Have you been told insulin resistance testing doesn't exist or wondered if you're increasing your GLP-1 dose too quickly?

Dr. Cooper, Andrea, and Mark tackle listener questions from around the world, addressing common concerns about insulin resistance testing availability, managing severe GI side effects from higher doses, interpreting DEXA scan results, and developing sustainable maintenance strategies. They discuss the difference between hunger and food noise, explain why winter illness might stall weight loss, and share insights about visceral fat concerns even at normal weight.

KEY TAKEAWAYS

• Insulin resistance can be tested through fasting insulin and glucose ratios, even in countries where insulin testing is less common

• Rapid weight loss rates above 15% annually may indicate no need for dose increases

• Severe GI side effects warrant investigation beyond medication adjustment, including gallbladder evaluation

• DEXA scans provide valuable visceral fat measurements, but results should be interpreted alongside overall health markers

• Maintenance strategies should focus on nutritional stability before considering medication tapering

NOTABLE QUOTE

"It's not that the medicine causes the rebound weight gain, it's that with the medication in there, the body is getting better signals, and then you go and take the medication away and you're in the same boat." — Dr. Emily Cooper

Links & Resources

Podcast Home: fatsciencepodcast.com

Cooper Center for Metabolism: coopermetabolic.com

Resources from Dr. Cooper: coopermetabolic.com/resources

Join Our Community: patreon.com/cw/FatSciencePodcast

Submit Your Question: questions@fatsciencepodcast.com or dr.c@fatsciencepodcast.com

Fat Science is supported by the Diabesity Institute, a nonprofit dedicated to increasing access to effective, science-based metabolic care.

Disclaimer: This podcast is for informational purposes only and is not intended as medical advice. Please consult with a qualified healthcare provider for personalized recommendations.

Are you getting a GLP-1 prescription from someone who's never examined you?

Dr. Vin Gupta, pulmonologist and former Chief Medical Officer at Amazon, joins Dr. Cooper to expose the dangerous gap between legitimate obesity medicine and the unregulated direct-to-consumer market. This conversation reveals why proper medical evaluation matters and how profit-driven platforms are exploiting desperate patients.

KEY TAKEAWAYS

• GLP-1 medications require individualized medical evaluation, not one-size-fits-all prescribing
• Direct-to-consumer microdosing platforms lack FDA approval and proper medical oversight
• The erosion of trust in healthcare has created opportunities for unregulated treatments
• Comprehensive metabolic care includes regular lab work, body composition monitoring, and personalized treatment plans
• Technology should enhance medical care, not replace proper physician evaluation

NOTABLE QUOTE

"I see so many people that come in, you know, they're obsessed with monitoring their HRV, their heart rate variability, and yet they had no idea they have pre-diabetes and they had no idea that they have triglyceride levels through the roof." — Dr. Emily Cooper

GUEST BIO

Dr. Vin Gupta is a pulmonologist, public health expert, and medical analyst for NBC News. He served as Chief Medical Officer at Amazon and has dedicated his career to translating complex science into actionable health insights at both individual and population levels.

GLOSSARY

GLP-1 medications: Glucagon-like peptide-1 receptor agonists, medications that help regulate blood sugar and appetite, including brand names like Ozempic, Wegovy, and Zepbound

Microdosing: Taking smaller amounts of medication than officially prescribed or approved

Direct-to-consumer (D2C): Healthcare services that bypass traditional medical settings, often delivered through apps or online platforms

HRV: Heart rate variability, a measurement of the variation in time between heartbeats

Pre-diabetes: Blood sugar levels that are higher than normal but not high enough to be diagnosed as type 2 diabetes

Links & Resources

• Podcast Home: fatsciencepodcast.com

• Cooper Center for Metabolism: coopermetabolic.com

• Resources from Dr. Cooper: coopermetabolic.com/resources

• Join Our Community: patreon.com/cw/FatSciencePodcast

• Submit Your Question: questions@fatsciencepodcast.com or dr.c@fatsciencepodcast.com

Fat Science is supported by the Diabesity Institute, a nonprofit dedicated to increasing access to effective, science-based metabolic care.

Disclaimer: This podcast is for informational purposes only and is not intended as medical advice. Please consult with a qualified healthcare provider for personalized recommendations.

What really happens when you stop GLP-1 medications — and are the headlines telling you the whole story? The answer is more nuanced than social media wants you to believe.

This week on Fat Science, Dr. Emily Cooper, Mark Wright, and Andrea Taylor break down four recent studies on GLP-1 treatment outcomes, weight regain, and a groundbreaking new drug that could preserve lean mass during treatment. They walk through the methodology behind each paper, explain why two studies asking the same question got opposite answers, and reveal what a new monoclonal antibody called bimagrumab could mean for the future of metabolic treatment.

Key Takeaways

• When you stop treating any chronic metabolic condition, the condition returns — that's not failure, that's biology.

• Real-world data showed 56% of people who stopped filling GLP-1 prescriptions maintained or continued losing weight — likely because they continued working with their clinician on alternative treatments.

• A new monoclonal antibody called bimagrumab showed 11% body weight reduction on its own, while simultaneously increasing lean mass by 3% — without affecting appetite.

• When combined with semaglutide, bimagrumab reduced lean mass loss from 28% to just 11% of total weight lost.

• Not eating enough while on GLP-1s drives greater lean mass loss — nutrition is still the best tool for preserving muscle.

Notable Quote

"It wasn't my failure and it was disease underneath everything. Finding that out — that it wasn't my fault — that was the miracle of the whole process to me." — Andrea Taylor

Links & Resources

• Podcast Home: fatsciencepodcast.com

• Cooper Center for Metabolism: coopermetabolic.com

• Resources from Dr. Cooper: coopermetabolic.com/resources

• Join Our Community: patreon.com/cw/FatSciencePodcast

• Submit Your Question: questions@fatsciencepodcast.com or dr.c@fatsciencepodcast.com

Fat Science is supported by the Diabesity Institute, a nonprofit dedicated to increasing access to effective, science-based metabolic care.

Disclaimer: This podcast is for informational purposes only and is not intended as medical advice. Please consult with a qualified healthcare provider for personalized recommendations