Fat Science

• Fat Science Mailbag: The Dangers of Restricting Calories, Bariatric Plateaus, GLP-1 Dose Adjustments, Weight Expectations & More

  This week on Fat Science, Dr. Emily Cooper, Andrea Taylor, and Mark Wright open the Fat Science mailbag to answer listener questions from around the globe. This episode covers real-world metabolic challenges—from navigating calorie restriction and GLP-1 medications to the complexities of bariatric surgery, prednisone’s impact on weight, and menopause. Dr. Cooper offers clear explanations and practical advice for healthcare professionals and patients alike on understanding metabolic dysfunction, interpreting lab results, and setting realistic weight loss expectations.Key Takeaways:Calorie restriction and intermittent fasting can destabilize metabolism, making recovery complex for some patients—gradual changes and medical monitoring are essential.Bariatric surgery can be an effective intervention for those with significant insulin resistance or high hunger signals. Pre-surgery metabolic testing (like insulin, glucose, and ghrelin levels) is valuable in assessing the likely benefit.Plateaus after surgery, persistent weight struggles, and the role of genetics highlight the need for root-cause investigation, not just symptom management.Prednisone and hormone therapies (including MHT for menopause) can affect metabolic health; small dietary adjustments, body composition testing, and tailored exercise are crucial for optimizing outcomes.Guidance on GLP-1 medication maintenance: Most patients benefit from staying on weight loss meds long-term, but dose adjustment is possible when side effects arise. Stability over many months is critical before considering any taper.Personal Stories & Practical Advice:Andrea shares her experience with bariatric surgery and ongoing metabolic management, emphasizing realistic expectations and the benefit of medication-surgery synergy.Listeners ask: how to evaluate readiness to stop weight loss meds, address side effects, and balance hormone needs during menopause.Resources from the episode:Fat Science is a podcast on a mission to share the real science behind why we get fat, addressing stigma and confusion with facts, hope, and empowering stories.Updates on Dr. Cooper’s upcoming virtual metabolic health training—ideal for practitioners in the UK and beyond.Information about Melanocortin pathway testing programs for severe, persistent obesity.https://uncoveringrareobesity.com/Link to previous show. “GLP-1s: Will I Have to Take Them Forever?” (5/19/25)https://open.spotify.com/episode/1GZA71gTMSz0idbnEYblVO?si=gJXxNkbYTHykhNDw0Ebltg Connect with Dr. Emily Cooper on LinkedIn.Connect with Mark Wright on LinkedIn.Connect with Andrea Taylor on Instagram.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. We are 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.If you have a question for Dr. Cooper, a show idea, feedback, or just want to connect, email us at [email protected] [email protected] Science is supported by the non-profit Diabesity Institute which is on a mission to increase access to effective, science-based medical care for those suffering from or at risk for diabesity. https://diabesityresearchfoundation.org/

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• Metabolic Drugs: Why One Size Doesn’t Fit All

  This week on Fat Science, Dr. Emily Cooper, Andrea Taylor, and Mark Wright unpack the latest breakthroughs in metabolic medications and why individual biology requires personalized treatment. Dr. Cooper explains how modern therapies for metabolic dysfunction go far beyond the old “one pill fixes all” approach. Discover how hormone-based medications like GLP-1 agonists are changing obesity and diabetes care, why medication response can differ drastically between individuals, and what the future holds for tailored metabolic treatments. You’ll come away with a clearer understanding of why effective weight management isn’t just about diet or willpower—it’s about precision medicine.Key Takeaways:Metabolic dysfunction is a complex, multi-hormonal disease; no single medication will work for everyone.New therapies, including dual and triple hormone agonists (like GLP-1, GIP, and amylin analogs), offer synergistic and individualized effects.Clinical observation shows that increasing doses or the “latest” medication doesn’t guarantee better results—some people may even find that their progress disappears after increasing to maximal doses.Lab markers (like ghrelin and leptin) could help personalize treatment, but cost and availability limit widespread testing.Concerns about muscle loss with GLP-1 drugs are common, but clinically, the risk mostly depends on nutrition, strength routines and muscle mass at baseline.Accessibility and cost remain barriers; new small-molecule drugs may improve affordability in the near future.Personal Stories & Practical Advice:Andrea relates how understanding her true metabolic issues, rather than just dieting, led to sustainable health changes.Dr. Cooper describes her clinic’s approach to measuring body composition and tracking lean mass to avoid unwanted muscle loss.Listeners are encouraged to work with knowledgeable providers, beware of “one size fits all” narratives, and stay hopeful as newer, more effective treatments emerge.Resources from the episode:Connect with Dr. Emily Cooper on LinkedIn.Connect with Mark Wright on LinkedIn.Connect with Andrea Taylor on Instagram.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. We are 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.If you have a question for Dr. Cooper, a show idea, feedback, or just want to connect, email us at [email protected] [email protected] Science is supported by the non-profit Diabesity Institute which is on a mission to increase access to effective, science-based medical care for those suffering from or at risk for diabesity. https://diabesityresearchfoundation.org/

