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The Mailbag: GLP‑1s, Leptin, Hormones & Insurance Advice

Fat Science

Release Date: 10/20/2025

Why GLP-1 Medications Work Even When the Scale Doesn't Move show art Why GLP-1 Medications Work Even When the Scale Doesn't Move

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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Mailbag: Food Tracking, Mechanical Eating Troubleshooting, COVID & Metabolism, and Metformin + GLP-1 Synergy show art Mailbag: Food Tracking, Mechanical Eating Troubleshooting, COVID & Metabolism, and Metformin + GLP-1 Synergy

Fat Science

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.  info_outline Mailbag: GLP-1 Weight Regain, Meals vs Snacks, and Why Some People Don’t Respond show art Mailbag: GLP-1 Weight Regain, Meals vs Snacks, and Why Some People Don’t Respond

Fat Science

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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What the Headlines Get Wrong About GLP-1 Drugs and Metabolism show art What the Headlines Get Wrong About GLP-1 Drugs and Metabolism

Fat Science

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

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GLP-1 Mailbag: Weight Regain, Leptin Resistance, Hypoglycemia & Why Calories Aren’t the Problem show art GLP-1 Mailbag: Weight Regain, Leptin Resistance, Hypoglycemia & Why Calories Aren’t the Problem

Fat 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

More Episodes

Fat Science Ep 106The Mailbag: GLP 1s, Leptin, Hormones & Insurance AdviceThis week on Fat Science, Dr. Emily Cooper, Mark Wright, and Andrea Taylor open the listener mailbag to answer real questions from around the world about metabolism, hormones, and GLP-1 therapy. From the UK to Seattle, listeners share personal stories of confusion and discovery — and Dr. Cooper brings metabolic science back into focus.What really happens when you stop GLP-1 medications? Why can someone eat less yet gain weight? What does leptin resistance actually mean? And how can hopeful moms safely navigate treatment before pregnancy?In this conversation-rich episode, the team moves beyond myths, helping listeners understand how hormones — not willpower — drive metabolism, appetite, and long-term health.Key Takeaways:• GLP-1 medications don’t “work by starving you” — they help the body use energy better by resetting fuel use hormones.• Restrictive eating and “calories in, calories out” oversimplify metabolism and often worsen hormonal imbalance.• Leptin isn’t just about levels — signaling quality determines how well your brain recognizes stored body fat.• Pregnancy and metabolic health require careful timing; GLP-1s aren't used during pregnancy, but improved metabolic strength before conception matters most.• Rapid weight loss from GLP-1 meds can risk muscle depletion; maintaining steady nutrition and proper dosing is key.• Insurance coverage for GLP 1s remains unpredictable, but persistence and documentation can open doors.Personal Stories & Practical Advice:Andrea and Mark share their own experiences reconciling appetite changes on GLP-1 therapy — from remembering to eat when hunger signals quiet down to finding fueling strategies that work.Dr. Cooper offers practical guidance rooted in clinical data: why ordered eating keeps metabolism stable, how dietitians with eating disorder expertise support GLP-1 patients, and when to adjust medication doses to protect muscle mass.Notable Quote:“It’s not technically the weight that’s messing up fertility — it’s the metabolic dysfunction that causes weight as a symptom.” — Emily Cooper, MD.In this listener mailbag edition of Fat Science, Dr. Emily Cooper, Mark Wright, and Andrea Taylor unpack the science behind GLP-1 medications, leptin resistance, and hormone balance. From fertility to appetite changes and insurance frustrations, this episode explains how metabolism—not willpower—drives lasting health. Hear real-world advice on fueling, mechanical eating, and safe GLP-1 use.

Resources from the episode:

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’re committed to a world where people understand that fat isn’t a failure and metabolism is not a math problem.This show is for informational purposes only and not a substitute for medical advice.

Check out our website where you can ask a mailbag question.

Have a question for Dr. Cooper, a show idea, feedback, or just want to connect?Email us at questions@fatsciencepodcast.com or dr.c@fatsciencepodcast.com.

Connect with:
Dr. Emily Cooper on LinkedIn
Mark Wright on LinkedIn
Andrea Taylor on Instagram