Fat Science

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: [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.
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: [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.
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: [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.
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: [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.
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 eight hours in bed but still waking up exhausted?
Dr. Emily Cooper shares groundbreaking findings from nearly 15,000 patient encounters at her metabolic clinic. The data reveals surprising connections between stress, eating frequency, sleep quality, and metabolic health — and why the number of hours you spend in bed doesn't tell the whole story.
KEY TAKEAWAYS
Over 60% of patients reported trouble staying asleep, even when they got eight hours in bed
Higher stress levels were associated with double the rate of low energy and significantly worse sleep quality
Eating frequency matters — patients eating five times per day reported the best sleep and highest energy levels
The sweet spot between meals is two to four hours — longer gaps were linked to sleep disruption and low energy
Any amount of alcohol was associated with fragmented sleep, regardless of stress levels
Nearly 65% of patients were not hydrating adequately throughout the day
NOTABLE QUOTE
"If your cortisol goes high, we can get the same effects that happen when we take steroids, which we know promote pre-diabetes, insulin resistance, weight gain." — 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: [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.
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.