Have you ever wondered why your body holds onto weight despite your best efforts?

In this eye-opening episode, Dr. Cooper reveals groundbreaking research showing that 100% of healthy adults carry at least six different plastic-related chemicals in their bodies daily. These endocrine disruptors don't just affect your hormones - they may be stored in your fat tissue and could be a hidden driver of metabolic dysfunction. The good news? New Australian research proves you can dramatically reduce these chemicals in just one week with targeted changes.

KEY TAKEAWAYS

• Every single person tested had at least 6 plastic chemicals in their urine, with food packaging being the primary source

• Participants cut phthalate levels by 38-54% and BPA by 60% in just 7 days with adjustments in reducing plastic exposure in food and food packaging

• Ultra-processed foods introduce plastic chemicals through multiple processing and packaging steps

• Certain chemicals like DEHP may be stored in fat tissue and released during weight loss

• Heat accelerates plastic migration into food - avoid microwaving in plastic and pouring hot food into plastic containers

• Simple swaps like choosing fresh over canned foods and using glass containers make significant impacts

• The EPA research office studying these chemicals was recently eliminated, removing key consumer protections

NOTABLE QUOTE

"People who switched to the low plastic food and kitchenware cut the phthalates excretion by 38 to 54% in one week and they cut their BPA excretion by 60% in one week." — 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.

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 happens when GLP-1 medications stop working the way you hoped they would? In this mailbag episode, Dr. Emily Cooper answers listener questions about fasting, insulin levels, PCOS, lipedema, plateaus on Zepbound, and the complicated reality behind metabolic dysfunction. From the dangers of under-fueling to why individualized treatment matters so much, this conversation unpacks the science behind weight resistance with clarity and compassion.Key Takeaways

• Why fasting and restrictive eating may worsen metabolic adaptation

• The real role insulin plays in metabolic health

• How PCOS and lipedema complicate weight loss treatment

• Why some people plateau on GLP-1 medications over time

• The importance of fueling, muscle preservation, and individualized care

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.

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

Could you have metabolic dysfunction even at a normal weight?

This episode challenges everything we've been taught about weight and health. Dr. Cooper reveals that up to 25% of normal-weight people have metabolic syndrome, yet they're rarely screened because doctors assume they're healthy based on appearance alone.

KEY TAKEAWAYS

• Weight and metabolic health are not the same thing - you can be metabolically unhealthy at any size

• Normal weight people with metabolic dysfunction are often overlooked and undertreated by healthcare providers

• Key screening tests include fasting glucose, insulin, HbA1c, triglycerides, HDL cholesterol, blood pressure, and inflammatory markers like HSCRP

• Metabolic dysfunction can start in your 20s and take decades to develop into serious disease

• Both normal weight and higher weight patients face bias - normal weight people aren't screened enough, while higher weight people have everything blamed on their weight

• Early screening and treatment can prevent catastrophic health outcomes later in life

• The liver plays a crucial role in metabolism and can become insulin resistant regardless of body weight

NOTABLE QUOTE

"You cannot tell anything about someone's health from their outside, what they look like or what, even what they're doing necessarily, but definitely not their body size. So you can be healthy or unhealthy at any size body, and I think that's what's overlooked quite a bit." — 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

Appendix: Key References

Primary literature supporting this episode

• Wang et al. Prevalence of Metabolically Unhealthy Normal Weight and Its Influence on the Risk of Diabetes. Journal of Clinical Endocrinology & Metabolism, 2023.

• Review: Beyond BMI — Rethinking Obesity Metrics and Cardiovascular Risk in the Era of Precision Medicine. Journal of Clinical Medicine, December 2025.

• Korean meta-analyses on metabolic dysfunction phenotypes and cardiometabolic risk, Cardiovascular and Metabolic Sciences Journal review, 2024.

• Frontiers in Nutrition, January 2026. Associations of metabolic heterogeneity with the progression of cardiometabolic multimorbidity.

• International Journal of Obesity, September 2025. Cardiovascular risk factors associated with metabolic health phenotypes.

Mechanism references

• MASLD — metabolic dysfunction-associated steatotic liver disease — nomenclature and clinical framework. AASLD/EASL consensus, 2023.

• Insulin signaling, adipose tissue dysfunction, and ectopic fat deposition — reviews on the upstream-downstream relationship.

• Epicardial adipose tissue and cardiovascular dysfunction — Frontiers in Cardiovascular Medicine, January 2026.

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

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

Have you been told your metabolism is broken and there's nothing you can do about it?

This mailbag episode tackles tough questions about medication effectiveness, unexpected side effects, and the complex realities of treating metabolic dysfunction. Dr. Cooper addresses why some people regain weight while still on GLP-1s, explores the connection between hair loss and weight loss medications, and explains why leptin levels can remain stubbornly low even with proper nutrition.

KEY TAKEAWAYS

• Weight regain while on GLP-1 medications is more common than most people realize

• Hair loss from weight loss medications is usually related to nutrient deficiencies, not the medication itself

• Leptin dysfunction involves both hormone levels and signaling pathways throughout the body

• Hypoglycemia after meals often indicates complex metabolic issues that require specialized testing

• Starting elderly patients on GLP-1s requires careful monitoring of nutrition, blood pressure, and side effects

• Mechanical eating differs from intuitive eating and remains important even when medications are working

• Annual weight loss rates of 10% or higher indicate medications are still effective

NOTABLE QUOTE

"It is not uncommon to see the weight go up while on these meds, contrary to what people think. They're great, but we always wanna point out some people don't even respond to these." — 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.

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

Ever wonder why you can improve your health but still feel like you're failing because the scale isn't cooperating?

