fat peoples problem

[Natkat]

I want to ask, have anyone had problems getting homones because they where being overweight? and if yes what did you do about it?

[LittleEmily24]

I have an FTM trans friend who is currently about to start transition - he is overweight and he hasn't been denied transition hormones - however; im not a doctor, but maybe something in your blood work could work against you in this sense i doubt it, but you never know

[Jill F]

It's not being overweight itself that will potentially get you denied, it's the other health risks that often go along with it.

[Nero]

Yeah, depends on your numbers - bloodwork, etc. I have heard some surgeons have weight limits though. I'm fat, but had no issues with getting HRT or surgery. Wasn't even mentioned. All my bloodwork was good.

[Natkat]

I am asking because a transguy mention he had problems on getting T due to his weight, I heard of one guy before some years ago with simular struggle and I wonder, how this infect the decissions being made, and what I can do for suport.

[Jill F]

Yeah, depends on your numbers - bloodwork, etc. I have heard some surgeons have weight limits though. I'm fat, but had no issues with getting HRT or surgery. Wasn't even mentioned. All my bloodwork was good.

Thanks for mentioning that, FA.  Now it's time for a rant.

I noticed on Marci Bowers' website that she has a weight limit of 210 pounds.  She will take your build into consideration, but from what I understand, it will still cost you more regardless. 

This is one of the dumbest things I've ever heard.  I am still considering her for SRS anyway because I know I can get myself under that limit easily, but the fact remains that our height, frame and muscle mass are not taken into account.  I happen to be 6'2", I'm built like a linebacker and have considerable muscle mass.  I would literally have to lose some lean muscle as well as some off the T and A (Boo!) to get me there now.   I understand that obese people tend to heal more slowly, but I am not remotely obese.  A little bit overweight, yes.  And that is intentional because I need that body fat to hide some pretty masculine muscle definition and pronounced nasolabial folds.  I don't "pass" without it right now.

I mean, from what I read, that same 210 pound limit would still apply if I was 5'4" and had a small frame, and that would put my BMI (another really stupid one-size-fits-all metric) at a whopping 36.  That's techinically "morbidly obese", but apparently still good enough for Dr. Bowers.

Whiskey Tango Foxtrot?

[Felix]

I'm getting fat and I am a little concerned that my hormones may be questioned in the context of my weight and cholesterol and blood pressure. I've spoken to my regular doctor about it and she assured me that altering hormones is not how she addresses weight problems in other men, so I have nothing to be afraid of.

I don't have the money or the insurance coverage for further surgeries, so I'm trying not to think about them. If I did have the means, I think I would be hurt and angry if a surgeon refused to work on me because I'm not fit enough, healthcare logic notwithstanding.

[Randi]

I think Christine McGinn insists on BMI of 28 or less, which calculates to 185 lb for me.

I noticed on Marci Bowers' website that she has a weight limit of 210 pounds.

[Miss_Bungle1991]

Thanks for mentioning that, FA.  Now it's time for a rant.

I noticed on Marci Bowers' website that she has a weight limit of 210 pounds.  She will take your build into consideration, but from what I understand, it will still cost you more regardless. 

This is one of the dumbest things I've ever heard.  I am still considering her for SRS anyway because I know I can get myself under that limit easily, but the fact remains that our height, frame and muscle mass are not taken into account.  I happen to be 6'2", I'm built like a linebacker and have considerable muscle mass.  I would literally have to lose some lean muscle as well as some off the T and A (Boo!) to get me there now.   I understand that obese people tend to heal more slowly, but I am not remotely obese.  A little bit overweight, yes.  And that is intentional because I need that body fat to hide some pretty masculine muscle definition and pronounced nasolabial folds.  I don't "pass" without it right now.

I mean, from what I read, that same 210 pound limit would still apply if I was 5'4" and had a small frame, and that would put my BMI (another really stupid one-size-fits-all metric) at a whopping 36.  That's techinically "morbidly obese", but apparently still good enough for Dr. Bowers.

Whiskey Tango Foxtrot?

I would bet that it has more to do with people and their eagerness to sue later on. But I could be wrong.

[Roxanne]

Since when is 6'2 (and up) and a little over 200 pounds FAT? Unless one is a couch potato or has a tiny frame.

Sure, it might make one too heavy to be an actress or a model, but from a health stand point PFFFFFFFFFFFFFFTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTT. Anyone who lifts weights and is tall is going to be likely pushing 200 (if not over) unless they are also a twig.

