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Mailbag: GLP-1s, Liver Health, Mechanical Eating & Metabolic Truths

Fat Science

Release Date: 08/25/2025

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

This week on Fat Science we answer your questions in another, always-popular mailbag episode. Join Mark Wright, Andrea Taylor, and Dr. Emily Cooper and learn why some people don’t respond to GLP-1 medications, get the latest on new, oral weight-loss drugs, and explore the science behind elevated liver enzymes. 

Dr. Cooper offers practical insights backed by metabolic research. She also addresses gluten-free diets, flavored seltzers, craving pathways in the brain, chronic pain management, and the importance of consistent eating patterns for metabolic health.

Key Takeaways:

  • About 20% of people may not respond to GLP-1s due to genetic and metabolic differences; deeper lab and genetic testing may be needed to uncover root causes.
  • New oral GLP-1 options like Orforglipron are on the horizon, promising greater convenience and accessibility.
  • Transient increases in liver enzymes can occur with rapid weight changes; regular monitoring and medical guidance are important.
  • The POMC pathway in the brain plays a crucial role in cravings and metabolism—medications like Contrave can help by targeting this pathway.
  • Flavored seltzers are generally fine, but watch for BPA-lined cans; gluten-free isn’t always healthier unless medically necessary.
  • Chronic pain medications often impact metabolism—exploring underlying metabolic causes and non-GABA, non-opioid alternatives with providers is key.
  • Consistent, “patterned” eating supports metabolic stability and brain function.

Personal Stories & Practical Advice:

  • Andrea shares how tweaking her medication “cocktail” and eating patterns improved her results.
  • Dr. Cooper and Mark discuss real-life snack strategies for fueling brain power and avoiding metabolic pitfalls.

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 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.

Check out our new website where you can ask a mailbag question and sign up to be in the audience for our 100th episode we’re recording on Thursday, September 4th at 9 a.m.PST. Be part of the live audience and ask Dr. Cooper a question. We’d love to celebrate this milestone with you!

If you 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.