Fat Science

• Mailbag: Metabolism Myths, Plateaus, and More

  This week on Fat Science, Dr. Emily Cooper, Andrea Taylor, and Mark Wright answer listener questions from around the world about metabolic health. This mailbag episode explores widely-debated topics like “starvation mode,” weight loss plateaus, the relationship between metabolism and cognitive health, cannabis and metabolism, metabolic effects of liposuction, and the latest on GLP-1 medications.Key Takeaways:Dr. Cooper dispels myths around “starvation mode,” citing research on the long-term metabolic impact of dieting and caloric restriction.Weight loss plateaus are often misunderstood—Dr. Cooper explains the natural adaptations behind them and how to assess true progress.Metabolic health plays a major role in brain function, cognitive decline, depression, and dementia prevention.Cannabis affects metabolic pathways in complex ways, with regular use potentially causing negative metabolic effects.Liposuction can trigger metabolic rebound and rapid fat regain for some patients, especially when leptin levels are low.Updates on GLP-1 meds: Liraglutide is available in generic form, but costs fluctuate. New oral and combination therapies are on the horizon.Personal Stories & Practical Advice:Andrea and Mark reflect on their own journeys with dieting, weight plateaus, and medication.Dr. Cooper shares clinical experiences with metabolic rebound after liposuction and ways to navigate pharmacologic treatments.Correction: Lilly has a lower cash pay for Medicare and Medicaid, but Novo Nordisk is not yet.References related to diet-induced metabolic adaptation, also called biological adaptation and defense of body weight. 1. Keys, A., Brozek, J., Henschel, A., Mickelsen, O., & Taylor, H. L. (1950). The Biology of Human Starvation. University of Minnesota Press.2. Dulloo, A. G. (2021). Physiology of weight regain: Lessons from the classic Minnesota Starvation Experiment on human body composition regulation. Obesity Reviews, 22, e13189.3. Müller, M. J., & Bosy-Westphal, A. (2013). Adaptive thermogenesis with weight loss in humans. Obesity, 21(2), 218-228.4. Rosenbaum, M., & Leibel, R. L. (2010). Adaptive thermogenesis in humans. International Journal of Obesity, 34(S1), S47-S55.5. Fothergill, E., Guo, J., Howard, L., Kerns, J. C., Knuth, N. D., Brychta, R., ... & Hall, K. D. (2016). Persistent metabolic adaptation 6 years after "The Biggest Loser" competition. Obesity, 24(8), 1612-1619.6. Johanssen, D. L., Knuth, N. D., Huizenga, R., Rood, J., Ravussin, E., & Hall, K. D. (2012). Metabolic slowing with massive weight loss despite preservation of fat-free mass. Journal of Clinical Endocrinology & Metabolism, 97(7), 2489-2496.7. Sumithran, P., Prendergast, L. A., Delbridge, E., Purcell, K., Shulkes, A., Kriketos, A., & Proietto, J. (2011). Long-term persistence of hormonal adaptations to weight loss. New England Journal of Medicine, 365(17), 1597-1604.8. MacLean, P. S., Bergouignan, A., Cornier, M. A., & Jackman, M. R. (2011). Biology's response to dieting: the impetus for weight regain. American Journal of Physiology-Regulatory, Integrative and Comparative Physiology, 301(3), R581-R600Resources: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, email us at [email protected] or [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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• Why Sometimes It Takes a Little Patience

  This week on Fat Science, Dr. Emily Cooper, Andrea Taylor, and Mark Wright explore why metabolic health transformations require time, persistence, and a holistic approach. Andrea shares her 14-year journey with Dr. Cooper, highlighting the slow, individualized nature of healing a dysfunctional metabolism and why quick fixes rarely work. Dr. Cooper explains how complex feedback loops, hormonal adaptations, and life events can slow progress—and why health markers, not just the number on the scale, are crucial measures of success. The conversation encourages patience, self-compassion, and a focus on sustainable health, not just rapid weight loss.Key Takeaways:Healing metabolic dysfunction is a complex, highly individualized process that often takes years—not weeks or months.Dieting, stress, disrupted sleep, and misguided exercise can send the body into "famine mode," making weight loss even harder.Metrics like blood pressure, cholesterol, and glucose often improve before significant weight loss occurs—these health gains matter.Medications and bariatric surgery can help in stubborn cases, but long-term success depends on a combination of medical, lifestyle, and psychological support.As many as 20% of patients may be "non-responders" to current treatments, highlighting the need for ongoing metabolic research and new therapies.Personal Stories & Practical Advice:Andrea details her long road—from early GLP-1 medications and plateaus to bariatric surgery and ongoing adjustments—with the emphasis that patience paid off.Dr. Cooper and Mark reinforce the importance of redefining food as fuel and joy, not the enemy, and letting go of blame or unrealistic expectations tied to the scale.The episode highlights small wins, the value of routine lab work, and celebrating all forms of progress—especially the non-scale victories.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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  40:41
• GLP-1s: Will I Have to Take Them Forever?

