Mailbag: GLP-1s, Liver Health, Mechanical Eating & Metabolic Truths

This week on Fat Science we answer your questions in another, always-popular mailbag episode. Join Mark Wright, Andrea Taylor, and Dr. Emily Cooper and learn why some people don’t respond to GLP-1 medications, get the latest on new, oral weight-loss drugs, and explore the science behind elevated liver enzymes.

Dr. Cooper offers practical insights backed by metabolic research. She also addresses gluten-free diets, flavored seltzers, craving pathways in the brain, chronic pain management, and the importance of consistent eating patterns for metabolic health.

Key Takeaways:

• About 20% of people may not respond to GLP-1s due to genetic and metabolic differences; deeper lab and genetic testing may be needed to uncover root causes.
• New oral GLP-1 options like Orforglipron are on the horizon, promising greater convenience and accessibility.
• Transient increases in liver enzymes can occur with rapid weight changes; regular monitoring and medical guidance are important.
• The POMC pathway in the brain plays a crucial role in cravings and metabolism—medications like Contrave can help by targeting this pathway.
• Flavored seltzers are generally fine, but watch for BPA-lined cans; gluten-free isn’t always healthier unless medically necessary.
• Chronic pain medications often impact metabolism—exploring underlying metabolic causes and non-GABA, non-opioid alternatives with providers is key.
• Consistent, “patterned” eating supports metabolic stability and brain function.

Personal Stories & Practical Advice:

• Andrea shares how tweaking her medication “cocktail” and eating patterns improved her results.
• Dr. Cooper and Mark discuss real-life snack strategies for fueling brain power and avoiding metabolic pitfalls.

Resources from the episode:

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.

Check out our new website where you can ask a mailbag question and sign up to be in the audience for our 100th episode we’re recording on Thursday, September 4th at 9 a.m.PST. Be part of the live audience and ask Dr. Cooper a question. We’d love to celebrate this milestone with you!

If you have a question for Dr. Cooper, a show idea, feedback, or just want to connect, email us at questions@fatsciencepodcast.com or dr.c@fatsciencepodcast.com.

• Connect with Dr. Emily Cooper on LinkedIn.
• Connect with Mark Wright on LinkedIn.
• Connect with Andrea Taylor on Instagram.