Fat Science

• Fatty Liver Disease: What You Need to Know

  This week on Fat Science, Dr. Emily Cooper, Andrea Taylor, and Mark Wright uncover the truth about fatty liver disease and its rapid rise in both adults and children. It’s estimated 125 million Americans have the disease. Dr. Cooper explains the critical role the liver plays in metabolism—covering hundreds of essential functions—and why fatty infiltration poses serious risks. The episode demystifies diagnosis, risk factors, and treatment options, empowering listeners to take a proactive approach to liver health and metabolic wellness.Key Takeaways:Fatty liver disease, now known as MASLD—Metabolic Dysfunction-Associated Steatotic Liver Disease, affects about 30% of adults, and is rising in youth, especially those with obesity or type-2 diabetes.Risk is not limited to higher body weights; up to 15% of normal-weight people are also affected, with genetics playing a significant role.Diagnosis can be tricky: blood enzymes (ALT, AST) and platelet counts factor into the highly predictive FIB-4 score, while imaging (like fibroscan) provides clarity on severity.Untreated, fatty liver can progress to inflammation, fibrosis, and even require a liver transplant, though early-stage disease is often reversible with proper intervention.Treatment focuses on improving metabolic function—through medication, diabetes management, and sometimes lifestyle changes—as solely relying on diet and exercise may not be enough, particularly for advanced cases.Personal Stories & Practical Advice:Andrea shares her own experience discovering fatty liver disease and seeing rapid improvement after metabolic treatment.The hosts discuss common misconceptions, and why liver health should be checked in both children and adults, regardless of body size or outward health.Resources:Connect with Dr. Emily Cooper on LinkedIn.Connect with Mark Wright on LinkedIn.Connect with Andrea Taylor on Instagram.Fat Science is a podcast on a mission to explain where our fat really comes from and why it won’t go and stay away. We are committed to creating a world where people are empowered with accurate information about metabolism and recognize that fat isn’t a failure. This podcast is for informational purposes only and is not intended to replace professional medical advice.If you have a question for Dr. Cooper, a show idea, feedback, or just want to connect, email us at [email protected] or [email protected] is supported by the non-profit Diabesity Institute which is on a mission to increase access to effective, science-based medical care for those suffering from or at risk for diabesity. https://diabesityresearchfoundation.org/

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• Is Male Menopause Real?

  This week on Fat Science, Dr. Emily Cooper, Andrea Taylor, and Mark Wright explore the concept of “male menopause” and whether it’s backed by science. Dr. Cooper breaks down hormonal changes in men, including testosterone decline, metabolic dysfunction, and the myths surrounding andropause. The episode dives into why men and women experience aging differently, how metabolism ties into hormone shifts, and what really happens to male fertility and energy over time. After listening, you’ll understand why “male menopause” isn’t the full story and what really matters for men’s health as they age.Key Takeaways:There’s no sudden “male menopause”—testosterone declines gradually in men, unlike the rapid hormonal changes seen in female menopause.Metabolic dysfunction can suppress testosterone in men, leading to fatigue, muscle loss, and changes in body fat distribution.Converting testosterone to estrogen in belly fat can further suppress testosterone, creating a cycle that impacts energy and mood.Testosterone therapy might be beneficial for some men with low levels, but should always be guided by a healthcare provider after thorough evaluation.Most supplements marketed to “boost testosterone” are unproven and potentially unsafe—focus on medical advice and proper testing.Personal Stories & Practical Advice:Mark shares his journey with testosterone treatment and how restoring balance improved his mood and energy.Andrea and Dr. Cooper discuss the importance of understanding individual lab results, getting the full metabolic picture, and consulting with primary care providers before considering hormone therapy.Resources:Connect with Dr. Emily Cooper on LinkedIn.Connect with Mark Wright on LinkedIn.Connect with Andrea Taylor on Instagram.Fat Science is a podcast on a mission to explain where our fat really comes from and why it won’t go and stay away. We are committed to creating a world where people are empowered with accurate information about metabolism and recognize that fat isn’t a failure. This podcast is for informational purposes only and is not intended to replace professional medical advice.If you have a question for Dr. Cooper, a show idea, feedback, or just want to connect, email us at [email protected] or [email protected] is supported by the non-profit Diabesity Institute which is on a mission to increase access to effective, science-based medical care for those suffering from or at risk for diabesity. https://diabesityresearchfoundation.org/

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  34:32
• The Rise of Metabolic Telehealth

