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 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 Tips

• Request 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 Cooper

Links & Resources

• Podcast Home: Fat Science Podcast Website
• Submit a Show Question: questions@fatsciencepodcast.com or dr.c@fatsciencepodcast.com
• Dr. Emily Cooper on LinkedIn
• Mark Wright on LinkedIn
• Andrea Taylor on Instagram

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. The show is informational only and does not constitute medical advice.

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 Answered

• What 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 Takeaways

• Care 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 Tips

• Request 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 Cooper

Links & Resources

Podcast Home: Fat Science Podcast WebsiteSubmit a Show Question: questions@fatsciencepodcast.com or dr.c@fatsciencepodcast.com
Dr. Emily Cooper on LinkedIn
Mark Wright on LinkedIn
Andrea Taylor on Instagram
Advanced 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.

This week on Fat Science, Dr. Emily Cooper, Mark Wright, and Andrea Taylor take a trip to the past when Dr. Cooper didn’t have many supporters in medicine. She shares what it was like to be ridiculed by her peers, why she refused to give up on her patients, and how her science-based approach to metabolism was finally validated by mainstream medicine.

Hear the raw, unfiltered story of resilience, patient advocacy, and scientific discovery that led Dr. Cooper from being dismissed as “voodoo” to blazing a trail for real metabolic health.

Key Questions Answered:

• Why did so many in the medical community reject Dr. Cooper’s methods—like challenging “calories in, calories out”—when she started treating metabolic issues?
• What does the rise of GLP-1 medications reveal about the true science behind appetite, metabolism, and weight?
• How did Dr. Cooper hold onto her integrity and keep practicing effective, patient-centered medicine despite overwhelming opposition?
• When does medical “common sense” get replaced by real science, and what does that mean for anyone struggling with diets that fail?

Key Takeaways:

• Progress means facing skepticism. Dr. Cooper was once called a "voodoo doctor" and even yelled at by other physicians for her scientific methods, but results spoke louder than her critics.
• Metabolism is personal and complex—restrictive diets and “eat less, move more” advice often backfire. Hormonal science and careful patient tracking revealed why old rules failed.
• Persistent curiosity and data-driven practice, not popularity, eventually shift the culture. Dr. Cooper leaned on a “matrix” of metabolic markers long before these tests were commonplace.
• GLP-1 medications (like Byetta and Victoza) have moved from obscure tools to mainstream, validating Dr. Cooper’s approach to treating the whole metabolic system.
• True healing means fueling, not restricting. “Eating more,” not less, was key to metabolic recovery for many patients—a radical, often ridiculed idea that’s now supported by science and real-world clinical data from thousands of patients.
• Patient stories mirror the medical journey—today, both patients and providers can look back and realize that “voodoo” was simply science ahead of its time.

Dr. Cooper’s Actionable Tips:

• Question easy answers—when in doubt, follow the data, not tradition.
• Find a provider who listens, tests, and adapts treatment to you—not just your weight or a number on a scale.
• Remember that real science can be lonely before it’s mainstream. Trust progress, even when it feels slow.
• Celebrate freedom from food guilt; focus on nourishment, steady energy, and self-compassion, not dieting extremes.

Notable Quote:

“It does make you feel lonely because you feel like there’s no one to talk to, but it was always about doing right by the science and by my patients.” — Dr. Emily Cooper

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. The show is informational only, not medical advice.

Check out our website to submit a question, explore resources, or reach our hosts.

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

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

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

This week on Fat Science, Dr. Emily Cooper, Mark Wright, and Andrea Taylor dive into the latest U.S. blood pressure guidelines—and reveal why nearly half of all Americans face risks that can no longer be ignored. Early intervention and smart lifestyle changes are at the heart of these new recommendations.

Why is high blood pressure such a hidden danger? What do the new “elevated” and “stage one” categories mean for real people? How do doctors decide when it’s time for medication versus lifestyle changes? And how does blood pressure connect to kidneys, strokes, and even dementia? Dr. Cooper unpacks the science, gives practical advice, and shares why home monitoring is now a crucial part of medical care.

