciencepodcast.com Cooper Center for Metabolism: coopermetabolic.com Resources from Dr. Cooper: coopermetabolic.com/resources Join Our Community: patreon.com/cw/FatSciencePodcast Submit Your Question: questions@fatsciencepodcast.com or dr.c@fatsciencepodcast.com Fat Science is supported by the Diabesity Institute, a nonprofit dedicated to increasing access to effective, science-based metabolic care. This podcast is for informational purposes only and is not intended as medical advice. Please consult with a qualified healthcare provider for personalized recommendations.

Plastic Chemicals in Your Blood and What Actually Works to Remove Them

Jun 29, 2026 50 min

Have you ever wondered why your body holds onto weight despite your best efforts? In this eye-opening episode, Dr. Cooper reveals groundbreaking research showing that 100% of healthy adults carry at least six different plastic-related chemicals in their bodies daily. These endocrine disruptors don't just affect your hormones - they may be stored in your fat tissue and could be a hidden driver of metabolic dysfunction. The good news? New Australian research proves you can dramatically reduce these chemicals in just one week with targeted changes. KEY TAKEAWAYS Every single person tested had at least 6 plastic chemicals in their urine, with food packaging being the primary source Participants cut phthalate levels by 38-54% and BPA by 60% in just 7 days with adjustments in reducing plastic exposure in food and food packaging Ultra-processed foods introduce plastic chemicals through multiple processing and packaging steps Certain chemicals like DEHP may be stored in fat tissue and released during weight loss Heat accelerates plastic migration into food - avoid microwaving in plastic and pouring hot food into plastic containers Simple swaps like choosing fresh over canned foods and using glass containers make significant impacts The EPA research office studying these chemicals was recently eliminated, removing key consumer protections NOTABLE QUOTE "People who switched to the low plastic food and kitchenware cut the phthalates excretion by 38 to 54% in one week and they cut their BPA excretion by 60% in one week." — Dr. Emily Cooper Links & Resources Podcast Home: fatsciencepodcast.com Cooper Center for Metabolism: coopermetabolic.com Resources from Dr. Cooper: coopermetabolic.com/resources Join Our Community: patreon.com/cw/FatSciencePodcast Submit Your Question: questions@fatsciencepodcast.com or dr.c@fatsciencepodcast.com Fat Science is supported by the Diabesity Institute, a nonprofit dedicated to increasing access to effective, science-based metabolic care. This pod...

Why Weight Loss Stalls on GLP-1s — Even When You’re Doing Everything “Right

Jun 22, 2026 47 min

What happens when GLP-1 medications stop working the way you hoped they would? In this mailbag episode, Dr. Emily Cooper answers listener questions about fasting, insulin levels, PCOS, lipedema, plateaus on Zepbound, and the complicated reality behind metabolic dysfunction. From the dangers of under-fueling to why individualized treatment matters so much, this conversation unpacks the science behind weight resistance with clarity and compassion.Key Takeaways Why fasting and restrictive eating may worsen metabolic adaptation The real role insulin plays in metabolic health How PCOS and lipedema complicate weight loss treatment Why some people plateau on GLP-1 medications over time The importance of fueling, muscle preservation, and individualized care Links & Resources Podcast Home: fatsciencepodcast.com Cooper Center for Metabolism: coopermetabolic.com Resources from Dr. Cooper: coopermetabolic.com/resources Join Our Community: patreon.com/cw/FatSciencePodcast Submit Your Question: questions@fatsciencepodcast.com or dr.c@fatsciencepodcast.com Fat Science is supported by the Diabesity Institute, a nonprofit dedicated to increasing access to effective, science-based metabolic care. This podcast is for informational purposes only and is not intended as medical advice. Please consult with a qualified healthcare provider for personalized recommendations.

Normal Weight Abnormal Metabolism: Why Your Scale Doesn't Tell the Whole Story

Jun 15, 2026 31 min

Could you have metabolic dysfunction even at a normal weight? This episode challenges everything we've been taught about weight and health. Dr. Cooper reveals that up to 25% of normal-weight people have metabolic syndrome, yet they're rarely screened because doctors assume they're healthy based on appearance alone. KEY TAKEAWAYS Weight and metabolic health are not the same thing - you can be metabolically unhealthy at any size Normal weight people with metabolic dysfunction are often overlooked and undertreated by healthcare providers Key screening tests include fasting glucose, insulin, HbA1c, triglycerides, HDL cholesterol, blood pressure, and inflammatory markers like HSCRP Metabolic dysfunction can start in your 20s and take decades to develop into serious disease Both normal weight and higher weight patients face bias - normal weight people aren't screened enough, while higher weight people have everything blamed on their weight Early screening and treatment can prevent catastrophic health outcomes later in life The liver plays a crucial role in metabolism and can become insulin resistant regardless of body weight NOTABLE QUOTE "You cannot tell anything about someone's health from their outside, what they look like or what, even what they're doing necessarily, but definitely not their body size. So you can be healthy or unhealthy at any size body, and I think that's what's overlooked quite a bit." — Dr. Emily Cooper Links & Resources Podcast Home: fatsciencepodcast.com Cooper Center for Metabolism: coopermetabolic.com Resources from Dr. Cooper: coopermetabolic.com/resources Join Our Community: patreon.com/cw/FatSciencePodcast Submit Your Question: questions@fatsciencepodcast.com or dr.c@fatsciencepodcast.com Appendix: Key References Primary literature supporting this episode • Wang et al. Prevalence of Metabolically Unhealthy Normal Weight and Its Influence on the Risk of Diabetes. Journal of Clinical Endocrinology & Metabolism, 2023. • Review: Beyo...

Mailbag: Why GLP-1 Medications Sometimes Stop Working

Jun 8, 2026 51 min

Have you been told your metabolism is broken and there's nothing you can do about it? This mailbag episode tackles tough questions about medication effectiveness, unexpected side effects, and the complex realities of treating metabolic dysfunction. Dr. Cooper addresses why some people regain weight while still on GLP-1s, explores the connection between hair loss and weight loss medications, and explains why leptin levels can remain stubbornly low even with proper nutrition. KEY TAKEAWAYS Weight regain while on GLP-1 medications is more common than most people realize Hair loss from weight loss medications is usually related to nutrient deficiencies, not the medication itself Leptin dysfunction involves both hormone levels and signaling pathways throughout the body Hypoglycemia after meals often indicates complex metabolic issues that require specialized testing Starting elderly patients on GLP-1s requires careful monitoring of nutrition, blood pressure, and side effects Mechanical eating differs from intuitive eating and remains important even when medications are working Annual weight loss rates of 10% or higher indicate medications are still effective NOTABLE QUOTE "It is not uncommon to see the weight go up while on these meds, contrary to what people think. They're great, but we always wanna point out some people don't even respond to these." — Dr. Emily Cooper Links & Resources Podcast Home: fatsciencepodcast.com Cooper Center for Metabolism: coopermetabolic.com Resources from Dr. Cooper: coopermetabolic.com/resources Join Our Community: patreon.com/cw/FatSciencePodcast Submit Your Question: questions@fatsciencepodcast.com or dr.c@fatsciencepodcast.com Fat Science is supported by the Diabesity Institute, a nonprofit dedicated to increasing access to effective, science-based metabolic care. This podcast is for informational purposes only and is not intended as medical advice. Please consult with a qualified healthcare provider for personalized recommendations.

