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. In each episode, we share little-known facts and personal experiences to dispel misconceptions, reduce stigma, and instill hope. Fat Science is 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.
How does biology affect our perception of body size? Dr. Emily Cooper answers listener questions about body dysmorphia and metabolic dysfunction. Mark and Andrea discuss the challenges with compounded medications and the implications of insurance-driven diet requirements. KEY TAKEAWAYS Body dysmorphia can have biological components related to metabolic dysfunction. Compounded medications may lack the testing and safety guarantees of brand names. Insurance requirements often lack a medical basis and can hinder proper treatment. NOTABLE QUOTE "The altered body image perception may be linked to metabolic signals." — Dr. Emily Cooper LINKS & RESOURCES None mentioned. Links & Resources Podcast Home: fatsciencepodcast.com Cooper Center for Metabolism: coopermetabolic.com Resources from Dr. Cooper: coopermetabolic.com/resources Join Our Community: patreon.com/cw/FatSciencePodcast Submit Your Question: questions@fatsciencepodcast.com or dr.c@fatsciencepodcast.com Fat Science is supported by the Diabesity Institute, a nonprofit dedicated to increasing access to effective, science-based metabolic care. This podcast is for informational purposes only and is not intended as medical advice. Please consult with a qualified healthcare provider for personalized recommendations.
Why is your fat talking to you? In the latest solo episode, Dr. Emily Cooper, Andrea Taylor, and Mark Wright explore groundbreaking research into metabolic health. Learn why the scale doesn't always reflect metabolic risk, and discover the science behind fat's active role in the body. KEY TAKEAWAYS Metabolic dysfunction cannot be judged by scale weight alone. Visceral fat is a stronger predictor of heart failure than BMI. Hormonal environments profoundly affect fat storage and health risks. NOTABLE QUOTE "Your fat is talking to you." — Andrea Taylor LINKS & RESOURCES Obesity Reviews Paper Immunological Reviews Journal Article European Congress on Obesity Study Links & Resources Podcast Home: fatsciencepodcast.com Cooper Center for Metabolism: coopermetabolic.com Resources from Dr. Cooper: coopermetabolic.com/resources Join Our Community: patreon.com/cw/FatSciencePodcast Submit Your Question: questions@fatsciencepodcast.com or dr.c@fatsciencepodcast.com Fat Science is supported by the Diabesity Institute, a nonprofit dedicated to increasing access to effective, science-based metabolic care. This podcast is for informational purposes only and is not intended as medical advice. Please consult with a qualified healthcare provider for personalized recommendations.
Is your brain starving for glucose? In this episode, Dr. Emily Cooper explores the critical role of the brain as a metabolic organ and its dependence on glucose and insulin. Listeners will learn why good sleep and a holistic lifestyle are vital for cognitive health. KEY TAKEAWAYS The brain uses about 20% of your body's energy at rest. Insulin plays a non-fuel role in brain function, supporting neural connections and mood. Sleep is essential for the brain's waste clearance system, the glymphatic system. Insulin resistance in the brain is linked to cognitive decline and dementia. Exercise, a balanced diet, and social engagement are key to brain health. NOTABLE QUOTE "The brain is the most metabolically active organ in our body." — Dr. Emily Cooper LINKS & RESOURCES JAMA: US POINTER Study on Cognitive Decline Novo Nordisk: EVOKE & EVOKE Plus Trials Links & Resources Podcast Home: fatsciencepodcast.com Cooper Center for Metabolism: coopermetabolic.com Resources from Dr. Cooper: coopermetabolic.com/resources Join Our Community: patreon.com/cw/FatSciencePodcast Submit Your Question: questions@fatsciencepodcast.com or dr.c@fatsciencepodcast.com Fat Science is supported by the Diabesity Institute, a nonprofit dedicated to increasing access to effective, science-based metabolic care. This podcast is for informational purposes only and is not intended as medical advice. Please consult with a qualified healthcare provider for personalized recommendations.
