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 TAKEAWAYSTrusting 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 & RESOURCESAmerican Board of Obesity Medicine: obesitymedicine.org Links & ResourcesPodcast Home: fatsciencepodcast.comCooper Center for Metabolism: coopermetabolic.comResources from Dr. Cooper: coopermetabolic.com/resourcesJoin Our Community: patreon.com/cw/FatSciencePodcastSubmit Your Question: [email protected] or [email protected] 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 TAKEAWAYSEvery single person tested had at least 6 plastic chemicals in their urine, with food packaging being the primary sourceParticipants cut phthalate levels by 38-54% and BPA by 60% in just 7 days with adjustments in reducing plastic exposure in food and food packagingUltra-processed foods introduce plastic chemicals through multiple processing and packaging stepsCertain chemicals like DEHP may be stored in fat tissue and released during weight lossHeat accelerates plastic migration into food - avoid microwaving in plastic and pouring hot food into plastic containersSimple swaps like choosing fresh over canned foods and using glass containers make significant impactsThe EPA research office studying these chemicals was recently eliminated, removing key consumer protectionsNOTABLE 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 CooperLinks & ResourcesPodcast Home: fatsciencepodcast.comCooper Center for Metabolism: coopermetabolic.comResources from Dr. Cooper: coopermetabolic.com/resourcesJoin Our Community: patreon.com/cw/FatSciencePodcastSubmit Your Question: [email protected] or [email protected] 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 TakeawaysWhy fasting and restrictive eating may worsen metabolic adaptationThe real role insulin plays in metabolic healthHow PCOS and lipedema complicate weight loss treatmentWhy some people plateau on GLP-1 medications over timeThe importance of fueling, muscle preservation, and individualized careLinks & ResourcesPodcast Home: fatsciencepodcast.comCooper Center for Metabolism: coopermetabolic.comResources from Dr. Cooper: coopermetabolic.com/resourcesJoin Our Community: patreon.com/cw/FatSciencePodcastSubmit Your Question: [email protected] or [email protected] 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 TAKEAWAYSWeight and metabolic health are not the same thing - you can be metabolically unhealthy at any sizeNormal weight people with metabolic dysfunction are often overlooked and undertreated by healthcare providersKey screening tests include fasting glucose, insulin, HbA1c, triglycerides, HDL cholesterol, blood pressure, and inflammatory markers like HSCRPMetabolic dysfunction can start in your 20s and take decades to develop into serious diseaseBoth normal weight and higher weight patients face bias - normal weight people aren't screened enough, while higher weight people have everything blamed on their weightEarly screening and treatment can prevent catastrophic health outcomes later in lifeThe liver plays a crucial role in metabolism and can become insulin resistant regardless of body weightNOTABLE 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 CooperLinks & ResourcesPodcast Home: fatsciencepodcast.comCooper Center for Metabolism: coopermetabolic.comResources from Dr. Cooper: coopermetabolic.com/resourcesJoin Our Community: patreon.com/cw/FatSciencePodcastSubmit Your Question: [email protected] or [email protected]: Key ReferencesPrimary 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 TAKEAWAYSWeight regain while on GLP-1 medications is more common than most people realizeHair loss from weight loss medications is usually related to nutrient deficiencies, not the medication itselfLeptin dysfunction involves both hormone levels and signaling pathways throughout the bodyHypoglycemia after meals often indicates complex metabolic issues that require specialized testingStarting elderly patients on GLP-1s requires careful monitoring of nutrition, blood pressure, and side effectsMechanical eating differs from intuitive eating and remains important even when medications are workingAnnual weight loss rates of 10% or higher indicate medications are still effectiveNOTABLE 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 CooperLinks & ResourcesPodcast Home: fatsciencepodcast.comCooper Center for Metabolism: coopermetabolic.comResources from Dr. Cooper: coopermetabolic.com/resourcesJoin Our Community: patreon.com/cw/FatSciencePodcastSubmit Your Question: [email protected] or [email protected] 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 TAKEAWAYSThree major obesity organizations worked collaboratively