HRT fat redistribution - what's the mechanism?

[Tasha.McKenna]

I'm curious to know if anyone currently understands how fat redistribution works from a medical / scientific perspective. Specifically, what exactly is being redistributed? What changes does HRT make to the fat cells? Is there any literature on the topic?

I like to know how things work

[Pisces228]

As you have small changes in fat in your body, such as losing a little fat and gaining it back, it goes to new places under the influence of hormones.  Also, your metabolism may change and you may start to lose muscle and have an increase in body fat and the new fat will go to new places.  I was very thin and had very minimal body fat when starting hrt.  I have gained a good amount of weight and it has mostly gone to my thighs and butt and boobs, not to my stomach as in the past.  The fat doesn't just shift places on your body.  It's a gradual process of lose some here and gain it there

[rochyrob]

Do you find you lose it first in the male areas?

So yoyo dieting would be beneficial to transition?

[ainsley]

This is a nice read on some of the factors:
https://arstechnica.com/science/2017/06/this-one-weird-antibody-to-reduce-belly-fat-in-post-menopausal-women/

[RobynD]

The steroid/hormone cortisol promotes fat growth. Heavier people have more cortisol. I suspect that female hormones stimulate the something that causes larger fat cells in those areas that they tend to collect in. There are genetics, diet and environmental causes too.

One of the reasons women have far more cellulite than men is that their fat cells - (we all pretty much carry the same number of cells for life) get larger in those areas due to the communication of various hormones such as progesterone, cortisol and the one mentioned in the article that Ainsley linked.

[StillAnonymous]

I thought it wasn't so much of a "redistribution" as in the fat you have moves to new spots, but new fat goes to new spots.  I've never looked into it and I wasn't heavy before neither now, and so it's difficult for me to assess from experience aside from "what I've heard."

[Megan.]

My (non medical)  understanding is that the number of fat cells in the body remain constant,  and don't move. But they expand/contract to store/release energy. My assumption is that hormones effect which cells grow to store those excess calories! On top of this,  a cell usually lives for about 8-10 years then dies,  when it does a new one takes its place,  but I guess it starts off 'empty'.

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[mako9802]

Correct HRT does not cause existing fat to redistribute.  But new fat will be accumulated a a feminine pattern.  So if you had a beer gut before HRT will not make you shed it

[RobynD]

Yeah migration of fat cells is not a thing. However, seesawing your weight up and down a bit may help the fat accumulate in a female pattern without getting permanently heavier. We pretty much have the same amount of fat cells our entire life with a few outlying exceptions.

[judithlynn]

Hi Tasha;
I have been on HRT now for about 5 years (Oestrogen only) and no blockers as my T is so low. In the last two years I have kept my weight pretty steady, as I aim for no carbs in my diet especially after 6pm. But where I have put on fat is in my butt, thighs, lower tummy (below the belly button) and my breasts. I am now a large 44B , small 44C Cup.
But I have not been able to shift my overall tummy and I am considering a BBL and Abdomen oplasty. Dr Aslani in Marbella is my possible surgeon. Part of the reason for the BBL is that he has such good results (see www.cirumed.es) and what I lack is decent rounded hips although my buttocks are coming on nicely. I am also looking at a possible BA, aiming for D+ or DD. Here I am talking to Nuffield Health in Bournemouth with a great surgeon . Cost is just UK Pounds 3990.

[Reyes]

Hmm, I didn't know how the fat redistribution worked before reading this thread, but now after reading it I have to ask. I have a high metabolism, always have, and I hardly ever gain or lose weight, no matter how much or how little I eat. For years I was 119, then for a few years 139. And currently for like a few months now, 150. Will this hinder the fat redistribution from giving me a feminine figure? If gaining and losing weight is needed I'm just a tad worried now.

[Deborah]

Here is my unscientific theory.  If someone has been with T for a while and has been fat enough to have excess abdominal fat then to get to a feminine shape they will have to get their bodyfat pretty low over time.  Otherwise that belly will always be there.  Even if you gain back weight on E the belly will still grow, although somewhat more slowly than when on T.  The fat cells are there just waiting for excess carbs to be stored as fat.

There is some controversial evidence that if you can empty the abdominal fat cells and keep them empty for a long time they might actually die off. 


Conform and be dull. —James Frank Dobie, The Voice of the Coyote

[Brooke]

As others have stated
Fat does NOT actually redistribute. The fat you have pre hrt will stay put if you're at a steady weight.

Once you're hormone levels are in the normal range for the gender you're transitioning to, you will start to accumulate new fat in the more typical fat pattern/deposits areas of said gender.

Old fat deposits at this point, i.e. Beer belly fat may very slowly over several years appear to move, however this is likely to take a long time if your weight is steady or if you end up gaining more weight.

In my experience, once my hormone levels were in a typical female range I noticed that the stubborn male fat deposits that would typically be the last to come off got upgraded to position #1. This basically equates to the fat on my stomach, upper back, and chin to be targeted first, and the first to go. Meanwhile fat around the breasts, butt and thighs were saved until the fat in the male regions was basically gone (minus the stubborn visceral fat on the abdomen which was/is still the last to go. The breast tissue/deposits was also mostly spared.

So. To speed up this process you can do the small yo yo. Gain and lose a few lbs again and again. Or you can try to get to a very low fat percentage, which is what I chose. I found this exponentially helpful especially in terms of fitting into women's clothing. Sure I have very little shape as of now, but I can fake that with the right cuts, and no longer have the bottom half of my tops not fit due to the beer belly, while everything above my chest being extremely loose.

My info
I was 245 a year before hrt
185 starting hrt, one year ago.
155 when my hormones got within normal female range
Currently 135.

5 ft 9 bmi of around 19.5


~Brooke~

[Tasha.McKenna]

Interesting. Thanks everyone for all the information.

I have some couple of decisions to make. It sounds like yo-yo dieting may be the way to go if I want to get rid of this belly. Changing my weight in either direction is possible but requires willpower.

Last week I decided to gain a few pounds so I started eating larger portions, eating when I am not hungry, etc. Then I caught a cold and my weight went back down to my set point.

[KayXo]

High enough testosterone, estradiol and low insulin (carbs) and cortisol (stress) levels help keep fat away from the waistline.

[Deborah]

High enough testosterone, estradiol and low insulin (carbs) and cortisol (stress) levels help keep fat away from the waistline.

Yes, and I would add to that, healthy and abundant gut flora.


Conform and be dull. —James Frank Dobie, The Voice of the Coyote

[rose]

Depends on everyone body


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