Is it normal for GLP-1 medications to become less effective over time? Dr. Emily Cooper discusses listener questions about the nuances of metabolic health and the real reasons behind weight fluctuations and food cravings. With insights into GLP-1 medications, mechanical eating, and more, the episode aims to debunk myths and provide science-based encouragement. KEY TAKEAWAYS Trusting your body's hunger signals can prevent metabolic slowdown. Mechanical eating can help manage sugar cravings and maintain metabolic health. Navigating pediatric metabolic issues requires understanding genetic influences and appropriate medical intervention. NOTABLE QUOTE "It's not your fault. Trust your body and step up to the higher end of your metabolic flexibility." — Dr. Emily Cooper LINKS & RESOURCES American Board of Obesity Medicine: obesitymedicine.org Links & Resources Podcast Home: fatsciencepodcast.com Cooper Center for Metabolism: coopermetabolic.com Resources from Dr. Cooper: coopermetabolic.com/resources Join Our Community: patreon.com/cw/FatSciencePodcast Submit Your Question: questions@fatsciencepodcast.com or dr.c@fatsciencepodcast.com Fat Science is supported by the Diabesity Institute, a nonprofit dedicated to increasing access to effective, science-based metabolic care. This podcast is for informational purposes only and is not intended as medical advice. Please consult with a qualified healthcare provider for personalized recommendations.
Have you ever wondered why your body holds onto weight despite your best efforts? In this eye-opening episode, Dr. Cooper reveals groundbreaking research showing that 100% of healthy adults carry at least six different plastic-related chemicals in their bodies daily. These endocrine disruptors don't just affect your hormones - they may be stored in your fat tissue and could be a hidden driver of metabolic dysfunction. The good news? New Australian research proves you can dramatically reduce these chemicals in just one week with targeted changes. KEY TAKEAWAYS Every single person tested had at least 6 plastic chemicals in their urine, with food packaging being the primary source Participants cut phthalate levels by 38-54% and BPA by 60% in just 7 days with adjustments in reducing plastic exposure in food and food packaging Ultra-processed foods introduce plastic chemicals through multiple processing and packaging steps Certain chemicals like DEHP may be stored in fat tissue and released during weight loss Heat accelerates plastic migration into food - avoid microwaving in plastic and pouring hot food into plastic containers Simple swaps like choosing fresh over canned foods and using glass containers make significant impacts The EPA research office studying these chemicals was recently eliminated, removing key consumer protections NOTABLE QUOTE "People who switched to the low plastic food and kitchenware cut the phthalates excretion by 38 to 54% in one week and they cut their BPA excretion by 60% in one week." — Dr. Emily Cooper Links & Resources Podcast Home: fatsciencepodcast.com Cooper Center for Metabolism: coopermetabolic.com Resources from Dr. Cooper: coopermetabolic.com/resources Join Our Community: patreon.com/cw/FatSciencePodcast Submit Your Question: questions@ fatsciencepodcast.com or dr.c@ fatsciencepodcast.com Fat Science is supported by the Diabesity Institute, a nonprofit dedicated to increasing access to effective, science-based metabolic care. This podcast is for informational purposes only and is not intended as medical advice. Please consult with a qualified healthcare provider for personalized recommendations.
What happens when GLP-1 medications stop working the way you hoped they would? In this mailbag episode, Dr. Emily Cooper answers listener questions about fasting, insulin levels, PCOS, lipedema, plateaus on Zepbound, and the complicated reality behind metabolic dysfunction. From the dangers of under-fueling to why individualized treatment matters so much, this conversation unpacks the science behind weight resistance with clarity and compassion. Key Takeaways Why fasting and restrictive eating may worsen metabolic adaptation The real role insulin plays in metabolic health How PCOS and lipedema complicate weight loss treatment Why some people plateau on GLP-1 medications over time The importance of fueling, muscle preservation, and individualized care Links & Resources Podcast Home: fatsciencepodcast.com Cooper Center for Metabolism: coopermetabolic.com Resources from Dr. Cooper: coopermetabolic.com/resources Join Our Community: patreon.com/cw/FatSciencePodcast Submit Your Question: questions@ fatsciencepodcast.com or dr.c@ fatsciencepodcast.com Fat Science is supported by the Diabesity Institute, a nonprofit dedicated to increasing access to effective, science-based metabolic care. This podcast is for informational purposes only and is not intended as medical advice. Please consult with a qualified healthcare provider for personalized recommendations.