  This week on Fat Science, Dr. Emily Cooper, Andrea Taylor, and Mark Wright break down the latest science behind GLP-1 medications like Ozempic, Wegovy, and Mounjaro. Dr. Cooper shares her decades of expertise on how these drugs work, their evolution, and whether you really have to take them for life. The episode dives deep into the individual factors that impact tapering off, the importance of metabolic signals (like famine and security signals), and why medication is just one piece of the metabolic puzzle. Key Takeaways:GLP-1 medications have advanced significantly, with more convenient dosing and greater effectiveness for many—but responses vary widely from patient to patient.Weight on the scale isn’t the only measure; body composition, nutrient levels, and metabolic markers are critical in determining treatment and possible tapering.Not everyone needs to take GLP-1s forever—tapering is possible, but it depends on individual health markers, genetics, and whether metabolic signals are balanced.The future of metabolic health lies in combination therapies that target multiple pathways, not just GLP-1s.Dieting alone disrupts metabolic signals, making professional metabolic medicine and nutrition guidance essential for long-term health.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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  39:51
• Dosing Download: How much? When? Is It Working?

  Join Dr. Emily Cooper, Andrea Taylor, and Mark Wright on Fat Science as they unpack the complexities of dosing GLP-1 medications for metabolic health and weight management. Dr. Cooper emphasizes the importance of an individualized approach, debunking the myth that higher doses or faster titration always lead to better outcomes. The team addresses listener questions about how and when to increase doses, highlight the risks of rapid escalation, and discuss the nuanced ways these drugs impact metabolic health beyond just weight loss. Real-life experiences and thoughtful, science-backed guidance will help you navigate your own journey with metabolic dysfunction and medication.Key Takeaways:Dosing of GLP-1 medications should always be tailored to the individual, considering response, side effects, and other health factors—not just the speed of weight loss.Starting at the lowest dose and titrating slowly increases medication tolerance and long-term effectiveness.Lab markers such as A1C, glucose, cholesterol, and muscle mass are key indicators in determining if the medication and dosing are "working."Rapidly escalating to the highest dose can backfire, causing side effects and limiting future treatment options.Dieting mindsets and using medication solely as an appetite suppressant can lead to loss of lean mass and suboptimal health outcomes.Ongoing patient-provider relationships and regular lab work ensure medication strategies remain safe and effective.Personal Stories & Practical Advice:Andrea reflects on her initial desire for quick fixes and shares lessons learned about patience, nourishment, and long-term progress. Mark discusses insurance-driven medication switches and finding the “sweet spot” for dosing with Dr. Cooper’s guidance.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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  44:10
• Mailbag: Your Questions Answered

  Join Dr. Emily Cooper, Andrea Taylor, and Mark Wright on Fat Science for a special mailbag episode answering listener questions about metabolic health. Dr. Cooper explains the difference between mindful and mechanical (timed) eating, especially for those using medications like Zepbound. The team also addresses emotional challenges tied to frequent eating, societal fat shaming, and the complexities of medication side effects for those on GLP-1 agonists and antipsychotics. Real experiences and practical advice help shed light on fueling your body, breaking free from diet culture guilt, and navigating complex emotions on the journey to better health.Key Takeaways:GLP-1 medications like Zepbound affect appetite and metabolism but can also suppress hunger cues; mechanical eating—timing meals and including all food groups—prevents nutritional deficits and supports long-term metabolic health.Eating too few calories, even when appetite is low, can be detrimental; mechanical eating helps maintain muscle mass and prevent stalled metabolism.Emotional barriers, guilt, and anxiety around food are common due to fat shaming and past dieting experiences. Meal planning and support from dietitians can help ease this transition.GLP-1s may alter medication absorption or trigger anxiety episodes due to blood sugar fluctuations; monitoring and professional advice are recommended when combining with psych meds.Personal Stories & Practical Advice:Andrea shares strategies for getting enough nutrition when appetite is low, her experiences with fat shaming, and her approach to enjoying food without guilt.Mark and Dr. Cooper discuss breaking free from restrictive food mindsets and building a positive, fuel-focused relationship with eating.Key Takeaways: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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