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Fat Science Mailbag: The Dangers of Restricting Calories, Bariatric Plateaus, GLP-1 Dose Adjustments, Weight Expectations & More

Fat Science

Release Date: 07/28/2025

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, 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.

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/