Fat Science

Dr Emily Cooper
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Jan 19, 2026 • 42min

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

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 CooperLinks & ResourcesPodcast Home: https://fatsciencepodcast.com/Episode References: https://fatsciencepodcast.com/wp-content/uploads/2025/06/Scientific-References-Fat-Science-Episodes.pdfCooper Center: https://coopermetabolic.com/podcast/Resources from Dr. Cooper: https://coopermetabolic.com/resources/Submit a Question: questions@fatsciencepodcast.comFat Science: No diets, no agendas—just science that makes you feel better. This podcast is for informational purposes only and is not intended to be medical advice.
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Jan 12, 2026 • 46min

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

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 AnsweredIf 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 TakeawaysGLP-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 TipsDon’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 backfire hormonally.Follow your real-world data: long-term changes matter more than short-term scale shifts.Ask about body composition testing if possible.Notable Quote:“What that study proved is that doing the calorie restriction is causing the metabolic slowing… and that’s why it’s so confusing to me that we keep advising people to restrict calories when they’re trying to improve their metabolic function.” —Dr. Emily CooperLinks & ResourcesPodcast Home: https://fatsciencepodcast.com/Episode References: https://fatsciencepodcast.com/wp-content/uploads/2025/06/Scientific-References-Fat-Science-Episodes.pdfCooper Center: https://coopermetabolic.com/podcast/Resources from Dr. Cooper: https://coopermetabolic.com/resources/Submit a Question: questions@fatsciencepodcast.comDr. Cooper Email: dr.c@fatsciencepodcast.comFat Science: No diets, no agendas—just science that makes you feel better. This podcast is for informational only, and is not intended to be medical advice.
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Jan 5, 2026 • 40min

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

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 AnsweredWhy 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 TakeawaysCalories 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 TipsIf 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 GLP-1 dose that’s working and adjust only when progress truly stalls.Push back on “appetite suppressant” language—these meds amplify hormones your body already makes.Notable Quote“GLP-1s aren’t about eating less—they’re about strengthening metabolic signaling” — Dr. Emily CooperLinks & ResourcesPodcast Home: Fat Science Podcast Website – https://fatsciencepodcast.com/Podcast Episode References: https://fatsciencepodcast.com/wp-content/uploads/2025/06/Scientific-References-Fat-Science-Episodes.pdfCooper Center for Metabolism & Fat Science Episodes: https://coopermetabolic.com/podcast/Resources from Dr. Cooper: https://coopermetabolic.com/resources/Submit a Show Question: questions@fatsciencepodcast.comDr. Cooper direct show email: dr.c@fatsciencepodcast.comFat Science breaks diet myths and advances the science of real metabolic health. No diets, no agendas—just science that makes you feel better. This show is informational only and does not constitute medical advice.
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Dec 29, 2025 • 1h 15min

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

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 AnsweredWhy 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 TakeawaysWeight 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 TipsIf 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? Monitor for under-fueling (skipped meals, low energy, food anxiety) and intervene promptly.Notable Quote“Not treating childhood obesity is doing harm. It’s a disease, not a lifestyle choice.” — Dr. Evan NadlerLinks & ResourcesPodcast Home: Fat Science WebsiteEpisodes & Show Archive: Cooper Center Podcast PageEducation & Metabolic Resources: coopermetabolic.com/resourcesSubmit a Show Question: questions@fatsciencepodcast.comEmail Dr. Cooper Directly: dr.c@fatsciencepodcast.comConnect with Our GuestsDr. Evan P. Nadler, MD, MBA – Founder, ProCare Consultants & ProCare TeleHealthWebsite: obesityexplained.comYouTube Channel: Obesity ExplainedDr. Julie K. O’Toole, M.D., M.P.H. – Chief Medical Officer & Founder, Kartini ClinicWebsite: kartiniclinic.comBooks: amazon.com/author/julieotoole*Fat Science breaks diet myths and advances the science of real metabolic health. No diets. No agendas. Just science that makes you feel better. This episode is informational only and not medical advice.
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Dec 22, 2025 • 1h 2min