Any doctor who uses BMI for anything other than record keeping is a crank too as it is unfairly biased against the tall as well. Waist should be half your height or less - that's a far better marker of whether you're overweight or not.

[Jill F]

Oddly enough, I have an ex-bandmate who is 6'3" and roughly 195 pounds now.  He used to weigh 155 with a 28" waist.  He used to be a walking stick figure, but now he has put on a significant beer belly.  He is not exactly what I'd call healthy.  Derek Jeter of the New York Yankees is also 6'3" and 195 pounds but has almost no body fat.   According to BMI, they are the same.

I thought doctors were supposed to be smarter than that, but I had one that I fired over a year ago because he told me that at 195 pounds, I was one pound overweight.  Really?  You could count my ribs back then from across the room.

[Teela Renee]

Thanks for mentioning that, FA.  Now it's time for a rant.

I noticed on Marci Bowers' website that she has a weight limit of 210 pounds.  She will take your build into consideration, but from what I understand, it will still cost you more regardless. 

This is one of the dumbest things I've ever heard.  I am still considering her for SRS anyway because I know I can get myself under that limit easily, but the fact remains that our height, frame and muscle mass are not taken into account.  I happen to be 6'2", I'm built like a linebacker and have considerable muscle mass.  I would literally have to lose some lean muscle as well as some off the T and A (Boo!) to get me there now.   I understand that obese people tend to heal more slowly, but I am not remotely obese.  A little bit overweight, yes.  And that is intentional because I need that body fat to hide some pretty masculine muscle definition and pronounced nasolabial folds.  I don't "pass" without it right now.

I mean, from what I read, that same 210 pound limit would still apply if I was 5'4" and had a small frame, and that would put my BMI (another really stupid one-size-fits-all metric) at a whopping 36.  That's techinically "morbidly obese", but apparently still good enough for Dr. Bowers.

Whiskey Tango Foxtrot?

the increased cost btw is cause the heavier/mass (fat or muscle) someone has the more anestishia (i butchered that word)  is needed. And it takes abit more work to make sure someone bigger gets appropriate depth. Its not to discriminate, its because of (in my mind) is logical medical reasons, Larger people use more supplies

[Hikari]

A few years ago I talked to a clinic about getting hormones and they told me a BMI less than 30 was required for FTMs or MTFs. Seemed a bit silly to me, I ended up going elsewhere and no one wanted to use BMI as a prerequisite for hormones there.

Wouldn't T make it even easier to lose weight though?

[h3llsb3lls]

I also worry about this. I realize that I am considered morbidly obese, and that that in itself is a health problem, but aside from my weight I am perfectly healthy. Low bp, no diabetes, good cholesterol. I am concerned because it is hard to find a doctor willing to do hrt in my area any way, and I worry that even though I run 5ks and am otherwise healthy they will deny me due to my weight. It is aggravating. As previously stated I am physically active, and though I could eat better, I just don't lose weight. No thyroid issues, although I do have a hormone imbalance

[Roxanne]

the increased cost btw is cause the heavier/mass (fat or muscle) someone has the more anestishia (i butchered that word)  is needed. And it takes abit more work to make sure someone bigger gets appropriate depth. Its not to discriminate, its because of (in my mind) is logical medical reasons, Larger people use more supplies

That's reasonable, although Marci Bowers "says unless height/weight proportionate". But what's the difference between someone who is 6'5 215 and someone who is 5'5 215 in terms of medical supplies? If anything, the 6'5 person would likely use more (they likely have a lot more muscle mass than the 5'5 person, and someone who is 215 and muscular has a much higher metabolism than someone who is 215 and fat).

The 6'5 person would probably get the green light too (but use more supplies) whereas the 5'5 person would not (but use less supplies).

[Roxanne]

Oddly enough, I have an ex-bandmate who is 6'3" and roughly 195 pounds now.  He used to weigh 155 with a 28" waist.  He used to be a walking stick figure, but now he has put on a significant beer belly.  He is not exactly what I'd call healthy.  Derek Jeter of the New York Yankees is also 6'3" and 195 pounds but has almost no body fat.   According to BMI, they are the same.

I thought doctors were supposed to be smarter than that, but I had one that I fired over a year ago because he told me that at 195 pounds, I was one pound overweight.  Really?  You could count my ribs back then from across the room.

Of course muscle mass and frame size should be taken into account and I have no problem two people can be the exact same height and weight whereas one can be extremely fit and the other extremely fat.