In this conversation-dense episode, the team breaks old myths and empowers listeners to take charge—so that “keeping an eye” on blood pressure becomes active prevention, not passive worry.

Key Takeaways:

• New guidelines lower the bar for concern—120 over 80 is now “caution,” and 130 over 80 is “hypertension.” Early action matters.
• Untreated high blood pressure can lead to irreversible organ damage, strokes, kidney disease, and cognitive decline.
• Doctors now have a better toolkit: updated cutoffs, risk “calculators” that include zip code, and clearer protocols for who needs medication right away.
• Lifestyle changes (fruit, vegetables, less sodium, more movement, quality sleep, stress management, and alcohol moderation) are the first line for many—especially in the “elevated” category.
• Metabolic syndrome often includes high blood pressure; medicines like GLP-1s and metformin may help regulate pressure as well as metabolism.
• Accurate home blood pressure monitoring is strongly recommended, with validated cuff meters (not wrist models).

Dr. Cooper shares actionable tips:

• Eat five servings of fruits and vegetables daily for potassium—bananas, spinach, potatoes, kiwis all help.
• Get a “validated” cuff monitor and check morning/evening, resting, following best practices.
• Ask your doctor about the new guidelines and risk calculators (found at the American Heart Association website).

Notable Quote:

“Home readings are very valuable. I really encourage people to look at the Validate BP site, find a good meter, and keep a log. Catching high blood pressure early and treating it aggressively can have profound impacts on your future health.”— Dr. Emily Cooper

Resources from the episode:

Fat Science is your source for understanding why blood pressure—and metabolic health—matter 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

Fat Science Ep 106The Mailbag: GLP 1s, Leptin, Hormones & Insurance AdviceThis week on Fat Science, Dr. Emily Cooper, Mark Wright, and Andrea Taylor open the listener mailbag to answer real questions from around the world about metabolism, hormones, and GLP-1 therapy. From the UK to Seattle, listeners share personal stories of confusion and discovery — and Dr. Cooper brings metabolic science back into focus.What really happens when you stop GLP-1 medications? Why can someone eat less yet gain weight? What does leptin resistance actually mean? And how can hopeful moms safely navigate treatment before pregnancy?In this conversation-rich episode, the team moves beyond myths, helping listeners understand how hormones — not willpower — drive metabolism, appetite, and long-term health.Key Takeaways:• GLP-1 medications don’t “work by starving you” — they help the body use energy better by resetting fuel use hormones.• Restrictive eating and “calories in, calories out” oversimplify metabolism and often worsen hormonal imbalance.• Leptin isn’t just about levels — signaling quality determines how well your brain recognizes stored body fat.• Pregnancy and metabolic health require careful timing; GLP-1s aren't used during pregnancy, but improved metabolic strength before conception matters most.• Rapid weight loss from GLP-1 meds can risk muscle depletion; maintaining steady nutrition and proper dosing is key.• Insurance coverage for GLP 1s remains unpredictable, but persistence and documentation can open doors.Personal Stories & Practical Advice:Andrea and Mark share their own experiences reconciling appetite changes on GLP-1 therapy — from remembering to eat when hunger signals quiet down to finding fueling strategies that work.Dr. Cooper offers practical guidance rooted in clinical data: why ordered eating keeps metabolism stable, how dietitians with eating disorder expertise support GLP-1 patients, and when to adjust medication doses to protect muscle mass.Notable Quote:“It’s not technically the weight that’s messing up fertility — it’s the metabolic dysfunction that causes weight as a symptom.” — Emily Cooper, MD.In this listener mailbag edition of Fat Science, Dr. Emily Cooper, Mark Wright, and Andrea Taylor unpack the science behind GLP-1 medications, leptin resistance, and hormone balance. From fertility to appetite changes and insurance frustrations, this episode explains how metabolism—not willpower—drives lasting health. Hear real-world advice on fueling, mechanical eating, and safe GLP-1 use.

Resources from the episode:

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’re committed to a world where people understand that fat isn’t a failure and metabolism is not a math problem.This show is for informational purposes only and not a substitute for medical advice.

Check out our website where you can ask a mailbag question.

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

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