Why Three Major Obesity Organizations Just Changed What Success Means

Jun 1, 2026 49 min

Ever wonder why you can improve your health but still feel like you're failing because the scale isn't cooperating? Dr. Cooper breaks down groundbreaking new clinical guidelines from three major obesity organizations that are completely reframing what success in obesity treatment actually means. For the first time, these groups are saying quality of life, energy levels, and overall health matter more than the number on the scale. KEY TAKEAWAYS Three major obesity organizations worked collaboratively to issue guidelines prioritizing quality of life over weight loss as primary treatment goals Guidelines explicitly address medical stigma as a structural barrier to care requiring systemic change Treatment is positioned as long-term management similar to other chronic conditions like thyroid disorders Document notably avoids calorie restriction language, focusing instead on healthy lifestyle alongside medication Setmelanotide receives strong recommendation for rare genetic obesity conditions with available genetic testing Strong medication recommendations now include GLP-1s like semaglutide and tirzepatide, plus bupropion-naltrexone combination NOTABLE QUOTE "Nobody ever asked. Nobody ever looked. Nobody ever said anything. I was like, 'I think there's something wrong with my metabolism or something because I'm not eating a ton.' They're like, 'Well, you must be.' And I'm like, 'N- n- no, I don't think so. I mean, unless it's happening when I'm sleeping. I don't know.'" — Andrea Taylor Reference Link Alexander L, Purnell JQ, et al. Pharmacological management of obesity in adults: a clinical guidance statement from The Obesity Society, the Obesity Medicine Association, and the Obesity Action Coalition. Obesity. 2026;34(4):851–870. doi:10.1002/oby.70164 https://onlinelibrary.wiley.com/doi/10.1002/oby.70164 Links & Resources Podcast Home: fatsciencepodcast.com Cooper Center for Metabolism: coopermetabolic.com Resources from Dr. Cooper: coopermetabolic.com/resources Join Ou...

PCOS is Now PMOS: The Name Change That Changes Everything

May 25, 2026 39 min

Have you been told you have PCOS but nothing seems to help? In May 2024, after 14 years of global collaboration involving 56 organizations and 22,000 stakeholders, the medical community officially changed PCOS to PMOS - and the reason why reveals everything that's been wrong with how this condition has been understood and treated for decades. Dr. Cooper breaks down why this isn't just a name change, but a complete reframe that puts metabolic dysfunction at the center where it belongs. KEY TAKEAWAYS PCOS is now officially called PMOS - Polyendocrine Metabolic Ovarian Syndrome - shifting focus from ovarian problems to metabolic dysfunction70 million women globally are affected during reproductive years, with 70% remaining undiagnosedThe condition can occur at any weight and is driven by insulin resistance and other metabolic signals, not ovarian problemsTreatment should focus on metabolic health rather than weight loss or ovarian interventionsThe name change parallels similar shifts in medicine like MASLD replacing non-alcoholic fatty liver diseaseNOTABLE QUOTE "Most patients with this label that they've had in the past, the PCOS label, feel a sense of hopelessness, and even join support groups and things like that, and thinking that this will be a condition they have forever. And what I try to do is explain, no, this is just a physical manifestation of the metabolic disruption that we treat all the time" — Dr. Emily Cooper Links & Resources Podcast Home: fatsciencepodcast.com Cooper Center for Metabolism: coopermetabolic.com Resources from Dr. Cooper: coopermetabolic.com/resources Join Our Community: patreon.com/cw/FatSciencePodcast Submit Your Question: questions@fatsciencepodcast.com or dr.c@fatsciencepodcast.com Fat Science is supported by the Diabesity Institute, a nonprofit dedicated to increasing access to effective, science-based metabolic care. This podcast is for informational purposes only and is not intended as medical advice. Please consult with a quali...

Mailbag - Why Your Doctor Still Believes Calories In Calories Out

May 18, 2026 45 min

Have you been told it's just calories in calories out while your lived experience says otherwise? In this mailbag episode, Dr. Cooper addresses complex metabolic questions from listeners worldwide. From eating disorders requiring specialized care to GLP-1 plateau management, each question reveals how individual biology trumps one-size-fits-all solutions. KEY TAKEAWAYS Eating disorders like anorexia require comprehensive medical team treatment, not self-management approaches Side effects from GLP-1 medications often improve with consistent eating patterns and adequate nutrition The calories in calories out model ignores the biological complexity of how your body actually burns fuel PCOS responds well to metabolic treatments because it's driven by underlying insulin and hunger hormone imbalances Sleep deprivation and chronic stress significantly impact GLP-1 effectiveness and overall metabolic function Bioidentical progesterone may help perimenopause sleep issues without the metabolic side effects of older formulations Stroke survivors may experience hypothalamic obesity that responds remarkably well to GLP-1 medications NOTABLE QUOTE "If that really worked, imagine, you know, would we actually need these sophisticated medications that are so groundbreaking? Would we have had decades and decades, or actually centuries of failed, you know, diet experiences by so many people?" — Dr. Emily Cooper Links & Resources Podcast Home: fatsciencepodcast.com Cooper Center for Metabolism: coopermetabolic.com Resources from Dr. Cooper: coopermetabolic.com/resources Join Our Community: patreon.com/cw/FatSciencePodcast Submit Your Question: questions@fatsciencepodcast.com or dr.c@fatsciencepodcast.com Fat Science is supported by the Diabesity Institute, a nonprofit dedicated to increasing access to effective, science-based metabolic care. This podcast is for informational purposes only and is not intended as medical advice. Please consult with a qualified healthcare provider for pers...

What Lipedema Really Is and Why Your Doctor Might Be Missing It

May 11, 2026 48 min

Are your legs painful to touch and resistant to weight loss despite your best efforts? Dr. Ellen Derrick, a vascular surgeon and lipedema specialist, reveals the truth about this misunderstood condition affecting 20% of women worldwide. Lipedema isn't obesity - it's a fat cell disorder where tissue responds abnormally to inflammation, creating painful, swollen areas that don't respond to traditional weight loss methods. She explains the connection between lipedema and venous insufficiency, why patients are often dismissed by doctors, and the emerging treatments offering hope. KEY TAKEAWAYS Lipedema affects 20% of the female population but is routinely misdiagnosed as obesityThe condition involves abnormal fat cell response to inflammation, creating painful tissue that resists weight loss86% of lipedema patients also have venous insufficiency, creating a perfect storm of symptomsAnkle cuffs, knee pouches, and saddlebags are classic physical signs that patients often notice from pubertyGLP-1 medications like tirzepatide may help reduce inflammation and tissue tendernessLipedema reduction surgery exists but lacks insurance billing codes, making access challengingA formal medical recognition campaign is underway to establish diagnostic codes by 2026-2027NOTABLE QUOTE "The medical community really has done an outstanding job, in a way, gaslighting these patients. These patients have been aware that something is different about their body and their legs since puberty." — Dr. Ellen Derrick GUEST BIO Dr. Ellen Derrick is a Seattle-based board-certified vascular and general surgeon with over 20 years of clinical experience and a Master of Public Health from the University of Washington. She founded Boxbar Vascular, specializing in lipedema and related metabolic conditions, and serves on the board of the Lipedema Society working toward formal medical recognition of the condition. Links & Resources Podcast Home: fatsciencepodcast.com Cooper Center for Metabolism: coopermetabol...

