Mailbag: Your GLP-1 Questions: Hair Loss, Blood Sugar Spikes & Hormone Therapy

Think squashing your post-meal glucose spike is the healthy thing to do? What if that flat line on your CGM is actually telling your brain you didn't eat — and slowing your metabolism as a result?

This week on Fat Science, Dr. Emily Cooper, Mark Wright, and Andrea Taylor open the mailbag to tackle listener questions from around the world — Australia, New Zealand, and across the U.S. They dig into hormone replacement therapy and metabolism, why your GLP-1 medication might be causing hair loss, what a normal blood sugar response actually looks like, and how lipedema differs from obesity. Dr. Cooper also revisits metabolic syndrome and why it's not outdated — just underutilized.

Key Takeaways

• Hormone replacement therapy isn't a reliable tool for improving metabolism — it's better suited for symptom relief and bone health in specific situations.

• Progesterone, which must accompany estrogen if you still have your uterus, can actually disrupt metabolism in some women — acting almost like a steroid.

• A flat glucose line after eating isn't the goal — your brain needs to see glucose go up to register that you've been nourished and keep your metabolism running.

• Hair loss on GLP-1 medications is more likely tied to nutrient deficiencies (especially iron and protein) than the drugs themselves.

• Lipedema is a disease of the fat tissue itself — separate from obesity — and tirzepatide may help reduce the inflammatory symptoms even though it won't eliminate the fat deposits.

Notable Quote

"If your glucose is flat line, your brain's not very convinced that you ate much — and then you're not getting the metabolic benefit." — 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.