Could you have metabolic dysfunction even at a normal weight? This episode challenges everything we've been taught about weight and health. Dr. Cooper reveals that up to 25% of normal-weight people have metabolic syndrome, yet they're rarely screened because doctors assume they're healthy based on appearance alone. KEY TAKEAWAYS Weight and metabolic health are not the same thing - you can be metabolically unhealthy at any size Normal weight people with metabolic dysfunction are often overlooked and undertreated by healthcare providers Key screening tests include fasting glucose, insulin, HbA1c, triglycerides, HDL cholesterol, blood pressure, and inflammatory markers like HSCRP Metabolic dysfunction can start in your 20s and take decades to develop into serious disease Both normal weight and higher weight patients face bias - normal weight people aren't screened enough, while higher weight people have everything blamed on their weight Early screening and treatment can prevent catastrophic health outcomes later in life The liver plays a crucial role in metabolism and can become insulin resistant regardless of body weight NOTABLE QUOTE "You cannot tell anything about someone's health from their outside, what they look like or what, even what they're doing necessarily, but definitely not their body size. So you can be healthy or unhealthy at any size body, and I think that's what's overlooked quite a bit." — Dr. Emily Cooper Links & Resources Podcast Home: fatsciencepodcast.com Cooper Center for Metabolism: coopermetabolic.com Resources from Dr. Cooper: coopermetabolic.com/resources Join Our Community: patreon.com/cw/FatSciencePodcast Submit Your Question: questions@ fatsciencepodcast.com or dr.c@ fatsciencepodcast.com Appendix: Key References Primary literature supporting this episode • Wang et al. Prevalence of Metabolically Unhealthy Normal Weight and Its Influence on the Risk of Diabetes. Journal of Clinical Endocrinology & Metabolism, 2023. • Review: Beyond BMI — Rethinking Obesity Metrics and Cardiovascular Risk in the Era of Precision Medicine. Journal of Clinical Medicine, December 2025. • Korean meta-analyses on metabolic dysfunction phenotypes and cardiometabolic risk, Cardiovascular and Metabolic Sciences Journal review, 2024. • Frontiers in Nutrition, January 2026. Associations of metabolic heterogeneity with the progression of cardiometabolic multimorbidity. • International Journal of Obesity, September 2025. Cardiovascular risk factors associated with metabolic health phenotypes. Mechanism references • MASLD — metabolic dysfunction-associated steatotic liver disease — nomenclature and clinical framework. AASLD/EASL consensus, 2023. • Insulin signaling, adipose tissue dysfunction, and ectopic fat deposition — reviews on the upstream-downstream relationship. • Epicardial adipose tissue and cardiovascular dysfunction — Frontiers in Cardiovascular Medicine, January 2026. Fat Science is supported by the Diabesity Institute, a nonprofit dedicated to increasing access to effective, science-based metabolic care. This podcast is for informational purposes only and is not intended as medical advice. Please consult with a qualified healthcare provider for personalized recommendations.
Have you been told your metabolism is broken and there's nothing you can do about it? This mailbag episode tackles tough questions about medication effectiveness, unexpected side effects, and the complex realities of treating metabolic dysfunction. Dr. Cooper addresses why some people regain weight while still on GLP-1s, explores the connection between hair loss and weight loss medications, and explains why leptin levels can remain stubbornly low even with proper nutrition. KEY TAKEAWAYS Weight regain while on GLP-1 medications is more common than most people realize Hair loss from weight loss medications is usually related to nutrient deficiencies, not the medication itself Leptin dysfunction involves both hormone levels and signaling pathways throughout the body Hypoglycemia after meals often indicates complex metabolic issues that require specialized testing Starting elderly patients on GLP-1s requires careful monitoring of nutrition, blood pressure, and side effects Mechanical eating differs from intuitive eating and remains important even when medications are working Annual weight loss rates of 10% or higher indicate medications are still effective NOTABLE QUOTE "It is not uncommon to see the weight go up while on these meds, contrary to what people think. They're great, but we always wanna point out some people don't even respond to these." — Dr. Emily Cooper Links & Resources Podcast Home: fatsciencepodcast.com Cooper Center for Metabolism: coopermetabolic.com Resources from Dr. Cooper: coopermetabolic.com/resources Join Our Community: patreon.com/cw/FatSciencePodcast Submit Your Question: questions@ fatsciencepodcast.com or dr.c@ fatsciencepodcast.com Fat Science is supported by the Diabesity Institute, a nonprofit dedicated to increasing access to effective, science-based metabolic care. This podcast is for informational purposes only and is not intended as medical advice. Please consult with a qualified healthcare provider for personalized recommendations.