Metabolic Breaking News: 3 Developments You Should Know About

May 7, 2026 8 min

Dr. Emily Cooper, Mark Wright, and Andrea Taylor break down three breaking metabolic health stories in this quick bonus episode — from a newly approved oral GLP-1 to a major price drop for Medicare patients. Links & Resources Podcast Home: fatsciencepodcast.com Cooper Center for Metabolism: coopermetabolic.com Resources from Dr. Cooper: coopermetabolic.com/resources Join Our Community: patreon.com/cw/FatSciencePodcast Submit Your Question: questions@fatsciencepodcast.com or dr.c@fatsciencepodcast.com Fat Science is supported by the Diabesity Institute, a nonprofit dedicated to increasing access to effective, science-based metabolic care. Disclaimer: This podcast is for informational purposes only and is not intended as medical advice. Please consult with a qualified healthcare provider for personalized recommendations.

Mailbag: Mechanical Eating vs Calorie Counting on Ozempic and Wegovy

May 4, 2026 44 min

Have you ever wondered if you should get liposuction when you need skin removal surgery after major weight loss? In this mailbag episode, Dr. Cooper, Mark, and Andrea tackle questions from listeners around the world, from Germany to Alabama to Chicago. They discuss why restricting calories while on GLP-1 medications can actually work against you, address the reality of finding metabolic-informed doctors internationally, and explain the science behind fat cell removal during skin surgeries. Plus, they share details about the newly approved oral GLP-1 medication orforglipron (Foundayo) and why vegetables, fats and starches matter even when you're protein-focused. KEY TAKEAWAYS Restricting calories on GLP-1 medications can lower your metabolic rate and weaken your body's natural GLP-1 production Liposuction during skin removal surgery may disrupt leptin signaling, though males may be less affected than females due to naturally lower leptin levels Finding metabolic-informed doctors globally remains challenging, but obesity medicine certification and Canadian and European obesity organizations may offer better resources The oral GLP-1 medication orforglipron will likely be less expensive but also less effective than dual-agonist medications like tirzepatide Mechanical eating without calorie counting often produces better long-term results than restrictive approaches Vegetables provide essential micronutrients and support healthy microbiome function that protein alone cannot replace Major weight loss surgery like tummy tucks is serious surgery that requires careful consideration and qualified surgeons NOTE: This episode was recorded before Foundayo (orforglipron) was released on the market. The price is the same as the Wegovy pill. Listen to our episode - “New Obesity Drugs” for more information https://podcasts.apple.com/us/podcast/fat-science/id1715377331?i=1000762362056 NOTABLE QUOTE "If only they didn't fall into that diet cycle, some of them, their weight would be a...

Top 10 GLP-1 Myths Debunked by Science

Apr 27, 2026 33 min

Ever hear someone say GLP-1 medications cause osteoporosis or make your hair fall out? This episode tackles the top 10 biggest myths about GLP-1 medications flooding social media and separates the science from the scary headlines. Dr. Cooper breaks down what's actually happening in your body versus what the internet claims, from bone density concerns to the dreaded "Ozempic face." KEY TAKEAWAYS · GLP-1 medications don't cause osteoporosis - inadequate nutrition while losing weight can weaken bones · Hair loss is typically from nutritional deficits, not the medication itself · These drugs slow gastric emptying but don't cause permanent stomach paralysis · Weight regain after stopping is expected since you're treating a chronic medical condition · Muscle loss comes from eating too little, not from the medication directly · The thyroid cancer warning comes from rodent studies and hasn't been observed in humans · GLP-1s actually protect the pancreas rather than damage it NOTABLE QUOTE "Metabolic dysfunction is biological, it's not something within your means to correct just through lifestyle strategies." — Dr. Emily Cooper Links & Resources Podcast Home: fatsciencepodcast.com Cooper Center for Metabolism: coopermetabolic.com Resources from Dr. Cooper: coopermetabolic.com/resources Join Our Community: patreon.com/cw/FatSciencePodcast Submit Your Question: questions@fatsciencepodcast.com or dr.c@fatsciencepodcast.com Fat Science is supported by the Diabesity Institute, a nonprofit dedicated to increasing access to effective, science-based metabolic care. This podcast is for informational purposes only and is not intended as medical advice. Please consult with a qualified healthcare provider for personalized recommendations.

New Obesity Drugs: What's FDA Approved and What's Coming

Apr 20, 2026 47 min

The obesity medication landscape just changed — again. One brand-new pill is already in pharmacies, and five more are in various stages of approval. But the real story isn't the drugs themselves: it's what they're revealing about how your metabolism actually works, and why willpower was never the problem. This week on Fat Science, Dr. Emily Cooper, Mark Wright, and Andrea Taylor break down six metabolic medications — two newly FDA-approved and four in the pipeline — covering everything from a flexible new oral GLP-1 pill to drugs that target the brain's central metabolic pathway directly. Dr. Cooper explains the science behind each one, who might benefit, and what the pipeline tells us about the future of metabolic care. This is the most comprehensive drug update the show has done, and it arrives at a moment when the field is moving faster than ever. Key Takeaways Foundayo (orforglipron), approved April 1st, is the first small molecule oral GLP-1 — no empty stomach requirement, no cold chain, and potentially lower production costs long-term. The amylin hormone may uniquely address both "I'm nourished" and "I weigh enough" signals in the brain — making the amylin pathway a powerful and underutilized target. Retatrutide (Lilly's triple agonist targeting GLP-1, GIP, and glucagon receptors) is showing unprecedented effectiveness plus significant non-scale benefits, including fatty liver reduction — but is still years from approval. The brain's melanocortin 4 receptor is the CEO of metabolism — regulating energy expenditure, appetite, and insulin — and new drugs targeting it represent the deepest intervention yet. Many of these medications are showing weight-independent benefits, including improvements in kidney, liver, cardiovascular risk, sleep apnea, and joint health that have nothing to do with how much weight is lost. Notable Quote "Everybody focuses on appetite, and you just need to eat less. But now with these medications and how they actually affect our biology,...

