Fat Science

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: [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 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: [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.

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: [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.

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: [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.

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: [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.