GLP-1 Mailbag: Weight Regain, Leptin Resistance, Hypoglycemia & Why Calories Aren’t the Problem
Release Date: 01/05/2026
Fat Science
What if the scale isn't moving, but your health is dramatically improving?
If you've ever felt discouraged because the number on the scale won't budge—even on a GLP-1 medication—this episode will change how you think about these drugs. Dr. Cooper breaks down the research showing that the biggest benefits have nothing to do with weight loss. It's all about metabolic health.
This Week on Fat Science
Dr. Emily Cooper, Mark Wright, and Andrea Taylor expl
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This week on Fat Science, Dr. Emily Cooper, Mark Wright, and Andrea Taylor answer listener mailbag questions from California, the UK, France, Washington, Wyoming, and beyond.
The team breaks down why Dr. Cooper does not recommend calorie tracking (and when limited tracking can make sense), how to build confidence in eating without data, and why “mechanical eating” sometimes needs medical customization—especially for people with slow gut transit or gastroparesis-like symptoms.
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his week on Fat Science, Dr. Emily Cooper, Mark Wright, and Andrea Taylor answer listener mailbag questions that get to the heart of metabolic health. The team explains the real difference between meals and snacks, discusses whether GLP-1 medications can be appropriate for children in complex cases, explores why some people appear to be “non-responders” to Wegovy, and breaks down why alarming headlines about rapid weight regain miss the bigger metabolic picture. They also explain how to set
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This week on Fat Science, Dr. Emily Cooper, Mark Wright, and Andrea Taylor break down two GLP-1 studies that challenge a major media myth: GLP-1 medications don’t drive weight loss just because people eat less. Instead, drugs like tirzepatide and semaglutide create direct metabolic shifts—including increased fat oxidation and improved fuel partitioning—regardless of appetite.
The team also explores mechanical eating, the psychological impact of “diet food,” and Andrea’s 13-yea
info_outlineFat Science
This week on Fat Science, Dr. Emily Cooper, Mark Wright, and Andrea Taylor tackle a wide-ranging mailbag episode with listener questions from the U.S., UK, and Europe. Topics include unexpected weight regain on GLP-1s, post-meal sleepiness and hypoglycemia, metabolic dysfunction despite normal labs, GLP-1 dosing strategies, and why these medications are about metabolism, not appetite suppression.
Key Questions Answered
- Why can weight regain happen on info_outline
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This week on Fat Science, Dr. Emily Cooper, Mark Wright, and Andrea Taylor talk with pediatric eating disorder specialist Dr. Julie O’Toole (Kartini Clinic) and pediatric obesity expert Dr. Evan Nadler about what childhood obesity really is: a biologic, metabolic disease—not a willpower problem and not a failure of parenting.
They explore how excess weight, constant hunger, and disordered eating in kids are often signs of underlying metabolic dysfunction and genetics—and why the old
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This week on Fat Science, Dr. Emily Cooper, Mark Wright, and Andrea Taylor talk with exercise physiologist Russell Cunningham and patient Becca Wert about a counterintuitive reality: for some people, exercise can actually slow metabolism, stall weight loss, and trigger weight gain—especially when the brain senses a threat to energy availability.
Dr. Cooper explains how overtraining, under-fueling, and even thinking about workouts can activate famine signals in the brain and shut down
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This week on Fat Science, Dr. Emily Cooper, Mark Wright, and Andrea Taylor unpack the biggest GLP-1 headlines from around the world—from the World Health Organization’s first-ever GLP-1 obesity guidelines to access battles, brain research, and the coming wave of generics and new meds.
Dr. Cooper explains what the WHO’s move really means for patients, why long-term treatment matters, and how policy decisions in places like California and India could reshape who actually benefits from
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This week on Fat Science, Dr. Emily Cooper, Mark Wright, and Andrea Taylor answer listener questions about BMI cutoffs, weight cycling, metabolic adaptation, trauma, GLP-1 differences, and why some people gain weight on ultra-low calories. Dr. Cooper explains what’s really happening inside the metabolic system and why individualized treatment—not dieting—creates sustainable change.
Key Questions Answered
- If my BMI doesn’t “qualify” for GLP-1s, is Na info_outline
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Dr. Emily Cooper, Mark Wright, and Andrea Taylor talk with Maria from Buffalo, a longtime listener who shares her lifelong journey with obesity, psoriatic arthritis, and binge eating—and how finally understanding the science of metabolism gave her hope. Maria describes early childhood weight gain, joint damage, and years of restrictive dieting and food shame, then explains how GLP‑1 therapy (Zepbound) plus mechanical eating helped her lose about 50 pounds while eating more food, more often, and with
info_outlineThis week on Fat Science, Dr. Emily Cooper, Mark Wright, and Andrea Taylor tackle a wide-ranging mailbag episode with listener questions from the U.S., UK, and Europe. Topics include unexpected weight regain on GLP-1s, post-meal sleepiness and hypoglycemia, metabolic dysfunction despite normal labs, GLP-1 dosing strategies, and why these medications are about metabolism, not appetite suppression.
Key Questions Answered
- Why can weight regain happen on GLP-1s even when habits haven’t changed?
- How do leptin, ghrelin, injury, stress, and under-fueling affect weight regulation?
- What does it mean if you get extremely sleepy after meals—is it hypoglycemia?
- Do GLP-1s increase insulin in a harmful way for non-diabetics?
- Can you have metabolic dysfunction with normal A1C, cholesterol, and blood pressure?
- Do GLP-1 medications “wear off,” and how should dosing be adjusted long term?
- Are GLP-1s just appetite suppressants—or true metabolic treatment?
- Is it possible to undo decades of calorie counting and restriction-based thinking?
- What are the risks of the return to extreme thinness in celebrity culture?
Key Takeaways
- Calories don’t explain metabolism. GLP-1 and GIP work across the brain and body—repairing signaling, not just reducing appetite.
- Leptin matters after dieting. Years of restriction and weight cycling can weaken leptin signaling, making the brain defend weight gain.
- Fueling is foundational. Medication can’t replace adequate food, sleep, and recovery.
- Post-meal fatigue is a clue. Reactive hypoglycemia is common and often misunderstood.
- Lowest effective dose wins. GLP-1 success is about pacing, not racing to the max dose.
- Chasing the “last 10 pounds” can backfire. Cosmetic restriction can create new metabolic problems.
Dr. Cooper’s Actionable Tips
- If weight gain appears after injury or stress, focus first on sleep, regular meals, and full fueling, not restriction.
- Suspected hypoglycemia? Ask about a mixed meal tolerance test to assess glucose and insulin response.
- Stay on the lowest GLP-1 dose that’s working and adjust only when progress truly stalls.
- Push back on “appetite suppressant” language—these meds amplify hormones your body already makes.
Notable Quote
“GLP-1s aren’t about eating less—they’re about strengthening metabolic signaling” — Dr. Emily Cooper
Links & Resources
Podcast Home: Fat Science Podcast Website – https://fatsciencepodcast.com/
Podcast Episode References: https://fatsciencepodcast.com/wp-content/uploads/2025/06/Scientific-References-Fat-Science-Episodes.pdfCooper Center for Metabolism & Fat Science Episodes: https://coopermetabolic.com/podcast/
Resources from Dr. Cooper: https://coopermetabolic.com/resources/
Submit a Show Question: questions@fatsciencepodcast.com
Dr. Cooper direct show email: dr.c@fatsciencepodcast.com
Fat Science breaks diet myths and advances the science of real metabolic health. No diets, no agendas—just science that makes you feel better. This show is informational only and does not constitute medical advice.