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• Endocrine Disruptors: Hidden Chemicals and Metabolic Health

  This week on Fat Science, Dr. Emily Cooper, Andrea Taylor, and Mark Wright revisit the critical topic of endocrine disruptors—chemicals in our environment that interfere with hormones and impact metabolism, weight, and overall health. Dr. Cooper breaks down how everyday exposures to substances like phthalates, BPA, and others can have generational effects on metabolic pathways and disease risk. The episode highlights the link between these chemicals and the rising rates of obesity, diabetes, and even cancer, while offering practical steps for minimizing exposure in daily life.Key Takeaways:Endocrine disruptors are chemicals found not only in food but in everyday items such as furniture, makeup, plastics, and baby products, making exposure widespread and difficult to avoid.These chemicals can mimic or block hormones, disrupting critical metabolic and developmental processes, with effects that may pass to future generations.Regulatory oversight in the U.S. is decreasing, with significant EPA budget cuts threatening existing screening and cleanup programs targeting endocrine-disrupting chemicals.Air quality improvements, especially through HEPA filtration, and making informed choices during preconception, pregnancy, and early childhood, can help reduce exposure.Consumer awareness, advocacy, and using resources like the Environmental Working Group (EWG) app are key strategies for individuals seeking to lower risk.Personal Stories & Practical Advice:Andrea shares the everyday struggle to find safe, affordable alternatives and the surprise of seeing improvements in metabolic hormone levels after changing air filters and reducing workplace exposures.Dr. Cooper discusses strategies to minimize risk during critical windows such as preconception and pregnancy, and emphasizes the power of informed consumer choices in driving safer product development.Resources from the episode:Environmental Working Group (EWG) resources and app for product safety ratingsU.S. EPA Endocrine Disruptor Screening Program (EDSP)PubMed for scientific research on specific chemicals (BPA, phthalates, PFAS)Connect with Dr. Emily Cooper on LinkedIn.Connect with Mark Wright on LinkedIn.Connect with Andrea Taylor on Instagram.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. We are 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.If you have a question for Dr. Cooper, a show idea, feedback, or just want to connect, email us at [email protected] or [email protected] Science is supported by the non-profit Diabesity Institute, which aims to increase access to effective, science-based medical care for those suffering from or at risk for diabesity. https://diabesityresearchfoundation.org/

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• Profits vs. Prevention: How Do We Fix Healthcare?

  This week on Fat Science, Dr. Emily Cooper, Andrea Taylor, and Mark Wright tackle the frustrations of navigating the American healthcare system—especially when it comes to treating metabolic dysfunction, diabetes, and obesity. Mark vents about insurance obstacles, while Dr. Cooper breaks down how short-term thinking, excessive profit layers and lack of preventive care put patient health at risk. Andrea and Dr. Cooper share personal stories and expertise about the high cost and complexity of accessing vital medications. Together, they explore how incentives, policies, and profit motives harm patient outcomes and propose ideas for a system that truly values health over profits.Key Takeaways:The U.S. healthcare system appears to prioritize short-term profits over long-term health, making it hard for patients to access necessary preventive treatments.Insurance companies create barriers to care by denying medications until a patient’s condition worsens, favoring “sick care” over prevention.The cost of medications in the U.S. is often exponentially higher than in other countries due to lack of price negotiation and excessive middlemen.Access to essential drugs often depends on your employer, state, or industry, creating inequities for those outside favored sectors.Real cost savings—and better outcomes—come from investing in prevention and allowing providers and patients to make informed decisions without interference.Personal Stories & Practical Advice:Mark and Andrea describe fights with insurance for medication access, including resorting to Canadian pharmacies and out-of-pocket payments.Dr. Cooper explains how prevention in her clinic has reduced heart attacks, strokes, and new cases of diabetes among her high-risk patients.Resources:Connect with Dr. Emily Cooper on LinkedIn.Connect with Mark Wright on LinkedIn.Connect with Andrea Taylor on Instagram.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. We are 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.If you have a question for Dr. Cooper, a show idea, feedback, or just want to connect, email us at [email protected] or [email protected] is supported by the non-profit Diabesity Institute which is on a mission to increase access to effective, science-based medical care for those suffering from or at risk for diabesity. https://diabesityresearchfoundation.org/

