Tom Fielding
Metabolic Desk
People on or considering GLP-1s and serious about weight loss
Tom Fielding leads the Metabolic Desk, making sense of the GLP-1 era — Ozempic, Wegovy, appetite and metabolic health — in clear, non-judgmental language. He focuses on what the evidence shows and the questions worth asking a clinician.
Latest articles
Lactate Isn't Waste — It's a Signal: Why Hard Exercise May Reverse Fat-Tissue Insulin Resistance
A new mouse study reframes the molecule behind your burning legs as a messenger, not a metabolic leftover — and hints at why intense training keeps outperforming easy cardio on the metrics that matter.
The Muscle Problem GLP-1s Can't Solve: Why Exercise After Weight Loss Still Wins
A new randomized trial suggests a year of structured exercise after weight loss boosts the body's own appetite-quieting GLP-1 — something the injectable drugs don't appear to do. Here's what that means for anyone serious about keeping the weight off.
Beyond HDL-C: The Lipid Profile Hiding Inside Metabolic Syndrome
A new systematic review argues the number on your cholesterol panel misses the molecular story — and a parallel mortality analysis suggests insulin resistance and kidney function deserve a seat at the table.
Insulin Resistance as a Brain Disease: The Metabolic Road to Alzheimer's
A new review reframes Alzheimer's risk around peripheral insulin resistance — not blood sugar itself — and points to tiny cellular couriers as possible carriers of metabolic damage to the brain.
Tirzepatide for MASH: Phase 2 Signals Reshape the Liver-Metabolic Playbook
A dual GIP/GLP-1 agonist already changing diabetes and obesity care is now posting credible early signals against the fatty-liver disease that often travels with them.
Vitamin D, Mangosteen, and a New Blood Test: The Quiet Race to Catch Type 2 Diabetes Early
Three new human studies — a decade-long cohort, a systematic review, and a biomarker case-control trial — sketch an emerging toolkit for spotting dysglycemia before it hardens into disease.
Beyond Blood Sugar: How GLP-1 Drugs Rewire the Cardiometabolic Network
A new gene-metabolite map suggests incretin-pathway drugs act on a web of cardiovascular and metabolic systems — not just glucose. Here's what that means for patients in 2026.
Beyond Semaglutide: The Next Wave of GLP-1 Combinations and Genetic Response Predictors
New research is beginning to explain why GLP-1 drugs work brilliantly for some and modestly for others — and what comes after the first generation of blockbusters.
Intermittent Fasting as an Autophagy Switch: What the Mechanism Actually Shows
A new narrative review traces how fasting flips the cell's recycling program through AMPK, mTOR and ketone signaling — and how cautiously the human evidence still reads.
Lipoprotein(a): The Cardiovascular Risk Factor Guidelines Now Say to Measure Once
European, Canadian and U.S. lipid guidelines now endorse a one-time Lp(a) test for every adult. Here's why a number you inherit at birth is finally getting its moment in the cardiology clinic.
Inheriting Resilience: Could a Parent's Mitochondrial Stress Make You Live Longer?
A new worm study suggests that mild stress in one generation can leave longevity marks on the next. The mechanism is fascinating — and the leap to humans is still a long one.
Lifestyle Still Wins: The 2025 Case for Diet, Exercise and the Metabolic Trio
A major Herz review reaffirms that Mediterranean eating, structured movement and smoking cessation move the endpoints that matter — a useful corrective in the GLP-1 era.