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

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 AnsweredHow 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 TakeawaysExercise 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, gentle climbing, yard work) helps break from all-or-nothing “training” mindsets that can backfire.Dr. Cooper’s Actionable TipsIf your weight climbs or stalls despite hard workouts and restricted eating, talk with a clinician about metabolic labs instead of just pushing harder.Cushion any exercise with real fuel: eat before, add carbs/electrolytes during, and refuel after—especially if you have a history of dieting, overtraining, or weight cycling.Consider starting with low-intensity, pleasant movement and always “leave gas in the tank” instead of chasing exhaustion as the goal.Notable Quote“Exercise should not be used as a weight loss tool. It should be used as a performance and a health tool.” — Dr. Emily CooperLinks & ResourcesPodcast Home: Fat Science Podcast Website – https://fatsciencepodcast.com/Cooper Center for Metabolism & Fat Science Episodes: https://coopermetabolic.com/podcast/Resources and education from Dr. Cooper: https://coopermetabolic.com/resources/Submit a Show Question: questions@fatsciencepodcast.comDr. Cooper direct show email: dr.c@fatsciencepodcast.comFat Science is your source for breaking diet myths and advancing the science of true metabolic health. No diets, no agendas—just science that makes you feel better. The show is informational only and does not constitute medical advice.
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Dec 15, 2025 • 40min

The Latest GLP-1 News

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 AnsweredWhy 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 TakeawaysWHO 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 obesity, a move Dr. Cooper calls penny-wise and pound-foolish given the downstream costs of diabetes and cardiovascular disease.Brain outcomes are nuanced. Large oral semaglutide trials failed to slow Alzheimer’s, but GLP-1s (and other obesity meds) still show promise for addiction by modulating reward pathways and the “internal drug factory” (POMC).Global markets are shifting. India’s huge population, looming Ozempic patent expirations, and emerging generics could eventually drive prices down—especially as more manufacturers compete.New meds may expand options. Orforglipron (a small-molecule oral GLP-1), higher-dose oral semaglutide, and a weekly GLP-1/amylin combo could bring more flexible, powerful, and potentially more affordable tools.Dr. Cooper’s Actionable TipsThink of obesity treatment like any chronic disease: long-term, medical, and individualized—not a short-term “diet.”If you’re using a GLP-1, pair it with real metabolic care: consistent fueling (not under-eating), good sleep, and appropriately fueled exercise.Be cautious with “cheap” or unsanctioned online GLP-1 options—especially if you’re being squeezed out of coverage. Safety and oversight matter.Remember there are other evidence-based obesity meds beyond GLP-1s; if you can’t tolerate or access one class, ask your clinician about alternatives.Notable Quote“Your metabolism is a lifelong issue. It’s not a headache.”— Andrea TaylorLinks & ResourcesPodcast Home: Fat Science Podcast Website – https://fatsciencepodcast.com/ Cooper Center for Metabolism & Fat Science Episodes: https://coopermetabolic.com/podcast/ Resources and education from Dr. Cooper: https://coopermetabolic.com/resources/ Submit a Show Question: questions@fatsciencepodcast.comDr. Cooper direct show email: dr.c@fatsciencepodcast.com*Fat Science is your source for breaking diet myths and advancing the science of true metabolic health. No diets, no agendas—just science that makes you feel better.
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Dec 8, 2025 • 47min

