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Metabolic Drugs: Why One Size Doesn’t Fit All

Fat Science

Release Date: 07/21/2025

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 unpack the latest breakthroughs in metabolic medications and why individual biology requires personalized treatment. 

Dr. Cooper explains how modern therapies for metabolic dysfunction go far beyond the old “one pill fixes all” approach. Discover how hormone-based medications like GLP-1 agonists are changing obesity and diabetes care, why medication response can differ drastically between individuals, and what the future holds for tailored metabolic treatments. 

You’ll come away with a clearer understanding of why effective weight management isn’t just about diet or willpower—it’s about precision medicine.

Key Takeaways:

  • Metabolic dysfunction is a complex, multi-hormonal disease; no single medication will work for everyone.
  • New therapies, including dual and triple hormone agonists (like GLP-1, GIP, and amylin analogs), offer synergistic and individualized effects.
  • Clinical observation shows that increasing doses or the “latest” medication doesn’t guarantee better results—some people may even find that their progress disappears after increasing to maximal doses.
  • Lab markers (like ghrelin and leptin) could help personalize treatment, but cost and availability limit widespread testing.
  • Concerns about muscle loss with GLP-1 drugs are common, but clinically, the risk mostly depends on nutrition, strength routines and muscle mass at baseline.
  • Accessibility and cost remain barriers; new small-molecule drugs may improve affordability in the near future.

Personal Stories & Practical Advice:

  • Andrea relates how understanding her true metabolic issues, rather than just dieting, led to sustainable health changes.
  • Dr. Cooper describes her clinic’s approach to measuring body composition and tracking lean mass to avoid unwanted muscle loss.
  • Listeners are encouraged to work with knowledgeable providers, beware of “one size fits all” narratives, and stay hopeful as newer, more effective treatments emerge.

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.

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/