Mailbag: Understanding Insulin Resistance Testing and GLP-1 Medication Side Effects

Apr 13, 2026 39 min

Have you been told insulin resistance testing doesn't exist or wondered if you're increasing your GLP-1 dose too quickly? Dr. Cooper, Andrea, and Mark tackle listener questions from around the world, addressing common concerns about insulin resistance testing availability, managing severe GI side effects from higher doses, interpreting DEXA scan results, and developing sustainable maintenance strategies. They discuss the difference between hunger and food noise, explain why winter illness might stall weight loss, and share insights about visceral fat concerns even at normal weight. KEY TAKEAWAYS Insulin resistance can be tested through fasting insulin and glucose ratios, even in countries where insulin testing is less common Rapid weight loss rates above 15% annually may indicate no need for dose increases Severe GI side effects warrant investigation beyond medication adjustment, including gallbladder evaluation DEXA scans provide valuable visceral fat measurements, but results should be interpreted alongside overall health markers Maintenance strategies should focus on nutritional stability before considering medication tapering NOTABLE QUOTE "It's not that the medicine causes the rebound weight gain, it's that with the medication in there, the body is getting better signals, and then you go and take the medication away and you're in the same boat." — Dr. Emily Cooper Links & Resources Podcast Home: fatsciencepodcast.com Cooper Center for Metabolism: coopermetabolic.com Resources from Dr. Cooper: coopermetabolic.com/resources Join Our Community: patreon.com/cw/FatSciencePodcast Submit Your Question: questions@fatsciencepodcast.com or dr.c@fatsciencepodcast.com Fat Science is supported by the Diabesity Institute, a nonprofit dedicated to increasing access to effective, science-based metabolic care. Disclaimer: This podcast is for informational purposes only and is not intended as medical advice. Please consult with a qualified healthcare provider for personalized re...

Navigating the GLP-1 Wild West: A Conversation With Dr. Vin Gupta

Apr 6, 2026 1 hr 2 min

Are you getting a GLP-1 prescription from someone who's never examined you? Dr. Vin Gupta, pulmonologist and former Chief Medical Officer at Amazon, joins Dr. Cooper to expose the dangerous gap between legitimate obesity medicine and the unregulated direct-to-consumer market. This conversation reveals why proper medical evaluation matters and how profit-driven platforms are exploiting desperate patients. KEY TAKEAWAYS GLP-1 medications require individualized medical evaluation, not one-size-fits-all prescribingDirect-to-consumer microdosing platforms lack FDA approval and proper medical oversightThe erosion of trust in healthcare has created opportunities for unregulated treatmentsComprehensive metabolic care includes regular lab work, body composition monitoring, and personalized treatment plansTechnology should enhance medical care, not replace proper physician evaluationNOTABLE QUOTE "I see so many people that come in, you know, they're obsessed with monitoring their HRV, their heart rate variability, and yet they had no idea they have pre-diabetes and they had no idea that they have triglyceride levels through the roof." — Dr. Emily Cooper GUEST BIO Dr. Vin Gupta is a pulmonologist, public health expert, and medical analyst for NBC News. He served as Chief Medical Officer at Amazon and has dedicated his career to translating complex science into actionable health insights at both individual and population levels. GLOSSARY GLP-1 medications: Glucagon-like peptide-1 receptor agonists, medications that help regulate blood sugar and appetite, including brand names like Ozempic, Wegovy, and Zepbound Microdosing: Taking smaller amounts of medication than officially prescribed or approved Direct-to-consumer (D2C): Healthcare services that bypass traditional medical settings, often delivered through apps or online platforms HRV: Heart rate variability, a measurement of the variation in time between heartbeats Pre-diabetes: Blood sugar levels that are higher than normal...

What Happens to Your Body When You Stop Taking GLP-1s

Mar 30, 2026 47 min

What really happens when you stop GLP-1 medications — and are the headlines telling you the whole story? The answer is more nuanced than social media wants you to believe. This week on Fat Science, Dr. Emily Cooper, Mark Wright, and Andrea Taylor break down four recent studies on GLP-1 treatment outcomes, weight regain, and a groundbreaking new drug that could preserve lean mass during treatment. They walk through the methodology behind each paper, explain why two studies asking the same question got opposite answers, and reveal what a new monoclonal antibody called bimagrumab could mean for the future of metabolic treatment. Key Takeaways When you stop treating any chronic metabolic condition, the condition returns — that's not failure, that's biology. Real-world data showed 56% of people who stopped filling GLP-1 prescriptions maintained or continued losing weight — likely because they continued working with their clinician on alternative treatments. A new monoclonal antibody called bimagrumab showed 11% body weight reduction on its own, while simultaneously increasing lean mass by 3% — without affecting appetite. When combined with semaglutide, bimagrumab reduced lean mass loss from 28% to just 11% of total weight lost. Not eating enough while on GLP-1s drives greater lean mass loss — nutrition is still the best tool for preserving muscle. Notable Quote "It wasn't my failure and it was disease underneath everything. Finding that out — that it wasn't my fault — that was the miracle of the whole process to me." — Andrea Taylor Links & Resources Podcast Home: fatsciencepodcast.com Cooper Center for Metabolism: coopermetabolic.com Resources from Dr. Cooper: coopermetabolic.com/resources Join Our Community: patreon.com/cw/FatSciencePodcast Submit Your Question: questions@fatsciencepodcast.com or dr.c@fatsciencepodcast.com Fat Science is supported by the Diabesity Institute, a nonprofit dedicated to increasing access to effective, science-based metabolic care. Disclaim...

Mailbag: Fasting, Food Noise & GLP-1s

Mar 23, 2026 44 min

Ever wonder why fasting worked at first — then stopped? Or why you lost 80 pounds only to gain back 100? In this mailbag episode, Dr. Emily Cooper, Mark Wright, and Andrea Taylor tackle the most misunderstood topics in metabolic health. From the harsh reality of fasting culture to the surprising metabolic challenges faced by normal-weight individuals, this conversation validates what you've been experiencing and explains the science behind it. You'll also hear why GLP-1 medications aren't just weight loss drugs, why your body might be fighting you even when you're doing everything right, and what happens when your job — like shift work or firefighting — disrupts your metabolism for years. KEY TAKEAWAYS You can have metabolic dysfunction at a normal weight with what appear to be normal labs, for example, when insulin is over suppressed from chronic under-fueling or overexercisingFasting triggers the same biological adaptation as any restrictive diet and typically results in weight regain that's 22 percent higher than starting weightFood noise is biological, not psychological, and stems from an imbalance of hormones and neurotransmitters signaling nutritional insecurityGLP-1 medications may improve immune function because metabolic health and immunity are deeply connectedShift work and chronic sleep disruption can cause real metabolic damage by weakening leptin signals, increasing insulin resistance, and amplifying hunger hormonesNOTABLE QUOTE "You can't trick your body. You have to have that foundational fueling in there." — Dr. Emily Cooper Links & Resources Podcast Home: fatsciencepodcast.com Cooper Center for Metabolism: coopermetabolic.com Resources from Dr. Cooper: coopermetabolic.com/resources Join Our Community: patreon.com/cw/FatSciencePodcast Submit Your Question: questions@fatsciencepodcast.com or dr.c@fatsciencepodcast.com Fat Science is supported by the Diabesity Institute, a nonprofit dedicated to increasing access to effective, science-based metabolic c...