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

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 AnsweredIf 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 Takeaways1. 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 and lower the defended level.7. Genetics often mean lifelong support.Family patterns of obesity usually indicate long-term need for metabolic medication.8. Trauma amplifies metabolic risk.Childhood trauma disrupts IGF-1, sleep, stress hormones, insulin, leptin, and ghrelin.9. Medications can cause weight gain—GLP-1s can help counteract it.Steroids, mood meds, hormonal agents, and more can be metabolically unfriendly.10. “Newer” isn’t always better.Some people respond poorly to the GIP component in Mounjaro/Zepbound. Individual physiology rules.Dr. Cooper’s Actionable TipsRequest deeper evaluation: DEXA, visceral fat, fasting insulin/glucose, leptin, reproductive hormones.Stop restrictive dieting permanently—mechanical eating protects metabolic stability.Work with a fueling-focused dietitian (often ED-trained).Review your medication list for drugs known to cause weight gain.Don’t switch GLP-1s or chase higher doses if your current regimen works.Notable Quote“Obesity isn’t a willpower problem. It’s a metabolic disease, and when the underlying system is supported, the body finally has permission to change.” — Dr. Emily CooperLinks & ResourcesPodcast Home: Fat Science Podcast WebsiteSubmit a Show Question: questions@fatsciencepodcast.com or dr.c@fatsciencepodcast.comDr. Emily Cooper on LinkedInMark Wright on LinkedInAndrea Taylor on InstagramFat Science is your source for breaking diet myths and advancing the science of true metabolic health. No diets, no agendas—just science that makes you feel better. The show is informational only and does not constitute medical advice.
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Dec 1, 2025 • 59min

A Patient’s Guide to Taking Back Your Health

Dr. Emily Cooper, Mark Wright, and Andrea Taylor talk with Maria from Buffalo, a longtime listener who shares her lifelong journey with obesity, psoriatic arthritis, and binge eating—and how finally understanding the science of metabolism gave her hope. Maria describes early childhood weight gain, joint damage, and years of restrictive dieting and food shame, then explains how GLP‑1 therapy (Zepbound) plus mechanical eating helped her lose about 50 pounds while eating more food, more often, and with more joy. Dr. Cooper breaks down the underlying biology—leptin, weight set point, the melanocortin pathway, and the impact of pain, sleep, and chronic inflammation on hunger hormones—and reframes obesity as a symptom of deeper metabolic problems, not a character flaw. This episode doubles as a practical, emotionally honest guide for patients trying to navigate a traditional health‑care system without a dedicated metabolic specialist.Key Questions AnsweredHow can rapid childhood weight gain, autoimmune disease, and early joint damage signal serious metabolic dysfunction rather than “too much food” or “not enough exercise”?What is leptin, what does “too low for your size” mean, and how does that affect hunger, weight set point, and weight loss?What is monogenic obesity testing, who might qualify for free genetic screening, and how can results inform (but not necessarily change) treatment?How do GLP‑1 medications like Zepbound work with mechanical eating so someone can lose weight while eating more regularly and with more variety?Which labs (fasting glucose, insulin, leptin, etc.) help uncover hidden metabolic issues, and when is a mixed‑meal test more useful than a simple fasting snapshot?When should brain‑active medications (such as bupropion/naltrexone combinations) be considered, and what trade‑offs and side effects matter?How can patients respectfully push for tests, challenge old “eat less, move more” advice, and set boundaries around weigh‑ins and stigmatizing language?Key TakeawaysIt’s not your fault: Rapid childhood weight gain and early‑onset obesity often reflect serious metabolic biology, including rare gene variants, growth phases, and hormone signaling—not gluttony or laziness.Obesity is a symptom: Excess weight is better understood as a side effect of underlying metabolic fires (leptin issues, insulin resistance, brain signaling problems) that need proper diagnosis and treatment.Leptin really matters: Low leptin for your size can act as a biological brake on weight loss, and chronic dieting, under‑fueling, over‑exercise, and some high‑dose supplements can suppress it further.GLP‑1s plus mechanical eating: Medications like Zepbound can quiet food noise and support weight loss, but scheduled, balanced eating is essential to avoid under‑fueling, protect muscle, and support hormones.Pain and sleep are metabolic: Chronic pain and poor sleep increase hunger hormones like ghrelin and disrupt repair processes, worsening metabolic dysfunction unless directly addressed.Script your visits: Bring a printed list of diagnoses, medications, and questions; use patient portals to request specific tests; and practice simple boundary phrases around weighing and diet talk.Notable Quote“This isn’t all just caused by diets and things like that. There was an original metabolic problem. It was amplified because of the food restriction and the psychology around it, but you are a product of cumulative insults to your system—not a moral failure.” — Dr. Emily CooperLinks & ResourcesPodcast Home: https://fatsciencepodcast.com/Cooper Center for Metabolism & Fat Science Episodes: https://coopermetabolic.com/podcast/Resources and education from Dr. Cooper: https://coopermetabolic.com/resources/Submit a Show Question: questions@fatsciencepodcast.comDr. Cooper direct show email: dr.c@fatsciencepodcast.comFat Science is informational only and does not constitute medical advice.
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Nov 24, 2025 • 47min