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• Metabolic Workup 101: What Tests Reveal About Your Health

  This week on Fat Science, Dr. Emily Cooper, Andrea Taylor, and Mark Wright break down the essentials of a true metabolic workup. This episode moves beyond social media diet trends and digs into the science behind comprehensive lab panels, what they measure, and why they matter for your whole-body health. Dr. Cooper explains how to interpret common and advanced metabolic markers—like blood sugar, insulin, cholesterol, hormone levels, and more—while Andrea and Mark share personal insights into the power of understanding your metabolic baseline. If you’re concerned about weight, diabetes, or just want to know your numbers, this episode gives you the knowledge to talk confidently with your healthcare provider.Key Takeaways:A whole-body metabolic approach goes beyond just weight or blood pressure—comprehensive lab work (plus family history) is essential to uncover risks or dysfunction early.Standard blood panels provide useful clues (glucose, cholesterol, liver, kidney, blood pressure), but advanced tests (A1C, lipid particles, hormone levels, inflammation markers) round out the picture.Metabolic dysfunction is driven by factors far deeper than calories in/out—dieting and under-fueling can actually weaken metabolism over time.Medication for metabolic health is not a failure; it’s a science-backed intervention. Early and accurate testing allows for better, evidence-based treatment.Don’t ignore “borderline” results—addressing issues early is easier and more effective than trying to reverse advanced dysfunction later.Personal Stories & Practical Advice:Andrea recounts her life-changing journey from endless dieting to real answers through complete metabolic testing and individualized treatment.Mark highlights the need for patients to advocate for themselves and ask for more than just the standard panel at annual exams.References:Diet Failure Rate• Mann, T., et al. (2007). "Medicare's search for effective obesity treatments: diets are not the answer." American Psychologist, 62(3), 220-233• Anderson, J. W., et al. (2001). "Long-term weight-loss maintenance: a meta-analysis of US studies." American Journal of Clinical Nutrition, 74(5), 579-584Persistent Metabolic Adaptation• Fothergill, E., et al. (2016). "Persistent metabolic adaptation 6 years after 'The Biggest Loser' competition." Obesity, 24(8), 1612-1619• Rosenbaum, M., & Leibel, R. L. (2010). "Adaptive thermogenesis in humans." International Journal of Obesity, 34(S1), S47-S55Long-Term Hormonal Disruption • Sumithran, P., et al. (2011). "Long-term persistence of hormonal adaptations to weight loss." New England Journal of Medicine, 365(17), 1597-1604• Rosenbaum, M., et al. (2005). "Low-dose leptin reverses skeletal muscle, autonomic, and neuroendocrine adaptations to maintenance of reduced weight." Journal of Clinical Investigation, 115, 3579-3586Weight Cycling Cardiovascular Risks• Montani, J. P., et al. (2006). "Weight cycling during growth and beyond as a risk factor for later cardiovascular diseases: the 'repeated overshoot' theory." International Journal of Obesity, 30(S4), S58-S66Resources:Connect with Dr. Emily Cooper on LinkedInConnect with Mark Wright on LinkedInConnect with Andrea Taylor on InstagramFat Science is a podcast on a mission to explain where our fat really comes from and why it won’t go and stay away. We are 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.If you have a question for Dr. Cooper, a show idea, feedback, or just want to connect, email us at [email protected] or [email protected] is supported by the non-profit Diabesity Institute which is on a mission to increase access to effective, science-based medical care for those suffering from or at risk for diabesity. https://diabesityresearchfoundation.org

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