Why You Keep Waking Up at Night — What 15,000 Patient Encounters Reveal About Sleep and Metabolism

Mar 16, 2026 49 min

Are you getting eight hours in bed but still waking up exhausted? Dr. Emily Cooper shares groundbreaking findings from nearly 15,000 patient encounters at her metabolic clinic. The data reveals surprising connections between stress, eating frequency, sleep quality, and metabolic health — and why the number of hours you spend in bed doesn't tell the whole story. KEY TAKEAWAYS Over 60% of patients reported trouble staying asleep, even when they got eight hours in bedHigher stress levels were associated with double the rate of low energy and significantly worse sleep qualityEating frequency matters — patients eating five times per day reported the best sleep and highest energy levelsThe sweet spot between meals is two to four hours — longer gaps were linked to sleep disruption and low energyAny amount of alcohol was associated with fragmented sleep, regardless of stress levelsNearly 65% of patients were not hydrating adequately throughout the dayNOTABLE QUOTE "If your cortisol goes high, we can get the same effects that happen when we take steroids, which we know promote pre-diabetes, insulin resistance, weight gain." — Dr. Emily Cooper Links & Resources Podcast Home: fatsciencepodcast.com Cooper Center for Metabolism: coopermetabolic.com Resources from Dr. Cooper: coopermetabolic.com/resources Join Our Community: patreon.com/cw/FatSciencePodcast Submit Your Question: questions@fatsciencepodcast.com or dr.c@fatsciencepodcast.com Fat Science is supported by the Diabesity Institute, a nonprofit dedicated to increasing access to effective, science-based metabolic care. Disclaimer: This podcast is for informational purposes only and is not intended as medical advice. Please consult with a qualified healthcare provider for personalized recommendations.

Mailbag: Your GLP-1 Questions: Hair Loss, Blood Sugar Spikes & Hormone Therapy

Mar 9, 2026 50 min

Think squashing your post-meal glucose spike is the healthy thing to do? What if that flat line on your CGM is actually telling your brain you didn't eat — and slowing your metabolism as a result? This week on Fat Science, Dr. Emily Cooper, Mark Wright, and Andrea Taylor open the mailbag to tackle listener questions from around the world — Australia, New Zealand, and across the U.S. They dig into hormone replacement therapy and metabolism, why your GLP-1 medication might be causing hair loss, what a normal blood sugar response actually looks like, and how lipedema differs from obesity. Dr. Cooper also revisits metabolic syndrome and why it's not outdated — just underutilized. Key Takeaways Hormone replacement therapy isn't a reliable tool for improving metabolism — it's better suited for symptom relief and bone health in specific situations. Progesterone, which must accompany estrogen if you still have your uterus, can actually disrupt metabolism in some women — acting almost like a steroid. A flat glucose line after eating isn't the goal — your brain needs to see glucose go up to register that you've been nourished and keep your metabolism running. Hair loss on GLP-1 medications is more likely tied to nutrient deficiencies (especially iron and protein) than the drugs themselves. Lipedema is a disease of the fat tissue itself — separate from obesity — and tirzepatide may help reduce the inflammatory symptoms even though it won't eliminate the fat deposits. Notable Quote "If your glucose is flat line, your brain's not very convinced that you ate much — and then you're not getting the metabolic benefit." — Dr. Emily Cooper Links & Resources Podcast Home: fatsciencepodcast.com Cooper Center for Metabolism: coopermetabolic.com Resources from Dr. Cooper: coopermetabolic.com/resources Join Our Community: patreon.com/cw/FatSciencePodcast Submit Your Question: questions@fatsciencepodcast.com or dr.c@fatsciencepodcast.com Fat Science is supported by the Diabesity Institute,...

Why GLP-1s Alone May Not Be Enough: A Listener's Real Story

Mar 2, 2026 56 min

What happens when you do everything "right" — the GLP-1, the protein shake, the tracking — and the scale still won't budge? This episode reveals why doing everything “right” might actually be a big part of the problem. This week on Fat Science, Dr. Emily Cooper, Mark Wright, and Andrea Taylor welcome Sandy, a listener from Pennsylvania who has been on the metabolic health journey for over a year. Sandy's story is one many listeners will recognize: decades of dieting starting in childhood, a body that kept adapting against her, and a medical system that kept telling her to try harder. But when Dr. Cooper reviews Sandy's actual lab work live on air, what she finds reframes everything — and offers a path forward that has nothing to do with restriction. Key Takeaways Suppressed leptin hides a portion of your body fat from your brain, and possibly signals your brain that you're underweight — so your brain fights weight loss even when your body doesn't need protecting. Low insulin isn't always healthy; it can be a sign of the "selfish brain" redirecting precious glucose to the brain at the expense of your muscles. Weight cycling — losing and regaining the same weight repeatedly — creates cardiovascular and metabolic risk. Mechanical eating is the antidote to disordered eating: structured, non-restrictive fueling that rebuilds metabolic trust. GLP-1 medications can suppress appetite, so under-eating becomes a real risk — especially for people already conditioned to restrict. The goal isn't the number on the scale. It's metabolic stability and metabolic health, and those things are not the same. Notable Quote "It was such a revelation to me to hear you guys talk about it — it's a metabolic disorder. It's not a willpower issue, it's not a personal failing. It's something absolutely beyond my control. Like diabetes would be. Like migraines would be." — Sandy Links & Resources Podcast Home: fatsciencepodcast.com Cooper Center for Metabolism: coopermetabolic.com Resources from...

The Science Behind the New Wegovy Pill: One-On-One with Novo Nordisk’s Dr. Jason Brett.

Feb 23, 2026 1 hr 0 min

The Science Behind the New Wegovy Pill (with Novo Nordisk’s Dr. Jason Brett) What actually makes a GLP-1 pill work in the real world—and why does taking it come with such specific rules? And if these meds improve health beyond weight, why does the conversation still get stuck on the scale? This week on Fat Science, Dr. Emily Cooper, Mark Wright, and Andrea Taylor are joined by Dr. Jason Brett of Novo Nordisk to break down the science behind the newly approved Wegovy pill. They talk about what it takes to deliver a peptide medication orally, what the dosing and day-to-day routine really look like, and why access and pricing remain such a big part of the story. The conversation also zooms out to the bigger point: treating obesity is about improving health outcomes—like liver and cardiovascular risk—not just weight. Key Takeaways Oral semaglutide requires specific formulation technology to survive the stomach and be absorbed at a meaningful level. The “30-minute rule” isn’t random—it’s part of how the pill has a chance to work as intended. Treating obesity is about improving health outcomes (like liver and heart risk), not just “moving a number on a scale.” Pricing and access shape who can actually benefit, even when the science is strong. Calorie-restriction messaging can backfire for people already dealing with metabolic adaptation and under-nutrition. Notable Quote "Fat Science has no financial relationship with Novo Nordisk. No sponsorship. No consulting fees, no affiliate arrangements. Zero." — Mark Wright Links & Resources Podcast Home: fatsciencepodcast.com Cooper Center for Metabolism: coopermetabolic.com Resources from Dr. Cooper: coopermetabolic.com/resources Join Our Community: patreon.com/cw/FatSciencePodcast Submit Your Question: questions@fatsciencepodcast.com or dr.c@fatsciencepodcast.com Fat Science is supported by the Diabesity Institute, a nonprofit dedicated to increasing access to effective, science-based metabolic care. Disclaimer: This podcast is...