Ever wonder why you can improve your health but still feel like you're failing because the scale isn't cooperating? Dr. Cooper breaks down groundbreaking new clinical guidelines from three major obesity organizations that are completely reframing what success in obesity treatment actually means. For the first time, these groups are saying quality of life, energy levels, and overall health matter more than the number on the scale. KEY TAKEAWAYS Three major obesity organizations worked collaboratively to issue guidelines prioritizing quality of life over weight loss as primary treatment goals Guidelines explicitly address medical stigma as a structural barrier to care requiring systemic change Treatment is positioned as long-term management similar to other chronic conditions like thyroid disorders Document notably avoids calorie restriction language, focusing instead on healthy lifestyle alongside medication Setmelanotide receives strong recommendation for rare genetic obesity conditions with available genetic testing Strong medication recommendations now include GLP-1s like semaglutide and tirzepatide, plus bupropion-naltrexone combination NOTABLE QUOTE "Nobody ever asked. Nobody ever looked. Nobody ever said anything. I was like, 'I think there's something wrong with my metabolism or something because I'm not eating a ton.' They're like, 'Well, you must be.' And I'm like, 'N- n- no, I don't think so. I mean, unless it's happening when I'm sleeping. I don't know.'" — Andrea Taylor Reference Link Alexander L, Purnell JQ, et al. Pharmacological management of obesity in adults: a clinical guidance statement from The Obesity Society, the Obesity Medicine Association, and the Obesity Action Coalition. Obesity . 2026;34(4):851–870. doi:10.1002/oby.70164 https://onlinelibrary.wiley.com/doi/10.1002/oby.70164 Links & Resources Podcast Home: fatsciencepodcast.com Cooper Center for Metabolism: coopermetabolic.com Resources from Dr. Cooper: coopermetabolic.com/resources Join Our Community: patreon.com/cw/FatSciencePodcast Submit Your Question: questions@ fatsciencepodcast.com or dr.c@ fatsciencepodcast.com Fat Science is supported by the Diabesity Institute, a nonprofit dedicated to increasing access to effective, science-based metabolic care. This podcast is for informational purposes only and is not intended as medical advice. Please consult with a qualified healthcare provider for personalized recommendations.
Have you been told you have PCOS but nothing seems to help? In May 2024, after 14 years of global collaboration involving 56 organizations and 22,000 stakeholders, the medical community officially changed PCOS to PMOS - and the reason why reveals everything that's been wrong with how this condition has been understood and treated for decades. Dr. Cooper breaks down why this isn't just a name change, but a complete reframe that puts metabolic dysfunction at the center where it belongs. KEY TAKEAWAYS PCOS is now officially called PMOS - Polyendocrine Metabolic Ovarian Syndrome - shifting focus from ovarian problems to metabolic dysfunction 70 million women globally are affected during reproductive years, with 70% remaining undiagnosed The condition can occur at any weight and is driven by insulin resistance and other metabolic signals, not ovarian problems Treatment should focus on metabolic health rather than weight loss or ovarian interventions The name change parallels similar shifts in medicine like MASLD replacing non-alcoholic fatty liver disease NOTABLE QUOTE "Most patients with this label that they've had in the past, the PCOS label, feel a sense of hopelessness, and even join support groups and things like that, and thinking that this will be a condition they have forever. And what I try to do is explain, no, this is just a physical manifestation of the metabolic disruption that we treat all the time" — Dr. Emily Cooper Links & Resources Podcast Home: fatsciencepodcast.com Cooper Center for Metabolism: coopermetabolic.com Resources from Dr. Cooper: coopermetabolic.com/resources Join Our Community: patreon.com/cw/FatSciencePodcast Submit Your Question: questions@ fatsciencepodcast.com or dr.c@ fatsciencepodcast.com Fat Science is supported by the Diabesity Institute, a nonprofit dedicated to increasing access to effective, science-based metabolic care. This podcast is for informational purposes only and is not intended as medical advice. Please consult with a qualified healthcare provider for personalized recommendations.
Have you been told it's just calories in calories out while your lived experience says otherwise? In this mailbag episode, Dr. Cooper addresses complex metabolic questions from listeners worldwide. From eating disorders requiring specialized care to GLP-1 plateau management, each question reveals how individual biology trumps one-size-fits-all solutions. KEY TAKEAWAYS Eating disorders like anorexia require comprehensive medical team treatment, not self-management approaches Side effects from GLP-1 medications often improve with consistent eating patterns and adequate nutrition The calories in calories out model ignores the biological complexity of how your body actually burns fuel PCOS responds well to metabolic treatments because it's driven by underlying insulin and hunger hormone imbalances Sleep deprivation and chronic stress significantly impact GLP-1 effectiveness and overall metabolic function Bioidentical progesterone may help perimenopause sleep issues without the metabolic side effects of older formulations Stroke survivors may experience hypothalamic obesity that responds remarkably well to GLP-1 medications NOTABLE QUOTE "If that really worked, imagine, you know, would we actually need these sophisticated medications that are so groundbreaking? Would we have had decades and decades, or actually centuries of failed, you know, diet experiences by so many people?" — Dr. Emily Cooper Links & Resources Podcast Home: fatsciencepodcast.com Cooper Center for Metabolism: coopermetabolic.com Resources from Dr. Cooper: coopermetabolic.com/resources Join Our Community: patreon.com/cw/FatSciencePodcast Submit Your Question: questions@ fatsciencepodcast.com or dr.c@ fatsciencepodcast.com Fat Science is supported by the Diabesity Institute, a nonprofit dedicated to increasing access to effective, science-based metabolic care. This podcast is for informational purposes only and is not intended as medical advice. Please consult with a qualified healthcare provider for personalized recommendations.
