Author, metabolic health researcher and patient advocate. Creator of the Shared Agency Framework. Based in Lansing, Michigan, published by unLit Publishing LLC.
Cat Clark is the author of FAT BITCH: Killing the Willpower Myth (unLit Publishing, October 15, 2026) and the Principal Patient Advocate at Her Metabolic Health. She writes about incretin pharmacology, weight stigma in clinical care, and what actually happens to a person after the prescription is filled.
She is not a physician, a dietitian or a therapist. She is a Lifer: someone who has been in the fight against metabolic disease her entire adult life, who read the endocrinology because nobody was going to explain it to her, and who then wrote it down in language the rest of us can use.
Twenty years ago the culture handed us a bestseller that called us gluttonous pigs and sold it as tough love. The prescription was always the same: eat less, move more, try harder. When it failed, and it failed for almost everyone, the verdict came back that we were weak.
Then GLP-1 receptor agonists arrived and did in eight weeks what thirty years of discipline could not. Not because we finally found willpower, but because the medication corrected a biological signaling malfunction that was never under our control in the first place. That is the whole argument of the book, and it is why the shame has to go.
FAT BITCH is not a diet book and it is not a memoir. It is a field manual: the science of metabolic adaptation and food noise, the trauma work the medication cannot do for us, the social scripts for the dinner table, and the paperwork for the insurance company.
Telehealth dismantled the gatekeeping and then quietly removed the care coordinator. Patients now carry one hundred percent of the day-to-day responsibility with none of the infrastructure. When we struggle, the chart says non-compliant. The Shared Agency Framework rejects that reading: it is not a failure of compliance, it is an infrastructure vacuum. SAF is the missing infrastructure, and it runs on three pillars.
An exact, objective accounting of what our endocrine system is actually doing: fasting insulin, HOMA-IR, leptin and ghrelin feedback, hypothalamic signaling. When we understand that the medication corrects a malfunction, the moral guilt has nowhere left to stand.
No patient exists in a vacuum. Pillar Two audits the terrain: ultra-processed food engineering, formularies built for attrition, PBM step-therapy barriers, and the weight bias that walks into the exam room ahead of us. Naming the obstacle turns helplessness into tactics.
The execution layer. We step into the role of lead project manager of our own body: the Leucine Anchor, the daily protein floor, food sequencing against the Ileal Brake, and demanding the diagnostic panels that should have been run years ago.