Mailbag: Your GLP-1 Questions on Pregnancy, Dosing, and Why Diets Cause Fat Gain

Feb 16, 2026 43 min

Mailbag: Your GLP-1 Questions on Pregnancy, Dosing, and Why Diets Cause Fat Gain What happens when you stop GLP-1 medications before getting pregnant? Why might your thyroid numbers change on Zepbound? And why do people gain more body fat after dieting — even when they're still eating well? Dr. Cooper tackles your toughest questions. This week on Fat Science, Dr. Emily Cooper, Mark Wright, and Andrea Taylor answer listener questions covering pregnancy planning on GLP-1s, unmasked thyroid problems, injection site reactions, mechanical eating after bariatric surgery, why diets cause fat regain at a cellular level, and discussing with your doctor whether you should (or shouldn't) increase your medication dose. Key Takeaways GLP-1 medications aren't causing gestational diabetes — they may have been masking underlying metabolic dysfunction that becomes visible when the medication is stopped Thyroid problems can be "unmasked" by GLP-1 treatment because the medications signal to your brain that you're not starving, allowing the pituitary TSH to rise, sometime uncovering a pre-existing thyroid issue Zepbound may improve iron absorption — if iron levels go too high, testing for hemochromatosis may be warranted To reduce injection site reactions: warm the medication to room temperature, clean and prep skin but don't over-rub with alcohol, inject at exactly 90 degrees, don't pinch the skin, and stay relaxed Diets cause fat regain at the cellular level — it's chemistry, not willpower — and the fat often accumulates in the visceral area around organs There's no need to increase your GLP-1 dose if you're making good progress — an annual weight loss rate of 15% or higher is considered strong Notable Quote "You can't think that just because somebody's weight is high, it's because something they're doing is wrong. That is just not founded in science whatsoever." — Dr. Emily Cooper Links & Resources Podcast Home: fatsciencepodcast.com Cooper Center for Metabolism: coopermetabolic.com...

Wegovy Pill vs. Injection — A Doctor Breaks Down the Newest Form of GLP-1

Feb 9, 2026 46 min

Wegovy Pill: Who's It For? The new Wegovy pill is generating massive buzz — but is it actually better than the injection? Before you ask your doctor to switch, there are some surprising requirements that could make or break whether this option works for you. This week on Fat Science, Dr. Emily Cooper, Mark Wright, and Andrea Taylor break down the new oral semaglutide approved for obesity treatment. They explain how the Wegovy pill differs from Rybelsus, who's a good candidate to switch (and who isn't), the strict dosing protocol most people don't know about, and what's coming next in the GLP-1 pill landscape — including a less fussy competitor from Eli Lilly. Key Takeaways The Wegovy pill uses an upgraded "version two" formulation with enhanced absorption — it's not the same as Rybelsus Semaglutide targets deep metabolic dysfunction, not just appetite — reducing inflammation, visceral fat, and cardiovascular risk The pill must be taken first thing in the morning on an empty stomach with minimal water, then nothing else for 30 minutes — breaking this protocol negates effectiveness The pill is slightly less effective than the highest-dose Wegovy injection, so switching isn't ideal for patients still making progress at maximum dose Novo Nordisk's cash pay program starts at $149/month for lower doses and $299/month for the highest dose Eli Lilly's upcoming orforglipron pill uses small molecule technology that won't require the strict dosing ritual Notable Quote "When people say it works because it just makes you eat less, that's really missing the point of the sophistication of these meds." — Dr. Emily Cooper Links & Resources Podcast Home: fatsciencepodcast.com Cooper Center for Metabolism: coopermetabolic.com Resources from Dr. Cooper: coopermetabolic.com/resources Join Our Community: patreon.com/cw/FatSciencePodcast Submit Your Question: questions@fatsciencepodcast.com or dr.c@fatsciencepodcast.com Fat Science is supported by the Diabesity Institute, a nonprofit dedi...

Why GLP-1 Medications Work Even When the Scale Doesn't Move

Feb 2, 2026 43 min

What if the scale isn't moving, but your health is dramatically improving? If you've ever felt discouraged because the number on the scale won't budge—even on a GLP-1 medication—this episode will change how you think about these drugs. Dr. Cooper breaks down the research showing that the biggest benefits have nothing to do with weight loss. It's all about metabolic health. This Week on Fat Science Dr. Emily Cooper, Mark Wright, and Andrea Taylor explore the research proving GLP-1 medications are far more than "weight loss drugs." The team explains how cardiovascular outcome trials revealed unexpected heart protection, why inflammation reduction may be the real mechanism behind these benefits, and what the latest FDA approvals for kidney disease, sleep apnea, and fatty liver mean for patients. Plus: the new oral Wegovy pill, what's coming next in metabolic medicine, and why everyone should be screened for metabolic dysfunction regardless of weight. What You'll Learn Why two-thirds of cardiovascular risk reduction from GLP-1s is completely independent of weight loss How these medications reduce inflammation, stabilize arterial plaque, and improve vascular function The difference between MASLD and MASH—and why the name change matters What the Flow Trial revealed about kidney protection (and why it was stopped early) How Zepbound earned FDA approval for sleep apnea Why metabolic screening should happen regardless of what the scale says Notable Quote "You can still become incredibly healthier even if the weight is more stubborn. So I think that's the thing, is to discuss with your doctor not 'Oh, I want to lose X amount of pounds' or 'How much weight do you think I should lose?' That is not the conversation. It's more, let's take a look at the health parameters." — Dr. Emily Cooper Links & Resources Podcast Home: fatsciencepodcast.com Cooper Center for Metabolism: coopermetabolic.com Resources from Dr. Cooper: coopermetabolic.com/resources Submit Your Question: questions...

Mailbag: Food Tracking, Mechanical Eating Troubleshooting, COVID & Metabolism, and Metformin + GLP-1 Synergy

Jan 26, 2026 41 min

This week on Fat Science, Dr. Emily Cooper, Mark Wright, and Andrea Taylor answer listener mailbag questions from California, the UK, France, Washington, Wyoming, and beyond. The team breaks down why Dr. Cooper does not recommend calorie tracking (and when limited tracking can make sense), how to build confidence in eating without data, and why “mechanical eating” sometimes needs medical customization—especially for people with slow gut transit or gastroparesis-like symptoms. They also dig into bile acid malabsorption after gallbladder removal, when metformin side effects deserve a second look, what we currently know about COVID-19’s potential impact on metabolic health, and why metformin and GLP-1 medications can be complementary—particularly in PCOS. Key Takeaways• Long-term calorie tracking can override physiologic cues and reinforce diet mentality.• Short-term, targeted tracking may be useful when guided by a clinician (e.g., nutrient deficiencies ).• Obesity and abnormal appetite are both manifestations of metabolic dysfunction—not simple cause and effect.• Mechanical eating is a framework, not a rigid rule—timing and food choices may need medical tailoring.• Post-gallbladder diarrhea may reflect bile acid malabsorption and can be treatable.• Metformin and GLP-1s often complement each other because they target different metabolic states (fasting vs fed). Dr. Cooper’s Actionable Tips• Stop daily calorie counting—focus on consistent patterns and metabolic nourishment.• Use mechanical eating basics: eat every few hours, include all food groups, and reduce chemical additives when possible.• If you’re transitioning away from tracking, consider a dietitian skilled in diet-mentality recovery.• If frequent eating worsens sleep or bloating, work with a medical dietitian to adjust intervals and food types (especially with slow GI transit).• If chronic diarrhea appears (especially after gallbladder removal), ask your clinician about bile acid malabsorption and treatment...