Are your legs painful to touch and resistant to weight loss despite your best efforts? Dr. Ellen Derrick, a vascular surgeon and lipedema specialist, reveals the truth about this misunderstood condition affecting 20% of women worldwide. Lipedema isn't obesity - it's a fat cell disorder where tissue responds abnormally to inflammation, creating painful, swollen areas that don't respond to traditional weight loss methods. She explains the connection between lipedema and venous insufficiency, why patients are often dismissed by doctors, and the emerging treatments offering hope. KEY TAKEAWAYS Lipedema affects 20% of the female population but is routinely misdiagnosed as obesity The condition involves abnormal fat cell response to inflammation, creating painful tissue that resists weight loss 86% of lipedema patients also have venous insufficiency, creating a perfect storm of symptoms Ankle cuffs, knee pouches, and saddlebags are classic physical signs that patients often notice from puberty GLP-1 medications like tirzepatide may help reduce inflammation and tissue tenderness Lipedema reduction surgery exists but lacks insurance billing codes, making access challenging A formal medical recognition campaign is underway to establish diagnostic codes by 2026-2027 NOTABLE QUOTE "The medical community really has done an outstanding job, in a way, gaslighting these patients. These patients have been aware that something is different about their body and their legs since puberty." — Dr. Ellen Derrick GUEST BIO Dr. Ellen Derrick is a Seattle-based board-certified vascular and general surgeon with over 20 years of clinical experience and a Master of Public Health from the University of Washington. She founded Boxbar Vascular, specializing in lipedema and related metabolic conditions, and serves on the board of the Lipedema Society working toward formal medical recognition of the condition. Links & Resources Podcast Home: fatsciencepodcast.com Cooper Center for Metabolism: coopermetabolic.com Resources from Dr. Cooper: coopermetabolic.com/resources Join Our Community: patreon.com/cw/FatSciencePodcast Submit Your Question: questions@ fatsciencepodcast.com or dr.c@ fatsciencepodcast.com Fat Science is supported by the Diabesity Institute, a nonprofit dedicated to increasing access to effective, science-based metabolic care. This podcast is for informational purposes only and is not intended as medical advice. Please consult with a qualified healthcare provider for personalized recommendations.
Dr. Emily Cooper, Mark Wright, and Andrea Taylor break down three breaking metabolic health stories in this quick bonus episode — from a newly approved oral GLP-1 to a major price drop for Medicare patients. Links & Resources Podcast Home: fatsciencepodcast.com Cooper Center for Metabolism: coopermetabolic.com Resources from Dr. Cooper: coopermetabolic.com/resources Join Our Community: patreon.com/cw/FatSciencePodcast Submit Your Question: questions@fatsciencepodcast.com or dr.c@fatsciencepodcast.com Fat Science is supported by the Diabesity Institute, a nonprofit dedicated to increasing access to effective, science-based metabolic care. Disclaimer: This podcast is for informational purposes only and is not intended as medical advice. Please consult with a qualified healthcare provider for personalized recommendations.
