Fat Science

This week on Fat Science, Dr. Emily Cooper, Andrea Taylor, and Mark Wright uncover the truth about fatty liver disease and its rapid rise in both adults and children. It’s estimated 125 million Americans have the disease. 

Dr. Cooper explains the critical role the liver plays in metabolism—covering hundreds of essential functions—and why fatty infiltration poses serious risks. The episode demystifies diagnosis, risk factors, and treatment options, empowering listeners to take a proactive approach to liver health and metabolic wellness.

Key Takeaways:

• Fatty liver disease, now known as MASLD—Metabolic Dysfunction-Associated Steatotic Liver Disease, affects about 30% of adults, and is rising in youth, especially those with obesity or type-2 diabetes.
• Risk is not limited to higher body weights; up to 15% of normal-weight people are also affected, with genetics playing a significant role.
• Diagnosis can be tricky: blood enzymes (ALT, AST) and platelet counts factor into the highly predictive FIB-4 score, while imaging (like fibroscan) provides clarity on severity.
• Untreated, fatty liver can progress to inflammation, fibrosis, and even require a liver transplant, though early-stage disease is often reversible with proper intervention.
• Treatment focuses on improving metabolic function—through medication, diabetes management, and sometimes lifestyle changes—as solely relying on diet and exercise may not be enough, particularly for advanced cases.

Personal Stories & Practical Advice:

• Andrea shares her own experience discovering fatty liver disease and seeing rapid improvement after metabolic treatment.
• The hosts discuss common misconceptions, and why liver health should be checked in both children and adults, regardless of body size or outward health.

Resources:

• 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 [email protected] or [email protected].

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/

This week on Fat Science, Dr. Emily Cooper, Andrea Taylor, and Mark Wright explore the concept of “male menopause” and whether it’s backed by science. Dr. Cooper breaks down hormonal changes in men, including testosterone decline, metabolic dysfunction, and the myths surrounding andropause. 

The episode dives into why men and women experience aging differently, how metabolism ties into hormone shifts, and what really happens to male fertility and energy over time. After listening, you’ll understand why “male menopause” isn’t the full story and what really matters for men’s health as they age.

Key Takeaways:

• There’s no sudden “male menopause”—testosterone declines gradually in men, unlike the rapid hormonal changes seen in female menopause.
• Metabolic dysfunction can suppress testosterone in men, leading to fatigue, muscle loss, and changes in body fat distribution.
• Converting testosterone to estrogen in belly fat can further suppress testosterone, creating a cycle that impacts energy and mood.
• Testosterone therapy might be beneficial for some men with low levels, but should always be guided by a healthcare provider after thorough evaluation.
• Most supplements marketed to “boost testosterone” are unproven and potentially unsafe—focus on medical advice and proper testing.

Personal Stories & Practical Advice:

• Mark shares his journey with testosterone treatment and how restoring balance improved his mood and energy.
• Andrea and Dr. Cooper discuss the importance of understanding individual lab results, getting the full metabolic picture, and consulting with primary care providers before considering hormone therapy.

Resources:

• 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 [email protected] or [email protected].

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/

This week on Fat Science, Dr. Emily Cooper, Andrea Taylor, and Mark Wright explore the expanding world of telehealth in treating metabolic issues. Dr. Cooper sheds light on both the promise and pitfalls of accessing medications like GLP-1s through online platforms. The episode dives into the effectiveness of patient-provider relationships, the importance of comprehensive and personalized care, and the potential red flags in impersonal telehealth services. After listening, you’ll understand the benefits of telehealth and why thoughtful, thorough medical guidance is crucial for metabolic health.

Key Takeaways:

• Telehealth has improved accessibility and convenience for metabolic care, but not all platforms offer the same quality of support.
• The lack of personalized interaction and lab-based assessments in many telehealth services can pose risks to patient health.
• Quick, transactional telehealth models often prioritize medication sales over holistic care and ongoing patient monitoring.
• Comprehensive care requires detailed history-taking, follow-up, and lab work—elements often missing in mass-market telehealth.
• Listeners should watch for red flags such as no direct provider interaction, absence of lab testing, and subscription models tied to product sales.

Personal Stories & Practical Advice:

• Andrea reflects on her own journey and the difference a dedicated, whole-person approach made to her health.
• Dr. Cooper shares her experience testing a mass-market telehealth site, exposing the superficial nature of some programs.
• The panel urges listeners to seek out board-certified providers and reputable telehealth organizations for genuine care.