Mailbag: GLP-1 Weight Regain, Meals vs Snacks, and Why Some People Don’t Respond

Jan 19, 2026 41 min

his week on Fat Science, Dr. Emily Cooper, Mark Wright, and Andrea Taylor answer listener mailbag questions that get to the heart of metabolic health. The team explains the real difference between meals and snacks, discusses whether GLP-1 medications can be appropriate for children in complex cases, explores why some people appear to be “non-responders” to Wegovy, and breaks down why alarming headlines about rapid weight regain miss the bigger metabolic picture. They also explain how to set a goal weight using body composition, labs, and overall health—rather than the scale alone. Key Questions Answered• What separates a meal from a snack metabolically?• Why can grazing all day backfire—even with healthy food?• Are GLP-1s ever appropriate for kids?• Why do some people feel hungrier as GLP-1 doses increase?• How are PCOS and insulin dysregulation connected?• What is a mixed meal tolerance test, and why does it matter?• Do GLP-1 users really regain weight faster?• How should goal weight be determined after major weight loss? Key Takeaways• Meals provide structure; snacks prevent long gaps—both matter.• GLP-1 “non-response” often signals deeper metabolic issues.• Weight regain reflects underlying dysfunction, not personal failure.• Maintenance dosing must be individualized.• Body composition matters more than BMI or scale weight. Dr. Cooper’s Actionable Tips• Eat structured meals with carbs, protein, and fats.• Use snacks strategically to avoid long gaps.• Ask about deeper glucose/insulin testing when progress stalls.• Prioritize DEXA body composition over scale-based goals.• Avoid compounded GLP-1s—especially in children. Notable Quote “If you stop treating the metabolic dysfunction, the dysfunction is still there—and the body will drive weight back to where it was headed all along.”—Dr. Emily Cooper Links & ResourcesPodcast Home: https://fatsciencepodcast.com/Episode References: https://fatsciencepodcast.com/wp-content/uploads/2025/06/Scientific-References-Fat-Scienc...

What the Headlines Get Wrong About GLP-1 Drugs and Metabolism

Jan 12, 2026 45 min

This week on Fat Science, Dr. Emily Cooper, Mark Wright, and Andrea Taylor break down two GLP-1 studies that challenge a major media myth: GLP-1 medications don’t drive weight loss just because people eat less. Instead, drugs like tirzepatide and semaglutide create direct metabolic shifts—including increased fat oxidation and improved fuel partitioning—regardless of appetite. The team also explores mechanical eating, the psychological impact of “diet food,” and Andrea’s 13-year metabolic recovery journey. Key Questions Answered If both groups are dieting, why does the tirzepatide group lose more weight?What is metabolic adaptation, and why does dieting slow metabolism so sharply?How do GLP-1s directly increase fat oxidation?What is mechanical eating, and why do GLP-1 users need it?Why does ad-lib eating produce different metabolic responses than calorie restriction?Can mindset alone change hunger hormones? (Yes—the milkshake study.)Why do diet foods and diet sodas fail to improve metabolic health?Why is response to GLP-1s so different from person to person? Key Takeaways GLP-1s are metabolic drugs—not appetite suppressants.Their power comes from hormonal effects on fat burning, not reduced food intake.Calorie restriction still slows metabolism.Even on GLP-1s, dieting triggers significant metabolic slowdown.Ad-lib eating outperforms dieting in the research.Semaglutide users who ate freely did not show the extra metabolic slowdown seen in dieters.Mechanical eating is the most durable long-term approach.Regular meals and snacks protect lean mass and prevent famine signaling.Mindset shapes hormones.Believing a food is “diet” vs. “indulgent” alters ghrelin and satisfaction.Track body composition—not just the scale.DEXA scans show whether you’re losing fat, muscle, or bone. Dr. Cooper’s Actionable Tips Don’t diet on GLP-1s. Focus on fueling, not restriction.Use mechanical eating: predictable meals and snacks, no long gaps.Prioritize satisfaction: diet foods often backfir...

GLP-1 Mailbag: Weight Regain, Leptin Resistance, Hypoglycemia & Why Calories Aren’t the Problem

Jan 5, 2026 39 min

This week on Fat Science, Dr. Emily Cooper, Mark Wright, and Andrea Taylor tackle a wide-ranging mailbag episode with listener questions from the U.S., UK, and Europe. Topics include unexpected weight regain on GLP-1s, post-meal sleepiness and hypoglycemia, metabolic dysfunction despite normal labs, GLP-1 dosing strategies, and why these medications are about metabolism, not appetite suppression. Key Questions Answered Why can weight regain happen on GLP-1s even when habits haven’t changed?How do leptin, ghrelin, injury, stress, and under-fueling affect weight regulation?What does it mean if you get extremely sleepy after meals—is it hypoglycemia?Do GLP-1s increase insulin in a harmful way for non-diabetics?Can you have metabolic dysfunction with normal A1C, cholesterol, and blood pressure?Do GLP-1 medications “wear off,” and how should dosing be adjusted long term?Are GLP-1s just appetite suppressants—or true metabolic treatment?Is it possible to undo decades of calorie counting and restriction-based thinking?What are the risks of the return to extreme thinness in celebrity culture?Key Takeaways Calories don’t explain metabolism. GLP-1 and GIP work across the brain and body—repairing signaling, not just reducing appetite.Leptin matters after dieting. Years of restriction and weight cycling can weaken leptin signaling, making the brain defend weight gain.Fueling is foundational. Medication can’t replace adequate food, sleep, and recovery.Post-meal fatigue is a clue. Reactive hypoglycemia is common and often misunderstood.Lowest effective dose wins. GLP-1 success is about pacing, not racing to the max dose.Chasing the “last 10 pounds” can backfire. Cosmetic restriction can create new metabolic problems.Dr. Cooper’s Actionable Tips If weight gain appears after injury or stress, focus first on sleep, regular meals, and full fueling, not restriction.Suspected hypoglycemia? Ask about a mixed meal tolerance test to assess glucose and insulin response.Stay on the lowest GL...