Listener Mailbag – Practical Metabolic Care, GLP‑1 Myths, and the Dangers of Microdosing

This week on Fat Science, Dr. Emily Cooper, Mark Wright, and Andrea Taylor field your most urgent metabolic health questions—exploring care advocacy, novel drug use, lab results, and how to filter fact from fiction in the TikTok age. Dr. Cooper offers clinical clarity, real-world perspective, and actionable hope—with an emphasis on what truly matters for your long-term health and energy.Hear from listeners experiencing real breakthroughs (and challenges) with GLP-1s, get tips for navigating confusing cholesterol results, and learn why self-advocacy and good science matter more than credentials or hype. This is not a quick-fix episode; it’s real metabolic medicine, mythbusting, and grounded encouragement for your health journey.Key Questions AnsweredWhat labs and scores best assess your true metabolic risk—and how do you make sense of fasting glucose, glucose-insulin ratio (GIR), and FIB-4?How can you find a medical provider who’ll actually give you the time and attention metabolic care requires?Why do GLP-1s benefit more than weight loss alone? Listeners report help with sleep apnea, inflammation, and food noise—what does the science say?How should you reintroduce carbs after restriction, and what’s the safest way to monitor (beyond A1C)?What’s up with rising cholesterol on Zepbound, and when do you worry?Does serotonin syndrome relate to GLP-1s? (Short answer: No—Dr. Cooper explains why.)What are the dangers of “GLP-1 microdosing” as pushed by social media, and what happens when influencers overstep good science?Key TakeawaysCare that cares: The best doctor isn’t always the most credentialed—find someone, MD, NP, or PA, who takes your questions seriously and goes deeper than the surface. Labs that matter: Fasting glucose, insulin, GIR, HbA1c, plus advanced lipid testing (CardioIQ, NMR) are critical for uncovering hidden risk—not just chasing numbers. GLP-1s act broadly: Listeners see gains in sleep, inflammation, and appetite regulation. These benefits are real, not just anecdotal, and Dr. Cooper shares the clinical rationale. Smart fueling, even on GLP-1s: If you lack hunger cues, “mechanical eating” prevents under-fueling and cellular stress—especially important for maintaining muscle and metabolism. Rethinking “microdosing”: TikTok trends are not medical advice—microdosing with black-market GLP-1s is unproven, poorly regulated, and potentially unsafe. Rely on trusted, legal medication sources only. Dr. Cooper’s Actionable TipsRequest a full panel for metabolic health: ask your provider about fasting insulin, GIR, HbA1c, lipids, and FIB-4—even if you haven’t been flagged as “at risk”. For those on GLP-1s: Don’t skip meals; create a schedule with protein and fiber to avoid muscle loss and ensure micronutrient intake. Experiencing cholesterol shifts on medication? Ask for a breakdown (HDL, LDL, particle size) and consider advanced panels (CardioIQ, NMR) to better understand your risk. If reintroducing carbs after restriction, pair them with protein or fat and test glucose/insulin at intervals post-meal to personalize your plan. Avoid unregulated “microdosing” and buy only from reputable, FDA-approved outlets—protect your long-term health over quick fixes. Notable Quote“The most important thing is somebody who cares, not necessarily their degrees.”— Dr. Emily CooperLinks & ResourcesPodcast Home: Fat Science Podcast WebsiteSubmit a Show Question: questions@fatsciencepodcast.com or dr.c@fatsciencepodcast.comDr. Emily Cooper on LinkedInMark Wright on LinkedInAndrea Taylor on InstagramAdvanced cholesterol testing: CardioIQ at Quest, NMR at LabCorpFat Science is your source for breaking diet myths and advancing the science of true metabolic health. No diets, no agendas—just science that makes you feel better. The show is informational only and does not constitute medical advice. 
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Nov 17, 2025 • 55min