Link to US National telehealth clinics with Board Certified Obesity Medicine providers: Knownwell (non-affiliated)

Resources:

• 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 [email protected] or[email protected].

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/

This week on Fat Science, Dr. Emily Cooper, Andrea Taylor, and Mark Wright answer listener questions from around the world about metabolic health. This mailbag episode explores widely-debated topics like “starvation mode,” weight loss plateaus, the relationship between metabolism and cognitive health, cannabis and metabolism, metabolic effects of liposuction, and the latest on GLP-1 medications.

Key Takeaways:

• Dr. Cooper dispels myths around “starvation mode,” citing research on the long-term metabolic impact of dieting and caloric restriction.
• Weight loss plateaus are often misunderstood—Dr. Cooper explains the natural adaptations behind them and how to assess true progress.
• Metabolic health plays a major role in brain function, cognitive decline, depression, and dementia prevention.
• Cannabis affects metabolic pathways in complex ways, with regular use potentially causing negative metabolic effects.
• Liposuction can trigger metabolic rebound and rapid fat regain for some patients, especially when leptin levels are low.
• Updates on GLP-1 meds: Liraglutide is available in generic form, but costs fluctuate. New oral and combination therapies are on the horizon.

Personal Stories & Practical Advice:

• Andrea and Mark reflect on their own journeys with dieting, weight plateaus, and medication.
• Dr. Cooper shares clinical experiences with metabolic rebound after liposuction and ways to navigate pharmacologic treatments.

Correction: Lilly has a lower cash pay for Medicare and Medicaid, but Novo Nordisk is not yet.

References related to diet-induced metabolic adaptation, also called biological adaptation and defense of body weight.

1. Keys, A., Brozek, J., Henschel, A., Mickelsen, O., & Taylor, H. L. (1950). The Biology of Human Starvation. University of Minnesota Press.

2. Dulloo, A. G. (2021). Physiology of weight regain: Lessons from the classic Minnesota Starvation Experiment on human body composition regulation. Obesity Reviews, 22, e13189.

3. Müller, M. J., & Bosy-Westphal, A. (2013). Adaptive thermogenesis with weight loss in humans. Obesity, 21(2), 218-228.

4. Rosenbaum, M., & Leibel, R. L. (2010). Adaptive thermogenesis in humans. International Journal of Obesity, 34(S1), S47-S55.

5. Fothergill, E., Guo, J., Howard, L., Kerns, J. C., Knuth, N. D., Brychta, R., ... & Hall, K. D. (2016). Persistent metabolic adaptation 6 years after "The Biggest Loser" competition. Obesity, 24(8), 1612-1619.

6. Johanssen, D. L., Knuth, N. D., Huizenga, R., Rood, J., Ravussin, E., & Hall, K. D. (2012). Metabolic slowing with massive weight loss despite preservation of fat-free mass. Journal of Clinical Endocrinology & Metabolism, 97(7), 2489-2496.

7. Sumithran, P., Prendergast, L. A., Delbridge, E., Purcell, K., Shulkes, A., Kriketos, A., & Proietto, J. (2011). Long-term persistence of hormonal adaptations to weight loss. New England Journal of Medicine, 365(17), 1597-1604.

8. MacLean, P. S., Bergouignan, A., Cornier, M. A., & Jackman, M. R. (2011). Biology's response to dieting: the impetus for weight regain. American Journal of Physiology-Regulatory, Integrative and Comparative Physiology, 301(3), R581-R600

Resources:

• 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, email us at [email protected] or [email protected].

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/

This week on Fat Science, Dr. Emily Cooper, Andrea Taylor, and Mark Wright explore why metabolic health transformations require time, persistence, and a holistic approach. Andrea shares her 14-year journey with Dr. Cooper, highlighting the slow, individualized nature of healing a dysfunctional metabolism and why quick fixes rarely work. 

Dr. Cooper explains how complex feedback loops, hormonal adaptations, and life events can slow progress—and why health markers, not just the number on the scale, are crucial measures of success. The conversation encourages patience, self-compassion, and a focus on sustainable health, not just rapid weight loss.

