Fat Science Mailbag: The Dangers of Restricting Calories, Bariatric Plateaus, GLP-1 Dose Adjustments, Weight Expectations & More
Release Date: 07/28/2025
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
info_outlineFat 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_outlineFat 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
info_outlineFat 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
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
Fat Science
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
info_outlineFat Science
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
info_outlineFat Science
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
info_outlineFat Science
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
Fat Science
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, Andrea Taylor, and Mark Wright open the Fat Science mailbag to answer listener questions from around the globe.
This episode covers real-world metabolic challenges—from navigating calorie restriction and GLP-1 medications to the complexities of bariatric surgery, prednisone’s impact on weight, and menopause.
Dr. Cooper offers clear explanations and practical advice for healthcare professionals and patients alike on understanding metabolic dysfunction, interpreting lab results, and setting realistic weight loss expectations.
Key Takeaways:
- Calorie restriction and intermittent fasting can destabilize metabolism, making recovery complex for some patients—gradual changes and medical monitoring are essential.
- Bariatric surgery can be an effective intervention for those with significant insulin resistance or high hunger signals. Pre-surgery metabolic testing (like insulin, glucose, and ghrelin levels) is valuable in assessing the likely benefit.
- Plateaus after surgery, persistent weight struggles, and the role of genetics highlight the need for root-cause investigation, not just symptom management.
- Prednisone and hormone therapies (including MHT for menopause) can affect metabolic health; small dietary adjustments, body composition testing, and tailored exercise are crucial for optimizing outcomes.
- Guidance on GLP-1 medication maintenance: Most patients benefit from staying on weight loss meds long-term, but dose adjustment is possible when side effects arise. Stability over many months is critical before considering any taper.
Personal Stories & Practical Advice:
- Andrea shares her experience with bariatric surgery and ongoing metabolic management, emphasizing realistic expectations and the benefit of medication-surgery synergy.
- Listeners ask: how to evaluate readiness to stop weight loss meds, address side effects, and balance hormone needs during menopause.
Resources from the episode:
Fat Science is a podcast on a mission to share the real science behind why we get fat, addressing stigma and confusion with facts, hope, and empowering stories.
- Updates on Dr. Cooper’s upcoming virtual metabolic health training—ideal for practitioners in the UK and beyond.
- Information about Melanocortin pathway testing programs for severe, persistent obesity.https://uncoveringrareobesity.com/
- Link to previous show. “GLP-1s: Will I Have to Take Them Forever?” (5/19/25)https://open.spotify.com/episode/1GZA71gTMSz0idbnEYblVO?si=gJXxNkbYTHykhNDw0Ebltg
- 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 info@diabesityinstitute.org ordr.c@fatsciencepodcast.com.
Fat 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/