Have you ever wondered if you should get liposuction when you need skin removal surgery after major weight loss? In this mailbag episode, Dr. Cooper, Mark, and Andrea tackle questions from listeners around the world, from Germany to Alabama to Chicago. They discuss why restricting calories while on GLP-1 medications can actually work against you, address the reality of finding metabolic-informed doctors internationally, and explain the science behind fat cell removal during skin surgeries. Plus, they share details about the newly approved oral GLP-1 medication orforglipron (Foundayo) and why vegetables, fats and starches matter even when you're protein-focused. KEY TAKEAWAYS Restricting calories on GLP-1 medications can lower your metabolic rate and weaken your body's natural GLP-1 production Liposuction during skin removal surgery may disrupt leptin signaling, though males may be less affected than females due to naturally lower leptin levels Finding metabolic-informed doctors globally remains challenging, but obesity medicine certification and Canadian and European obesity organizations may offer better resources The oral GLP-1 medication orforglipron will likely be less expensive but also less effective than dual-agonist medications like tirzepatide Mechanical eating without calorie counting often produces better long-term results than restrictive approaches Vegetables provide essential micronutrients and support healthy microbiome function that protein alone cannot replace Major weight loss surgery like tummy tucks is serious surgery that requires careful consideration and qualified surgeons NOTE: This episode was recorded before Foundayo (orforglipron) was released on the market. The price is the same as the Wegovy pill. Listen to our episode - “New Obesity Drugs” for more information https://podcasts.apple.com/us/podcast/fat-science/id1715377331?i=1000762362056 NOTABLE QUOTE "If only they didn't fall into that diet cycle, some of them, their weight would be a hundred pounds less. Yes, it might be still elevated, but a large chunk of that weight was caused by the diet cycle itself." — Dr. Emily Cooper Links & Resources Podcast Home: fatsciencepodcast.com Cooper Center for Metabolism: coopermetabolic.com Resources from Dr. Cooper: coopermetabolic.com/resources Join Our Community: patreon.com/cw/FatSciencePodcast Submit Your Question: questions@ fatsciencepodcast.com or dr.c@ fatsciencepodcast.com Fat Science is supported by the Diabesity Institute, a nonprofit dedicated to increasing access to effective, science-based metabolic care. Disclaimer: This podcast is for informational purposes only and is not intended as medical advice. Please consult with a qualified healthcare provider for personalized recommendations.
Ever hear someone say GLP-1 medications cause osteoporosis or make your hair fall out? This episode tackles the top 10 biggest myths about GLP-1 medications flooding social media and separates the science from the scary headlines. Dr. Cooper breaks down what's actually happening in your body versus what the internet claims, from bone density concerns to the dreaded "Ozempic face." KEY TAKEAWAYS · GLP-1 medications don't cause osteoporosis - inadequate nutrition while losing weight can weaken bones · Hair loss is typically from nutritional deficits, not the medication itself · These drugs slow gastric emptying but don't cause permanent stomach paralysis · Weight regain after stopping is expected since you're treating a chronic medical condition · Muscle loss comes from eating too little, not from the medication directly · The thyroid cancer warning comes from rodent studies and hasn't been observed in humans · GLP-1s actually protect the pancreas rather than damage it NOTABLE QUOTE "Metabolic dysfunction is biological, it's not something within your means to correct just through lifestyle strategies." — Dr. Emily Cooper Links & Resources Podcast Home: fatsciencepodcast.com Cooper Center for Metabolism: coopermetabolic.com Resources from Dr. Cooper: coopermetabolic.com/resources Join Our Community: patreon.com/cw/FatSciencePodcast Submit Your Question: questions@ fatsciencepodcast.com or dr.c@ fatsciencepodcast.com Fat Science is supported by the Diabesity Institute, a nonprofit dedicated to increasing access to effective, science-based metabolic care. This podcast is for informational purposes only and is not intended as medical advice. Please consult with a qualified healthcare provider for personalized recommendations.
The obesity medication landscape just changed — again. One brand-new pill is already in pharmacies, and five more are in various stages of approval. But the real story isn't the drugs themselves: it's what they're revealing about how your metabolism actually works, and why willpower was never the problem. This week on Fat Science, Dr. Emily Cooper, Mark Wright, and Andrea Taylor break down six metabolic medications — two newly FDA-approved and four in the pipeline — covering everything from a flexible new oral GLP-1 pill to drugs that target the brain's central metabolic pathway directly. Dr. Cooper explains the science behind each one, who might benefit, and what the pipeline tells us about the future of metabolic care. This is the most comprehensive drug update the show has done, and it arrives at a moment when the field is moving faster than ever. Key Takeaways Foundayo (orforglipron), approved April 1st, is the first small molecule oral GLP-1 — no empty stomach requirement, no cold chain, and potentially lower production costs long-term. The amylin hormone may uniquely address both "I'm nourished" and "I weigh enough" signals in the brain — making the amylin pathway a powerful and underutilized target. Retatrutide (Lilly's triple agonist targeting GLP-1, GIP, and glucagon receptors) is showing unprecedented effectiveness plus significant non-scale benefits, including fatty liver reduction — but is still years from approval. The brain's melanocortin 4 receptor is the CEO of metabolism — regulating energy expenditure, appetite, and insulin — and new drugs targeting it represent the deepest intervention yet. Many of these medications are showing weight-independent benefits, including improvements in kidney, liver, cardiovascular risk, sleep apnea, and joint health that have nothing to do with how much weight is lost. Notable Quote "Everybody focuses on appetite, and you just need to eat less. But now with these medications and how they actually affect our biology, it becomes very clear that there's so much more to this." — Dr. Emily Cooper Links & Resources Podcast Home: fatsciencepodcast.com Cooper Center for Metabolism: coopermetabolic.com Resources from Dr. Cooper: coopermetabolic.com/resources Join Our Community: patreon.com/cw/FatSciencePodcast Submit Your Question: questions@ fatsciencepodcast.com or dr.c@ fatsciencepodcast.com Fat Science is supported by the Diabesity Institute, a nonprofit dedicated to increasing access to effective, science-based metabolic care. Disclaimer: This podcast is for informational purposes only and is not intended as medical advice. Please consult with a qualified healthcare provider for personalized recommendations.