Listener Mailbag – Metabolic Mysteries, Medication Strategies, and Dr. Cooper’s Science-Based Answers

This week on Fat Science, Dr. Emily Cooper, Mark Wright, and Andrea Taylor dive into your burning questions from around the world—exploring misunderstood metabolic problems, hard-won solutions for real people, and the science behind the headlines. From “selfish brain” physiology to the rollercoaster of insurance and medication access, Dr. Cooper brings clinical clarity and practical hope.Hear real-world listener stories, get advice on tuning your metabolic health, and learn why personalization—not “calories in, calories out”—leads to better outcomes. This is no silver bullet show: it’s metabolic medicine, mythbusting, and science-backed encouragement for your journey.Key Questions AnsweredWhat is the “selfish brain” and how does it really impact blood sugar and diabetes risk?Why do GLP-1 medications affect stamina and hunger, and how should you fuel your body if you’re using them?If insurance pulls coverage for medications like Ozempic or Zepbound, what are your practical, safe, and affordable options?How do metabolic markers, medication “cocktails,” and genetic testing shape Dr. Cooper’s individualized care—and can you taper off meds and maintain results?What does “normal” blood sugar look like after meals, and how do you distinguish trends from outliers?Key TakeawaysMetabolism is complex—individualized care is essential. Diabetes, hypoglycemia, and insulin resistance all have personal causes and require testing like the Mixed Meal Tolerance Test to solve—not one-size-fits-all advice. GLP-1s require smart fueling. Many experience reduced stamina on these medications. Dr. Cooper recommends upping both complex and simple carbs pre-exercise and consulting with a registered dietitian if fatigue persists. Insurance coverage is a challenge—but not the end. Generic options (like liraglutide/Victoza via Mark Cuban Cost Plus Drugs), manufacturer programs, and “cocktail” regimens can support continued progress, even if you lose access to top-brand GLP-1s. Feedback loops & genetics drive lasting outcomes. While some patients can successfully—slowly—taper medications, most with metabolic dysfunction will need long-term support. “Clean eating” alone rarely reverses underlying feedback loop glitches. Monitoring is powerful. Using blood sugar monitors (especially for diabetics) can demystify meal spikes and help fine-tune nutrition and medication timing. Personal stories reflect broader truths. Listeners share struggles and solutions, reinforcing that metabolic health spans medication, motivation, and mindset.Dr. Cooper’s Actionable TipsAlways dig deeper with testing—not just A1C but also post-meal spikes via the Mixed Meal Tolerance Test.If you’re prescribed a GLP-1 and struggle with energy, increase carb intake safely and talk to a doctor about medication adjustment. For lost coverage, stick to FDA-approved sources: Lilly Direct for Zepbound, Novocare for Wegovy, and Mark Cuban for generics. Don’t risk unregulated online compounds. Recognize the difference between generalized “healthy” habits and targeted strategies that actually move your biomarkers.Stay consistent and compassionate—focus on small improvements over extremes and absolutes.Notable Quote“The metabolism is regulated by a feedback loop…when you introduce outside hormone forms, you strengthen signals to favor fuel utilization over energy conservation.”— Dr. Emily CooperLinks & ResourcesPodcast Home: Fat Science Podcast WebsiteSubmit a Show Question: questions@fatsciencepodcast.com or dr.c@fatsciencepodcast.comDr. Emily Cooper on LinkedInMark Wright on LinkedInAndrea Taylor on InstagramGeneric medication access: Mark Cuban Cost Plus DrugsZepbound direct: Lilly DirectAdditional info: Novocare for WegovyFat Science is your source for breaking diet myths and advancing the science of true metabolic health. No diets, no agendas—just science that makes you feel better. The show is informational only and does not constitute medical advice.

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