  This week on Fat Science, Dr. Emily Cooper, Andrea Taylor, and Mark Wright explore the expanding world of telehealth in treating metabolic issues. Dr. Cooper sheds light on both the promise and pitfalls of accessing medications like GLP-1s through online platforms. The episode dives into the effectiveness of patient-provider relationships, the importance of comprehensive and personalized care, and the potential red flags in impersonal telehealth services. After listening, you’ll understand the benefits of telehealth and why thoughtful, thorough medical guidance is crucial for metabolic health.Key Takeaways:Telehealth has improved accessibility and convenience for metabolic care, but not all platforms offer the same quality of support.The lack of personalized interaction and lab-based assessments in many telehealth services can pose risks to patient health.Quick, transactional telehealth models often prioritize medication sales over holistic care and ongoing patient monitoring.Comprehensive care requires detailed history-taking, follow-up, and lab work—elements often missing in mass-market telehealth.Listeners should watch for red flags such as no direct provider interaction, absence of lab testing, and subscription models tied to product sales.Personal Stories & Practical Advice:Andrea reflects on her own journey and the difference a dedicated, whole-person approach made to her health.Dr. Cooper shares her experience testing a mass-market telehealth site, exposing the superficial nature of some programs.The panel urges listeners to seek out board-certified providers and reputable telehealth organizations for genuine care.Link to US National telehealth clinics with Board Certified Obesity Medicine providers: Knownwell (non-affiliated)Resources:Connect with Dr. Emily Cooper on LinkedIn.Connect with Mark Wright on LinkedIn.Connect with Andrea Taylor on Instagram.Fat Science is a podcast on a mission to explain where our fat really comes from and why it won’t go and stay away. We are committed to creating a world where people are empowered with accurate information about metabolism and recognize that fat isn’t a failure. This podcast is for informational purposes only and is not intended to replace professional medical advice.If you have a question for Dr. Cooper, a show idea, feedback, or just want to connect, email us at [email protected] [email protected] is supported by the non-profit Diabesity Institute which is on a mission to increase access to effective, science-based medical care for those suffering from or at risk for diabesity. https://diabesityresearchfoundation.org/

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  39:45
• Mailbag: Metabolism Myths, Plateaus, and More

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

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  33:26
• Why Sometimes It Takes a Little Patience

  This week on Fat Science, Dr. Emily Cooper, Andrea Taylor, and Mark Wright explore why metabolic health transformations require time, persistence, and a holistic approach. Andrea shares her 14-year journey with Dr. Cooper, highlighting the slow, individualized nature of healing a dysfunctional metabolism and why quick fixes rarely work. Dr. Cooper explains how complex feedback loops, hormonal adaptations, and life events can slow progress—and why health markers, not just the number on the scale, are crucial measures of success. The conversation encourages patience, self-compassion, and a focus on sustainable health, not just rapid weight loss.Key Takeaways:Healing metabolic dysfunction is a complex, highly individualized process that often takes years—not weeks or months.Dieting, stress, disrupted sleep, and misguided exercise can send the body into "famine mode," making weight loss even harder.Metrics like blood pressure, cholesterol, and glucose often improve before significant weight loss occurs—these health gains matter.Medications and bariatric surgery can help in stubborn cases, but long-term success depends on a combination of medical, lifestyle, and psychological support.As many as 20% of patients may be "non-responders" to current treatments, highlighting the need for ongoing metabolic research and new therapies.Personal Stories & Practical Advice:Andrea details her long road—from early GLP-1 medications and plateaus to bariatric surgery and ongoing adjustments—with the emphasis that patience paid off.Dr. Cooper and Mark reinforce the importance of redefining food as fuel and joy, not the enemy, and letting go of blame or unrealistic expectations tied to the scale.The episode highlights small wins, the value of routine lab work, and celebrating all forms of progress—especially the non-scale victories.Resources:Connect with Dr. Emily Cooper on LinkedIn.Connect with Mark Wright on LinkedIn.Connect with Andrea Taylor on Instagram.Fat Science is a podcast on a mission to explain where our fat really comes from and why it won’t go and stay away. We are committed to creating a world where people are empowered with accurate information about metabolism and recognize that fat isn’t a failure. This podcast is for informational purposes only and is not intended to replace professional medical advice.If you have a question for Dr. Cooper, a show idea, feedback, or just want to connect, email us at [email protected] or [email protected] is supported by the non-profit Diabesity Institute which is on a mission to increase access to effective, science-based medical care for those suffering from or at risk for diabesity. https://diabesityresearchfoundation.org/

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