Key Takeaways:

• Healing metabolic dysfunction is a complex, highly individualized process that often takes years—not weeks or months.
• Dieting, stress, disrupted sleep, and misguided exercise can send the body into "famine mode," making weight loss even harder.
• Metrics like blood pressure, cholesterol, and glucose often improve before significant weight loss occurs—these health gains matter.
• Medications and bariatric surgery can help in stubborn cases, but long-term success depends on a combination of medical, lifestyle, and psychological support.
• As many as 20% of patients may be "non-responders" to current treatments, highlighting the need for ongoing metabolic research and new therapies.

Personal Stories & Practical Advice:

• Andrea details her long road—from early GLP-1 medications and plateaus to bariatric surgery and ongoing adjustments—with the emphasis that patience paid off.
• Dr. Cooper and Mark reinforce the importance of redefining food as fuel and joy, not the enemy, and letting go of blame or unrealistic expectations tied to the scale.
• The episode highlights small wins, the value of routine lab work, and celebrating all forms of progress—especially the non-scale victories.

Resources:

• 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 [email protected] or [email protected].

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/

This week on Fat Science, Dr. Emily Cooper, Andrea Taylor, and Mark Wright break down the latest science behind GLP-1 medications like Ozempic, Wegovy, and Mounjaro. Dr. Cooper shares her decades of expertise on how these drugs work, their evolution, and whether you really have to take them for life. 

The episode dives deep into the individual factors that impact tapering off, the importance of metabolic signals (like famine and security signals), and why medication is just one piece of the metabolic puzzle. 

Key Takeaways:

• GLP-1 medications have advanced significantly, with more convenient dosing and greater effectiveness for many—but responses vary widely from patient to patient.
• Weight on the scale isn’t the only measure; body composition, nutrient levels, and metabolic markers are critical in determining treatment and possible tapering.
• Not everyone needs to take GLP-1s forever—tapering is possible, but it depends on individual health markers, genetics, and whether metabolic signals are balanced.
• The future of metabolic health lies in combination therapies that target multiple pathways, not just GLP-1s.
• Dieting alone disrupts metabolic signals, making professional metabolic medicine and nutrition guidance essential for long-term health.

Resources:

• 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 [email protected] or [email protected].

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/

Join Dr. Emily Cooper, Andrea Taylor, and Mark Wright on Fat Science as they unpack the complexities of dosing GLP-1 medications for metabolic health and weight management. Dr. Cooper emphasizes the importance of an individualized approach, debunking the myth that higher doses or faster titration always lead to better outcomes. 

The team addresses listener questions about how and when to increase doses, highlight the risks of rapid escalation, and discuss the nuanced ways these drugs impact metabolic health beyond just weight loss. Real-life experiences and thoughtful, science-backed guidance will help you navigate your own journey with metabolic dysfunction and medication.

Key Takeaways:

• Dosing of GLP-1 medications should always be tailored to the individual, considering response, side effects, and other health factors—not just the speed of weight loss.
• Starting at the lowest dose and titrating slowly increases medication tolerance and long-term effectiveness.
• Lab markers such as A1C, glucose, cholesterol, and muscle mass are key indicators in determining if the medication and dosing are "working."
• Rapidly escalating to the highest dose can backfire, causing side effects and limiting future treatment options.
• Dieting mindsets and using medication solely as an appetite suppressant can lead to loss of lean mass and suboptimal health outcomes.
• Ongoing patient-provider relationships and regular lab work ensure medication strategies remain safe and effective.

Personal Stories & Practical Advice:

• Andrea reflects on her initial desire for quick fixes and shares lessons learned about patience, nourishment, and long-term progress. 
• Mark discusses insurance-driven medication switches and finding the “sweet spot” for dosing with Dr. Cooper’s guidance.

Resources:

• 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 [email protected] or [email protected].

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/

Join Dr. Emily Cooper, Andrea Taylor, and Mark Wright on Fat Science for a special mailbag episode answering listener questions about metabolic health. Dr. Cooper explains the difference between mindful and mechanical (timed) eating, especially for those using medications like Zepbound. 

The team also addresses emotional challenges tied to frequent eating, societal fat shaming, and the complexities of medication side effects for those on GLP-1 agonists and antipsychotics. Real experiences and practical advice help shed light on fueling your body, breaking free from diet culture guilt, and navigating complex emotions on the journey to better health.