Dr. Cooper breaks down groundbreaking new clinical guidelines from three major obesity organizations that are completely reframing what success in obesity treatment actually means. For the first time, these groups are saying quality of life, energy levels, and overall health matter more than the number on the scale.

KEY TAKEAWAYS

• Three major obesity organizations worked collaboratively to issue guidelines prioritizing quality of life over weight loss as primary treatment goals

• Guidelines explicitly address medical stigma as a structural barrier to care requiring systemic change

• Treatment is positioned as long-term management similar to other chronic conditions like thyroid disorders

• Document notably avoids calorie restriction language, focusing instead on healthy lifestyle alongside medication

• Setmelanotide receives strong recommendation for rare genetic obesity conditions with available genetic testing

• Strong medication recommendations now include GLP-1s like semaglutide and tirzepatide, plus bupropion-naltrexone combination

NOTABLE QUOTE

"Nobody ever asked. Nobody ever looked. Nobody ever said anything. I was like, 'I think there's something wrong with my metabolism or something because I'm not eating a ton.' They're like, 'Well, you must be.' And I'm like, 'N- n- no, I don't think so. I mean, unless it's happening when I'm sleeping. I don't know.'" — Andrea Taylor

Reference Link

Alexander L, Purnell JQ, et al. Pharmacological management of obesity in adults: a clinical guidance statement from The Obesity Society, the Obesity Medicine Association, and the Obesity Action Coalition. Obesity. 2026;34(4):851–870. doi:10.1002/oby.70164 https://onlinelibrary.wiley.com/doi/10.1002/oby.70164

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.

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

Have you been told you have PCOS but nothing seems to help?

In May 2024, after 14 years of global collaboration involving 56 organizations and 22,000 stakeholders, the medical community officially changed PCOS to PMOS - and the reason why reveals everything that's been wrong with how this condition has been understood and treated for decades. Dr. Cooper breaks down why this isn't just a name change, but a complete reframe that puts metabolic dysfunction at the center where it belongs.

KEY TAKEAWAYS

• PCOS is now officially called PMOS - Polyendocrine Metabolic Ovarian Syndrome - shifting focus from ovarian problems to metabolic dysfunction
• 70 million women globally are affected during reproductive years, with 70% remaining undiagnosed
• The condition can occur at any weight and is driven by insulin resistance and other metabolic signals, not ovarian problems
• Treatment should focus on metabolic health rather than weight loss or ovarian interventions
• The name change parallels similar shifts in medicine like MASLD replacing non-alcoholic fatty liver disease

NOTABLE QUOTE

"Most patients with this label that they've had in the past, the PCOS label, feel a sense of hopelessness, and even join support groups and things like that, and thinking that this will be a condition they have forever. And what I try to do is explain, no, this is just a physical manifestation of the metabolic disruption that we treat all the time" — 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.

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

Have you been told it's just calories in calories out while your lived experience says otherwise?

In this mailbag episode, Dr. Cooper addresses complex metabolic questions from listeners worldwide. From eating disorders requiring specialized care to GLP-1 plateau management, each question reveals how individual biology trumps one-size-fits-all solutions.

KEY TAKEAWAYS

• Eating disorders like anorexia require comprehensive medical team treatment, not self-management approaches

• Side effects from GLP-1 medications often improve with consistent eating patterns and adequate nutrition

• The calories in calories out model ignores the biological complexity of how your body actually burns fuel

• PCOS responds well to metabolic treatments because it's driven by underlying insulin and hunger hormone imbalances

• Sleep deprivation and chronic stress significantly impact GLP-1 effectiveness and overall metabolic function

• Bioidentical progesterone may help perimenopause sleep issues without the metabolic side effects of older formulations

• Stroke survivors may experience hypothalamic obesity that responds remarkably well to GLP-1 medications

NOTABLE QUOTE

"If that really worked, imagine, you know, would we actually need these sophisticated medications that are so groundbreaking? Would we have had decades and decades, or actually centuries of failed, you know, diet experiences by so many people?" — 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.

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 your legs painful to touch and resistant to weight loss despite your best efforts?

Dr. Ellen Derrick, a vascular surgeon and lipedema specialist, reveals the truth about this misunderstood condition affecting 20% of women worldwide. Lipedema isn't obesity - it's a fat cell disorder where tissue responds abnormally to inflammation, creating painful, swollen areas that don't respond to traditional weight loss methods. She explains the connection between lipedema and venous insufficiency, why patients are often dismissed by doctors, and the emerging treatments offering hope.

KEY TAKEAWAYS

• Lipedema affects 20% of the female population but is routinely misdiagnosed as obesity
• The condition involves abnormal fat cell response to inflammation, creating painful tissue that resists weight loss
• 86% of lipedema patients also have venous insufficiency, creating a perfect storm of symptoms
• Ankle cuffs, knee pouches, and saddlebags are classic physical signs that patients often notice from puberty
• GLP-1 medications like tirzepatide may help reduce inflammation and tissue tenderness
• Lipedema reduction surgery exists but lacks insurance billing codes, making access challenging
• A formal medical recognition campaign is underway to establish diagnostic codes by 2026-2027

NOTABLE QUOTE

"The medical community really has done an outstanding job, in a way, gaslighting these patients. These patients have been aware that something is different about their body and their legs since puberty." — Dr. Ellen Derrick

GUEST BIO

Dr. Ellen Derrick is a Seattle-based board-certified vascular and general surgeon with over 20 years of clinical experience and a Master of Public Health from the University of Washington. She founded Boxbar Vascular, specializing in lipedema and related metabolic conditions, and serves on the board of the Lipedema Society working toward formal medical recognition of the condition.

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.

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