Mailbag: Low Blood Sugar Explained, Relief From Food Noise, Calorie Restriction Warning, Metabolic Health care on a Budget, and More.

his week on Fat Science, Dr. Emily Cooper, Mark Wright, and Andrea Taylor tackle the biggest listener questions about sustainable weight loss, metabolic health, and why restrictive diets so often backfire. From medications like GLP-1s to common myths about exercise and nutrition, this episode delivers practical science and down-to-earth advice for anyone struggling with their weight and/or health.

Dr. Cooper breaks down why obesity is a physical sign of underlying metabolic dysfunction and sets the record straight about what really works for long-term health—spoiler: it’s not endless calorie counting or exercise alone. Listeners from around the world share their struggles and triumphs, and Dr. Cooper explains the roles of genetics, “food noise,” dealing with hypoglycemia, and the best ways to fuel your body.

Key Questions Answered:

• Can someone with obesity achieve lasting weight loss without medication? Why don’t diets and exercise alone work long-term?
• What is reactive hypoglycemia after gastric bypass, and how should it be managed?
• How can people with limited access to healthcare still improve metabolic health?
• What is “food noise,” and how do new medications target the brain’s hunger and satiety signals?
• Should people use calorie restriction or focus on fueling their bodies for better metabolic health?

Key Takeaways:

• Obesity is best understood as a physical sign of metabolic disease, not a personal failure.
• There is no diet or exercise program shown to sustain long-term weight loss for those with obesity—medical therapies are usually necessary. 
• Caloric restriction and exercise without medical intervention can slow metabolism and drive weight regain (the “diet backlash” effect). 
• Good metabolic health is possible at any body size. Nutrition, physical activity, sleep, and stress management are essential but cannot, by themselves, reverse obesity.
• Medications like GLP-1s can help “quiet” food noise by restoring healthy communication between the gut and brain.
• Lifestyle strategies support metabolic function but aren’t strong enough to reverse metabolic disease alone. Focus on eating regular meals, balanced nutrients, and fueling your activity—not on perfection or restriction.

Dr. Cooper’s Actionable Tips:

• Find a clinician who listens and is curious about your health, not just weight or calorie intake.
• Don’t be pressured to take medication if you feel healthy and have good lab results, regardless of your weight.
• Fuel your body consistently with a mix of protein, healthy fats, and complex carbs—perfection isn’t necessary.
• Prioritize sleep and stress management, as both are critical for metabolism.

Notable Quote:"There is no diet or exercise program that leads to long-term weight loss in someone with obesity. There isn't. Any time you're introducing that restriction you're opening the door to what's called metabolic adaptation, a slowing of the metabolic system. Why would you want to do that? If your whole goal is to strengthen the metabolic system, why would we want to introduce something that's been proven scientifically to slow the metabolic system down?" — Dr. Emily Cooper

Resources from the episode:Fat Science is your source for understanding why metabolic health—not weight alone—matters more than ever. No diets, no agendas, just science that makes you feel better. This show is informational only, not medical advice.

Check out our website to submit a question to the listener mailbag.

Have questions for Dr. Cooper, a show idea, feedback, or just want to connect?Email questions@fatsciencepodcast.com or dr.c@fatsciencepodcast.com.

Connect with:
Dr. Emily Cooper on LinkedIn
Mark Wright on LinkedIn
Andrea Taylor on Instagram