Having said that, I think one needs to be careful when assigning overweight vs normal weight and normal weight vs underweight in a medical context. Remember this isn't overweight or underweight in terms of a beauty contest, but in terms of health and healing... and many studies have shown that those in the overweight category (25-30 by BMI) and borderline obese category (low 30s in terms of BMI) have the lowest risk of death. It's called the obesity paradox. I don't know how well that translates to wound healing after  surgery though.

Anyway I think that we can all tell when someone is extremely overweight or extremely underweight, but again in terms of health it gets tricky where to mark the borders for those who aren't. I'm sure someone with a small gut isn't really overweight medical wise, but when does that slight gut become significant enough to mark the person overweight?

[Natkat]

Wouldn't T make it even easier to lose weight though?

I dont really think theres any provements of that.
T change your fat patterns so you are likely to gain less around the hip and get more belly fat, it also make
your stronger so you can train more which likely would make your more thin but then on the other hand many also say T made them more hungry and eat more which would likely make your more fat. so I think it can go either ways.
--

but when does that slight gut become significant enough to mark the person overweight

when the number got 1 point above or below the number they want then your over or underweight.
I took a test on my previous school about health, and I should have a BMI around 18 which is normal but insteed I got 17,9 or something and my teacher got very worryed on me being underweigt.

[Silver Centurion]

There are a few overweight men here that have been on T for awhile now and are fine. Another two that have recently started and such. I think it really has to do with the factors that your eyes can't see. Blood pressure, diabetes and cholesterol etc. If you have any medical issues that could be made worse by starting treatment or if there is a high risk for problems with your heart and such. I know when my husband went on E there was a lot of talk about making certain that his diabetes was under control and a few other blood work numbers were squared away and then he was good to go! I worried that my weight would keep me from going on T but that's not the case. If my numbers came back crap then I'd have to work on that on top of weight loss for general health. Hopefully endo's are cool everywhere and base decisions off chemistry not the scale. Surgeries wise there'd be a lot to take into account like anesthesia, recovery ability and how the person would look post op. There was someone in group a few weeks back that was asked this and they had been talked to about the BMI and having to be a certain BMI to get surgery because surgeons would refuse to work on a heavier person because that person would end up not being happy with the way they look and need multiple revisions over time.

[Nero]

<snip> and how the person would look post op. There was someone in group a few weeks back that was asked this and they had been talked to about the BMI and having to be a certain BMI to get surgery because surgeons would refuse to work on a heavier person because that person would end up not being happy with the way they look and need multiple revisions over time.

I think part of this thinking is assuming that the patient will later be able to lose weight and keep it off (which is a lot harder for some people than others, particularly those with certain medical conditions). Then the results might not look the same? 

There are also some popular surgeons who don't do very good work on bigger guys. It's always a good idea to look for results of guys with your body type.
I was pretty big when I had top surgery and no dog ears or anything like that. It does depend on the surgeon.

[Roxanne]

There are a few overweight men here that have been on T for awhile now and are fine. Another two that have recently started and such. I think it really has to do with the factors that your eyes can't see. Blood pressure, diabetes and cholesterol etc. If you have any medical issues that could be made worse by starting treatment or if there is a high risk for problems with your heart and such. I know when my husband went on E there was a lot of talk about making certain that his diabetes was under control and a few other blood work numbers were squared away and then he was good to go! I worried that my weight would keep me from going on T but that's not the case. If my numbers came back crap then I'd have to work on that on top of weight loss for general health. Hopefully endo's are cool everywhere and base decisions off chemistry not the scale. Surgeries wise there'd be a lot to take into account like anesthesia, recovery ability and how the person would look post op. There was someone in group a few weeks back that was asked this and they had been talked to about the BMI and having to be a certain BMI to get surgery because surgeons would refuse to work on a heavier person because that person would end up not being happy with the way they look and need multiple revisions over time.

Again though, BMI is a crap measure because of height bias. BMI makes shorter people sound thinner than they really are and taller people sound fatter than they really are. In general. And that's not even accounting for things like muscle mass (though that can be changed, unlike height). Any doctor who uses BMI for all of his or her patients is IMHO an utter fool who does not understand fairly basic math. There is utterly no reason to use a square term in the denominator of BMI instead of a cube term... or at least something between 2 and 3.

If a doctor is really looking at a patient in terms of whether said patient is fit or not and is on the cusp because of high weight, they should be measuring body fat % or at least measuring waist to height ratio.