to issue guidelines prioritizing quality of life over weight loss as primary treatment goalsGuidelines explicitly address medical stigma as a structural barrier to care requiring systemic changeTreatment is positioned as long-term management similar to other chronic conditions like thyroid disordersDocument notably avoids calorie restriction language, focusing instead on healthy lifestyle alongside medicationSetmelanotide receives strong recommendation for rare genetic obesity conditions with available genetic testingStrong medication recommendations now include GLP-1s like semaglutide and tirzepatide, plus bupropion-naltrexone combinationNOTABLE 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 TaylorReference LinkAlexander 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 & ResourcesPodcast Home: fatsciencepodcast.comCooper Center for Metabolism: coopermetabolic.comResources from Dr. Cooper: coopermetabolic.com/resourcesJoin Our Community: patreon.com/cw/FatSciencePodcastSubmit Your Question: [email protected] or [email protected] 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 TAKEAWAYSPCOS is now officially called PMOS - Polyendocrine Metabolic Ovarian Syndrome - shifting focus from ovarian problems to metabolic dysfunction70 million women globally are affected during reproductive years, with 70% remaining undiagnosedThe condition can occur at any weight and is driven by insulin resistance and other metabolic signals, not ovarian problemsTreatment should focus on metabolic health rather than weight loss or ovarian interventionsThe name change parallels similar shifts in medicine like MASLD replacing non-alcoholic fatty liver diseaseNOTABLE 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 CooperLinks & ResourcesPodcast Home: fatsciencepodcast.comCooper Center for Metabolism: coopermetabolic.comResources from Dr. Cooper: coopermetabolic.com/resourcesJoin Our Community: patreon.com/cw/FatSciencePodcastSubmit Your Question: [email protected] or [email protected] 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 TAKEAWAYSEating disorders like anorexia require comprehensive medical team treatment, not self-management approachesSide effects from GLP-1 medications often improve with consistent eating patterns and adequate nutritionThe calories in calories out model ignores the biological complexity of how your body actually burns fuelPCOS responds well to metabolic treatments because it's driven by underlying insulin and hunger hormone imbalancesSleep deprivation and chronic stress significantly impact GLP-1 effectiveness and overall metabolic functionBioidentical progesterone may help perimenopause sleep issues without the metabolic side effects of older formulationsStroke survivors may experience hypothalamic obesity that responds remarkably well to GLP-1 medicationsNOTABLE 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 CooperLinks & ResourcesPodcast Home: fatsciencepodcast.comCooper Center for Metabolism: coopermetabolic.comResources from Dr. Cooper: coopermetabolic.com/resourcesJoin Our Community: patreon.com/cw/FatSciencePodcastSubmit Your Question: [email protected] or [email protected] 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 TAKEAWAYSLipedema affects 20% of the female population but is routinely misdiagnosed as obesityThe condition involves abnormal fat cell response to inflammation, creating painful tissue that resists weight loss86% of lipedema patients also have venous insufficiency, creating a perfect storm of symptomsAnkle cuffs, knee pouches, and saddlebags are classic physical signs that patients often notice from pubertyGLP-1 medications like tirzepatide may help reduce inflammation and tissue tendernessLipedema reduction surgery exists but lacks insurance billing codes, making access challengingA formal medical recognition campaign is underway to establish diagnostic codes by 2026-2027NOTABLE 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 DerrickGUEST BIODr. 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 & ResourcesPodcast Home: fatsciencepodcast.comCooper Center for Metabolism: coopermetabolic.comResources from Dr. Cooper: coopermetabolic.com/resourcesJoin Our Community: patreon.com/cw/FatSciencePodcastSubmit Your Question: [email protected] or [email protected] 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 & ResourcesPodcast Home: fatsciencepodcast.comCooper Center for Metabolism: coopermetabolic.comResources from Dr. Cooper: coopermetabolic.com/resourcesJoin Our Community: patreon.com/cw/FatSciencePodcastSubmit Your Question: [email protected] or [email protected] 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.