Is this a Prudent Suggestion?

[Yukari-sensei]

To explain first I should disclose that I am very much a big girl. To begin with, I'm 5'11" and when I came out to myself (just before Easter this year) I was at my peak weight of 360lbs (163kg). Since that revelation, I have more or less shed weight and increased my cardio activity. As of last week, my weight was 313lbs (142kg). I'm setting my target weight at 200lbs (91kg) but will be discussing with my new endocrinologist when it will be safe to start HRT.

A good friend of mine and a bit of a fitness nut says that I need to start incorporating strength building exercises. He insists that given the fact I will inevitably lose muscle on HRT that I should build it up now so I will have it post-HRT. I tell him more or less this is a rather Sisyphean endeavor. Also given my current state I should be more concerned about cardiomyopathy risk due to my weight and stick to pure cardio.

Should I start weight training for strength or should I avoid it like the plague? Would the effort now even have any real effect in the long run?

[musicofthenight]

Yes you absolutely should weight train.  Do it safely and build slowly.  Who's telling you that lifting causes cardiomyopathy?  Very heavy weights aren't recommended for patients who have it, but I can't find any medical sources that say lifting is a risk factor.

The advantage of lifting comes from the metabolic function of fatigued muscles.  They demand more energy without automatically stimulating appetite (cardio does stimulate appetite as you know), and they suck extra sugar out of the blood after meals so less is converted to fat.

[Yukari-sensei]

Yes you absolutely should weight train.  Do it safely and build slowly.  Who's telling you that lifting causes cardiomyopathy?  Very heavy weights aren't recommended for patients who have it, but I can't find any medical sources that say lifting is a risk factor.

The advantage of lifting comes from the metabolic function of fatigued muscles.  They demand more energy without automatically stimulating appetite (cardio does stimulate appetite as you know), and they suck extra sugar out of the blood after meals so less is converted to fat.

My cardiologist told me I'm at high risk for developing cardiomyopathy due to my weight. "Whatever you do, lose weight first" was his directive. I think he was afraid I would try to focus on muscle for looks (completely unaware of my dysphoria), instead of the cardio he insisted I needed.

I think I'm going to make an appointment to see a fitness consultant this week and see what specific weight training exercises I should incorporate into my workout... especially if it boosts my metabolism without increasing my appetite!