Childhood Obesity, Eating Disorders & GLP-1s: Why It’s Not Your Fault

Dec 29, 2025 1 hr 15 min

This week on Fat Science, Dr. Emily Cooper, Mark Wright, and Andrea Taylor talk with pediatric eating disorder specialist Dr. Julie O’Toole (Kartini Clinic) and pediatric obesity expert Dr. Evan Nadler about what childhood obesity really is: a biologic, metabolic disease—not a willpower problem and not a failure of parenting. They explore how excess weight, constant hunger, and disordered eating in kids are often signs of underlying metabolic dysfunction and genetics—and why the old “eat less, move more” advice can do real harm, especially when children are shamed or restricted in the name of “health.” Key Questions Answered Why is childhood obesity a metabolic disease, not a behavior problem?How are obesity and eating disorders deeply connected instead of opposite extremes?What role do GLP-1 medications play in children—and how do we protect against under-fueling?When should parents suspect genetic drivers like hyperphagia or MC4 mutations?How can medical treatment for obesity actually reduce disordered eating behaviors?When does excess weight become a medical issue requiring metabolic evaluation—not another diet? Key Takeaways Weight is a symptom. Childhood obesity is often a sign of metabolic dysfunction, not overeating.Obesity & eating disorders overlap. Restriction can trigger disordered eating; disordered eating can worsen obesity.“Eat less, move more” harms. Shame-based approaches delay treatment and increase risk of eating disorders.GLP-1s work metabolically, not just through appetite suppression. Kids still need consistent fueling.Genetics matter. Single-gene differences can drive severe childhood hunger & rapid weight gain.Not treating is harm. Avoiding obesity care violates first, do no harm. Dr. Cooper’s Actionable Tips If your child is gaining weight or constantly hungry, request metabolic labs (insulin, glucose, lipids, liver, hormones).If the doctor only says “eat less, move more,” ask: “How are we evaluating metabolism and genetics?”On GLP-1s? Monit...

I’m Working Out—So Why Am I Getting Fatter?

Dec 22, 2025 1 hr 2 min

This week on Fat Science, Dr. Emily Cooper, Mark Wright, and Andrea Taylor talk with exercise physiologist Russell Cunningham and patient Becca Wert about a counterintuitive reality: for some people, exercise can actually slow metabolism, stall weight loss, and trigger weight gain—especially when the brain senses a threat to energy availability. Dr. Cooper explains how overtraining, under-fueling, and even thinking about workouts can activate famine signals in the brain and shut down key hormone pathways and what it takes to rebuild trust so movement becomes helpful instead of harmful. Key Questions Answered How can exercise trigger metabolic slowdown and weight gain instead of weight loss?What lab markers (leptin, ghrelin, thyroid, cortisol, sex hormones) signal that your body is in “conservation mode”?Why did Becca lose more than 120 pounds after stopping intense workouts—and what did her COVID experience reveal about her metabolism?How did Russell’s overtraining syndrome develop, and what did his recovery teach him about fueling, rest, and nervous system regulation?How should fueling before, during, and after activity look different for people who are highly sensitive to energy deficits?When is it time to pull back on exercise, even if every message you’ve heard says “move more”?Key Takeaways Exercise is stress, not magic. When the brain perceives low energy or famine risk, it can respond to exercise by slowing metabolism, shutting down hormones, and defending body fat.Labs tell the story. Low leptin with high “famine signals,” along with thyroid, cortisol, and reproductive hormone suppression, are red flags that the body is conserving energy—not freely burning fuel.Fueling beats punishment. For sensitive metabolisms, you often “can’t overdo the fueling” around movement—sports drinks and carbs, even for short sessions, can help reassure the brain that it’s safe.Movement ≠ grind. Reframing exercise as enjoyable movement and nervous system regulation (walking, gen...

The Latest GLP-1 News

Dec 15, 2025 39 min

This week on Fat Science, Dr. Emily Cooper, Mark Wright, and Andrea Taylor unpack the biggest GLP-1 headlines from around the world—from the World Health Organization’s first-ever GLP-1 obesity guidelines to access battles, brain research, and the coming wave of generics and new meds. Dr. Cooper explains what the WHO’s move really means for patients, why long-term treatment matters, and how policy decisions in places like California and India could reshape who actually benefits from these breakthroughs. This isn’t hype—it’s metabolic medicine, health-system reality, and grounded hope. Key Questions Answered Why is the WHO’s new guidance on GLP-1s for obesity such a historic turning point?What does it mean to treat obesity as a chronic, relapsing disease—not a willpower problem?Why do GLP-1s usually need to be taken long term, and how is that similar to blood pressure or cholesterol meds?How should GLP-1s be paired with metabolic care—fueling, sleep, movement, and real clinical oversight?What did the “stone cold negative” Alzheimer’s trials show—and why are addiction trials still promising?How could India’s launch of Ozempic and future generics impact global pricing and access?What new GLP-1 and metabolic drugs are on the horizon (like orforglipron, higher-dose oral semaglutide, and GLP-1/amylin combos)? Key Takeaways WHO is catching up to the science. Obesity is affirmed as a chronic, relapsing disease that deserves pharmacologic treatment—not “eat less, move more” lectures or moral judgment.Long-term meds are the rule, not the exception. Stopping GLP-1s usually leads to weight and risk factors returning, just like stopping blood-pressure meds. That’s physiology, not failure.Behavior ≠ blame. WHO calls for pairing GLP-1s with “behavioral” care—but Dr. Cooper reframes this around fueling, sleep, and supported habits, not deprivation or diet culture.Access is the battleground. Even as WHO elevates GLP-1s, programs like California’s Medi-Cal are cutting coverage for o...

Listener Mailbag: Set Point Theory, Trauma & Metabolism, and Why 1200 Calories Can Still Lead to Weight Gain

Dec 8, 2025 47 min

This week on Fat Science, Dr. Emily Cooper, Mark Wright, and Andrea Taylor answer listener questions about BMI cutoffs, weight cycling, metabolic adaptation, trauma, GLP-1 differences, and why some people gain weight on ultra-low calories. Dr. Cooper explains what’s really happening inside the metabolic system and why individualized treatment—not dieting—creates sustainable change. Key Questions Answered If my BMI doesn’t “qualify” for GLP-1s, is Naltrexone + Bupropion helpful—and what labs matter first?Does being overweight always indicate metabolic dysfunction, and why are U.S. rates so high?If diets damage metabolism, what do you do when you’re already 80 pounds overweight?How long does it take for leptin and ghrelin to stabilize with mechanical eating?How can someone gain weight on 1,200 calories/day?After sleeve gastrectomy, how do you eat enough while on a GLP-1?Is set point theory real—and how does the melanocortin pathway influence it?If obesity runs in my family, will I need meds like Zepbound for life?How do trauma and stress alter long-term metabolic health?Can GLP-1s offset weight gain from steroids, mood meds, or hormones?Why might Ozempic work well while Mounjaro causes weight gain?Key Takeaways 1. BMI rules don’t reflect metabolic truth.A mid-20s BMI can still mask significant dysfunction, especially with weight cycling. 2. Weight cycling is metabolically stressful.Repeated losses/regains increase visceral fat, insulin abnormalities, and cardiovascular risk. 3. Obesity is a multi-hormonal disease.Most people need pharmacology plus sleep, fueling, and movement—not restrictive dieting. 4. Metabolic adaptation is powerful.Under-fueling lowers thyroid output, suppresses fat-burning, and slows metabolism dramatically. 5. After bariatric surgery or on GLP-1s, frequency matters.Frequent, nutrient-dense snacks protect muscle, metabolism, and energy. 6. Set point changes with better signaling.GLP-1s and related therapies help the brain accurately detect weight...

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Podcast details

Created by: Dr Emily Cooper
Status: Active
Latest episode: Nov 9, 2026
Episodes: 163
Release period: Weekly
Avg. episode length: 41 min
Explicit: No
Language: English

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