Mailbag: Mechanical Eating vs Calorie Counting on Ozempic and Wegovy

Have you ever wondered if you should get liposuction when you need skin removal surgery after major weight loss?

In this mailbag episode, Dr. Cooper, Mark, and Andrea tackle questions from listeners around the world, from Germany to Alabama to Chicago. They discuss why restricting calories while on GLP-1 medications can actually work against you, address the reality of finding metabolic-informed doctors internationally, and explain the science behind fat cell removal during skin surgeries. Plus, they share details about the newly approved oral GLP-1 medication orforglipron (Foundayo) and why vegetables, fats and starches matter even when you're protein-focused.

KEY TAKEAWAYS

• Restricting calories on GLP-1 medications can lower your metabolic rate and weaken your body's natural GLP-1 production

• Liposuction during skin removal surgery may disrupt leptin signaling, though males may be less affected than females due to naturally lower leptin levels

• Finding metabolic-informed doctors globally remains challenging, but obesity medicine certification and Canadian and European obesity organizations may offer better resources

• The oral GLP-1 medication orforglipron will likely be less expensive but also less effective than dual-agonist medications like tirzepatide

• Mechanical eating without calorie counting often produces better long-term results than restrictive approaches

• Vegetables provide essential micronutrients and support healthy microbiome function that protein alone cannot replace

• Major weight loss surgery like tummy tucks is serious surgery that requires careful consideration and qualified surgeons

NOTE: This episode was recorded before Foundayo (orforglipron) was released on the market. The price is the same as the Wegovy pill. Listen to our episode - “New Obesity Drugs” for more information https://podcasts.apple.com/us/podcast/fat-science/id1715377331?i=1000762362056

NOTABLE QUOTE

"If only they didn't fall into that diet cycle, some of them, their weight would be a hundred pounds less. Yes, it might be still elevated, but a large chunk of that weight was caused by the diet cycle itself." — Dr. Emily Cooper

Links & Resources

Podcast Home: fatsciencepodcast.com

Cooper Center for Metabolism: coopermetabolic.com

Resources from Dr. Cooper: coopermetabolic.com/resources

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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.