Have you been told insulin resistance testing doesn't exist or wondered if you're increasing your GLP-1 dose too quickly? Dr. Cooper, Andrea, and Mark tackle listener questions from around the world, addressing common concerns about insulin resistance testing availability, managing severe GI side effects from higher doses, interpreting DEXA scan results, and developing sustainable maintenance strategies. They discuss the difference between hunger and food noise, explain why winter illness might stall weight loss, and share insights about visceral fat concerns even at normal weight. KEY TAKEAWAYS Insulin resistance can be tested through fasting insulin and glucose ratios, even in countries where insulin testing is less common Rapid weight loss rates above 15% annually may indicate no need for dose increases Severe GI side effects warrant investigation beyond medication adjustment, including gallbladder evaluation DEXA scans provide valuable visceral fat measurements, but results should be interpreted alongside overall health markers Maintenance strategies should focus on nutritional stability before considering medication tapering NOTABLE QUOTE "It's not that the medicine causes the rebound weight gain, it's that with the medication in there, the body is getting better signals, and then you go and take the medication away and you're in the same boat." — Dr. Emily Cooper Links & Resources Podcast Home: fatsciencepodcast.com Cooper Center for Metabolism: coopermetabolic.com Resources from Dr. Cooper: coopermetabolic.com/resources Join Our Community: patreon.com/cw/FatSciencePodcast Submit Your Question: questions@ fatsciencepodcast.com or dr.c@ fatsciencepodcast.com Fat Science is supported by the Diabesity Institute, a nonprofit dedicated to increasing access to effective, science-based metabolic care. Disclaimer: This podcast is for informational purposes only and is not intended as medical advice. Please consult with a qualified healthcare provider for personalized recommendations.
Are you getting a GLP-1 prescription from someone who's never examined you? Dr. Vin Gupta, pulmonologist and former Chief Medical Officer at Amazon, joins Dr. Cooper to expose the dangerous gap between legitimate obesity medicine and the unregulated direct-to-consumer market. This conversation reveals why proper medical evaluation matters and how profit-driven platforms are exploiting desperate patients. KEY TAKEAWAYS GLP-1 medications require individualized medical evaluation, not one-size-fits-all prescribing Direct-to-consumer microdosing platforms lack FDA approval and proper medical oversight The erosion of trust in healthcare has created opportunities for unregulated treatments Comprehensive metabolic care includes regular lab work, body composition monitoring, and personalized treatment plans Technology should enhance medical care, not replace proper physician evaluation NOTABLE QUOTE "I see so many people that come in, you know, they're obsessed with monitoring their HRV, their heart rate variability, and yet they had no idea they have pre-diabetes and they had no idea that they have triglyceride levels through the roof." — Dr. Emily Cooper GUEST BIO Dr. Vin Gupta is a pulmonologist, public health expert, and medical analyst for NBC News. He served as Chief Medical Officer at Amazon and has dedicated his career to translating complex science into actionable health insights at both individual and population levels. GLOSSARY GLP-1 medications: Glucagon-like peptide-1 receptor agonists, medications that help regulate blood sugar and appetite, including brand names like Ozempic, Wegovy, and Zepbound Microdosing: Taking smaller amounts of medication than officially prescribed or approved Direct-to-consumer (D2C): Healthcare services that bypass traditional medical settings, often delivered through apps or online platforms HRV: Heart rate variability, a measurement of the variation in time between heartbeats Pre-diabetes: Blood sugar levels that are higher than normal but not high enough to be diagnosed as type 2 diabetes Links & Resources Podcast Home: fatsciencepodcast.com Cooper Center for Metabolism: coopermetabolic.com Resources from Dr. Cooper: coopermetabolic.com/resources Join Our Community: patreon.com/cw/FatSciencePodcast Submit Your Question: questions@fatsciencepodcast.com or dr.c@fatsciencepodcast.com Fat Science is supported by the Diabesity Institute, a nonprofit dedicated to increasing access to effective, science-based metabolic care. Disclaimer: This podcast is for informational purposes only and is not intended as medical advice. Please consult with a qualified healthcare provider for personalized recommendations.