Key Takeaways:

• GLP-1 medications like Zepbound affect appetite and metabolism but can also suppress hunger cues; mechanical eating—timing meals and including all food groups—prevents nutritional deficits and supports long-term metabolic health.
• Eating too few calories, even when appetite is low, can be detrimental; mechanical eating helps maintain muscle mass and prevent stalled metabolism.
• Emotional barriers, guilt, and anxiety around food are common due to fat shaming and past dieting experiences. Meal planning and support from dietitians can help ease this transition.
• GLP-1s may alter medication absorption or trigger anxiety episodes due to blood sugar fluctuations; monitoring and professional advice are recommended when combining with psych meds.

Personal Stories & Practical Advice:

• Andrea shares strategies for getting enough nutrition when appetite is low, her experiences with fat shaming, and her approach to enjoying food without guilt.
• Mark and Dr. Cooper discuss breaking free from restrictive food mindsets and building a positive, fuel-focused relationship with eating.

Key Takeaways:

Resources:

• 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 [email protected] or [email protected].

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/

This week on Fat Science, Dr. Emily Cooper, Andrea Taylor and Mark Wright tackle the urgent issue of deep funding cuts to scientific research in the United States. Dr. Cooper shares firsthand insight on how these changes are affecting patient care and scientific integrity, highlighting the pressures researchers face—including censorship and loss of resources at institutions like the NIH. 

The conversation sheds light on how misinformation, government interference, and reduced diversity in studies threaten the future of metabolic, cancer and public health research. Listeners will better understand why research matters for everyday health, and what’s at stake when critical projects lose funding.

Key Takeaways:

• Sweeping research cuts at major institutions like NIH jeopardize progress in areas like metabolic health, cancer, ALS, heart disease, and Alzheimer’s.
• Researchers are facing censorship and pressure to alter or suppress scientific findings in nutrition, autism, and vaccine research.
• Reducing diversity in research undermines scientific accuracy and inclusivity, risking treatments that don’t address the needs of all populations.
• Slashed funding will stall new medical discoveries, limit future treatment options, and may have consequences for decades to come.
• Misinformation around vaccines and public health is rising as government agencies are pressured to alter or hide true scientific data.

Resources:

Links: 

Current Medical Reporting

Vin Gupta, MD

Nutrition Information

Nutrition for Mortals Podcast with Dietitians: Matt and Jen

Infectious Diseases, Immunizations

Maria Van Kerkhove - WHO

Jeff Duchin

Michael Osterholm, CIDRAP

Kevin Hall Research

Kevin Hall on LinkedIn

• 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, send an email to [email protected]. If you have a show idea, feedback, or just want to connect, you can also reach us us at[email protected].

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/

This week on Fat Science, Dr. Emily Cooper, Andrea Taylor, and Mark Wright dive into the world of blood fats—unpacking what cholesterol numbers really mean for your health. They break down HDL (the “good” cholesterol), LDL (the “bad” cholesterol), triglycerides, and spotlight the often-overlooked lipoprotein(a), a genetic risk marker with significant consequences for heart health. The team dispels myths about fats in our diet, covers the impact of lifestyle and genetics, and explores how advanced testing can reveal hidden risks. You’ll come away understanding which fats matter most, why particle size counts, and what actions can help manage your numbers and protect your heart.

Key Takeaways:

• Blood fats, specifically HDL, LDL, and triglycerides, are critical indicators of cardiovascular risk. Advanced testing can identify dangerous subtypes and genetic markers like lipoprotein(a) that standard panels miss.
• HDL has benefits, but high numbers don’t cancel out high LDL; LDL particle size and count are crucial—small, dense particles are more harmful.
• Lipoprotein(a) is a major genetic risk factor for heart disease and stroke that isn’t modifiable by diet or exercise; new treatments are in development.
• Plant-based monounsaturated fats (like olive oil and avocados), resistant starches, and soluble fiber offer metabolic and heart-health benefits, but even perfect diets may not lower genetic cholesterol risks.
• Lifestyle factors—exercise, avoiding smoking, quality sleep, and managing conditions like diabetes—are critical for reducing cardiovascular risk, especially if you have inherited risk markers.
• Heart health isn’t just about body size—“looking healthy” doesn’t guarantee healthy arteries; everyone should know their numbers and consider advanced heart scans as needed.

Resources:

• 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, send an email to [email protected]. If you have a show idea, feedback, or just want to connect, you can also reach us us at [email protected].

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/