<p>This week on <em>Fat Science</em>, Dr. Emily Cooper, Andrea Taylor, and Mark Wright open the Fat Science mailbag to answer listener questions from around the globe. </p><p>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. </p><p>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.</p><p><strong>Key Takeaways:</strong></p><ul><li>Calorie restriction and intermittent fasting can destabilize metabolism, making recovery complex for some patients—gradual changes and medical monitoring are essential.</li><li>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.</li><li>Plateaus after surgery, persistent weight struggles, and the role of genetics highlight the need for root-cause investigation, not just symptom management.</li><li>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.</li><li>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.</li></ul><p><strong>Personal Stories & Practical Advice:</strong></p><ul><li>Andrea shares her experience with bariatric surgery and ongoing metabolic management, emphasizing realistic expectations and the benefit of medication-surgery synergy.</li><li>Listeners ask: how to evaluate readiness to stop weight loss meds, address side effects, and balance hormone needs during menopause.</li></ul><p><strong>Resources from the episode:</strong></p><p>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.</p><ul><li>Updates on Dr. Cooper’s upcoming virtual metabolic health training—ideal for practitioners in the UK and beyond.</li><li>Information about Melanocortin pathway testing programs for severe, persistent obesity.<a href="https://uncoveringrareobesity.com/">https://uncoveringrareobesity.com/</a></li><li>Link to previous show. “GLP-1s: Will I Have to Take Them Forever?” (5/19/25)<a href="https://open.spotify.com/episode/1GZA71gTMSz0idbnEYblVO?si=gJXxNkbYTHykhNDw0Ebltg">https://open.spotify.com/episode/1GZA71gTMSz0idbnEYblVO?si=gJXxNkbYTHykhNDw0Ebltg</a> </li><li>Connect with Dr. Emily Cooper on <a href="https://www.linkedin.com/in/emily-cooper-md-072778/">LinkedIn.</a></li><li>Connect with Mark Wright on <a href="https://www.linkedin.com/in/mark-wright-media/">LinkedIn</a>.</li><li>Connect with Andrea Taylor on <a href="https://www.instagram.com/andreatay323/">Instagram</a>.</li></ul><p><em>Fat Science</em> 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.</p><p>If you have a question for Dr. Cooper, a show idea, feedback, or just want to connect, email us at <a href="mailto:[email protected]">[email protected]</a> or<a href="mailto:[email protected]">[email protected]</a><u>.</u></p><p><em>Fat Science</em> 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. <a href="https://diabesityresearchfoundation.org/">https://diabesityresearchfoundation.org/</a></p>