What really happens when you stop GLP-1 medications — and are the headlines telling you the whole story? The answer is more nuanced than social media wants you to believe. This week on Fat Science, Dr. Emily Cooper, Mark Wright, and Andrea Taylor break down four recent studies on GLP-1 treatment outcomes, weight regain, and a groundbreaking new drug that could preserve lean mass during treatment. They walk through the methodology behind each paper, explain why two studies asking the same question got opposite answers, and reveal what a new monoclonal antibody called bimagrumab could mean for the future of metabolic treatment. Key Takeaways When you stop treating any chronic metabolic condition, the condition returns — that's not failure, that's biology. Real-world data showed 56% of people who stopped filling GLP-1 prescriptions maintained or continued losing weight — likely because they continued working with their clinician on alternative treatments. A new monoclonal antibody called bimagrumab showed 11% body weight reduction on its own, while simultaneously increasing lean mass by 3% — without affecting appetite. When combined with semaglutide, bimagrumab reduced lean mass loss from 28% to just 11% of total weight lost. Not eating enough while on GLP-1s drives greater lean mass loss — nutrition is still the best tool for preserving muscle. Notable Quote "It wasn't my failure and it was disease underneath everything. Finding that out — that it wasn't my fault — that was the miracle of the whole process to me." — Andrea Taylor Links & Resources Podcast Home: fatsciencepodcast.com Cooper Center for Metabolism: coopermetabolic.com Resources from Dr. Cooper: coopermetabolic.com/resources Join Our Community: patreon.com/cw/FatSciencePodcast Submit Your Question: questions@fatsciencepodcast.com or dr.c@fatsciencepodcast.com Fat Science is supported by the Diabesity Institute, a nonprofit dedicated to increasing access to effective, science-based metabolic care. Disclaimer: This podcast is for informational purposes only and is not intended as medical advice. Please consult with a qualified healthcare provider for personalized recommendations
Ever wonder why fasting worked at first — then stopped? Or why you lost 80 pounds only to gain back 100? In this mailbag episode, Dr. Emily Cooper, Mark Wright, and Andrea Taylor tackle the most misunderstood topics in metabolic health. From the harsh reality of fasting culture to the surprising metabolic challenges faced by normal-weight individuals, this conversation validates what you've been experiencing and explains the science behind it. You'll also hear why GLP-1 medications aren't just weight loss drugs, why your body might be fighting you even when you're doing everything right, and what happens when your job — like shift work or firefighting — disrupts your metabolism for years. KEY TAKEAWAYS You can have metabolic dysfunction at a normal weight with what appear to be normal labs, for example, when insulin is over suppressed from chronic under-fueling or overexercising Fasting triggers the same biological adaptation as any restrictive diet and typically results in weight regain that's 22 percent higher than starting weight Food noise is biological, not psychological, and stems from an imbalance of hormones and neurotransmitters signaling nutritional insecurity GLP-1 medications may improve immune function because metabolic health and immunity are deeply connected Shift work and chronic sleep disruption can cause real metabolic damage by weakening leptin signals, increasing insulin resistance, and amplifying hunger hormones NOTABLE QUOTE "You can't trick your body. You have to have that foundational fueling in there." — Dr. Emily Cooper Links & Resources Podcast Home: fatsciencepodcast.com Cooper Center for Metabolism: coopermetabolic.com Resources from Dr. Cooper: coopermetabolic.com/resources Join Our Community: patreon.com/cw/FatSciencePodcast Submit Your Question: questions@ fatsciencepodcast.com or dr.c@ fatsciencepodcast.com Fat Science is supported by the Diabesity Institute, a nonprofit dedicated to increasing access to effective, science-based metabolic care. Disclaimer: This podcast is for informational purposes only and is not intended as medical advice. Please consult with a qualified healthcare provider for personalized recommendations.
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Observed July 31, 2026.
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