Weight loss and HRT, need advice

[Nightwatch]

I'm going to start HRT once I save up enough to afford it. MtF. Will probably take about 3 months.

In the meantime, I'm pretty fat. I'm 5'10 and around 230 pounds.

How should I expect HRT to affect weight loss?

From what I understand, it's better to lose weight before starting HRT.

But, I need to start HRT as soon as I can afford it. I have a few kind of feminine features, but since I'm 21 they still might have some time to become more masculine. For example, my skin is ridiculously smooth and silky without using any sort of product aside from normal body wash. In fact my skin is smoother than that of all of my ex-girlfriends and female family members. I really, really don't want to risk losing that, as well as other traits I don't want to risk losing.

So the solution seems to be for me to lose as much weight as I can in the few months before I can start.

However, I believe most of my (few) feminine features are a result of being a complete couch potato since I started puberty all those years ago. Exercise and general exposure to the world tend to coax the body into pumping out testosterone from what I understand. Being fat seems to reduce testosterone levels, so those two factors can readily explain why I'm not a bald manly man like most of the men in my family. Even then I still ended up with a stocky chest and shoulders.

So that's why I'm hesitant to do any sort of rigorous weight loss. I'm dieting, but unless I want to starve myself it won't be enough to make much of an impact in the few months it will take me to raise funds. I'm losing weight at a little under 1 pound a week, so I can expect to lose about 10 pounds over the course of three months which is almost completely negligible compared to the weight loss exercise + dieting provides.

I have heard that HRT makes it harder to burn fat. If that's the case, then I'll be in for a rough time when I start.

What I'm thinking is to take a testosterone blocker and a little bit of estrogen right now, just enough to keep my body from freaking out over having no sex hormones. Then I can hopefully exercise without worrying about my body suddenly deciding to make normal amounts of testosterone, while also hopefully avoiding the weight loss difficulty that full HRT might cause. This is of course all before I can afford a therapist and endocrinologist and all that, so it would be entirely self-medication for those few months which worries me.

I just really don't know what to do here. I've obviously put a lot of thought and research into it, but advice from people who have gone through all of this will really help.

Also hi, this is my first post.

[Deborah]

Weight loss is not harder on HRT.  It's hard on HRT, yes.  But its hard not on HRT also.  HRT also does not make it harder to burn fat.  If anything, high estrogen levels improve the body's ability to burn fat.

Losing one pound a week is fine and a whole lot healthier than trying to lose a lot of weight really fast.  Given your height and weight though you could lose two, or even three pounds a week safely and healthily as you need to lose about 70 lbs.

Start with diet.  Most of the weight loss success will come from fixing your diet.  Eliminate all soda and all processed sugar.  If you can eliminate all processed foods, otherwise known as food like substances, and eat real food instead.  Track all your calories using something like MyFitnessPal so that you know how much you are eating.  Most people are eating a lot more calories than they think they are.  Get a food scale and weigh everything before you eat it.  You won't need to do that forever, but long enough that you gain an appreciation for food amounts.

I have had a lot of success with a ketogenic and then just low carb diet and with intermittent fasting.  Either low carb or fasting or both together make weight loss and weight maintenance a whole lot easier.

As for exercise, you need to do it simply to be healthy.  Running will not increase testosterone and if done to excess will actually lower testosterone a lot.  You also should take up some sort of resistance training to build strong bones and otherwise to build a healthy body.  My preferred resistance training is heavy powerlifting kinds of exercise.  These will build a lot of strength very quickly without building a lot of size.  It also burns a lot of calories.

While diet is the primary means of weight loss, both running and resistance training make it easier as they will raise your metabolism and allow you to not reduce your calories to the point you actually start reducing your metabolism and ability to lose weight.  In the long term they also make it a whole lot easier to maintain whatever goal weight you achieve.

[Kara_Rae]

I have lost over 40 pounds in 4 months. I am also the same height as you and started at the same weight as you. I started off walking and doing light cardio but the biggest chunk of weight came from cutting out sugar and soda like Deborah mentioned. I then got a fitbit and started to set step goals to help keep me active throughout the day. I also tracked my calories and ran a calorie deficit of 1000 calories a day.

As I got over 30 pounds of weight lost it got harder to lose the weight but also to run that 1k deficit due to needing less calories per day so I cut down to just 750 calorie deficit per day. Now that I am down to 186 it is much harder to lose weight and I am stagnating around this weight right now but I already feel so much better about myself and clothes I have not worn in a while fit again. It can happen but it requires a lot of willpower on your part.

[Deborah]

FWIW, I'm 5'11 and started HRT in Jan 2015 at 205 lbs.  I wasn't quite as heavy as you but I did have a lot of fat to lose. 

I'm still 5'11 but weigh 165 lbs now.  I have rebuilt my fitness to a pretty decent level at the same time.  So while I do generally eat very healthily as I described above, I eat a lot now without really gaining weight.  I run often, lift heavy weights, walk a lot and probably average somewhere between 2500 to 3000 cal a day while maintaining my current weight.  If I had to cut my calories forever below 2000 or lower cal I would be seriously unhappy.

[Nightwatch]

I already don't drink much soda or consume much sugar (mostly just eat fat and protein) so basically I just need to start running like I'm Forrest Gump?

[Deborah]

You should figure out about how many calories a day you are burning and then eat 500 to 1000 cal a day less than that. 

If you use MyFitnessPal the calculation is done for you automatically once you enter your weight and activity level.  What I found works best is to enter your activity level as sedentary and then record your exercise.  Those exercise cal then are added to your daily total.

Using a step counter such as Fitbit and then aiming for a daily goal of 10,000 or more steps is very helpful too.


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[AnamethatstartswithE]

I would also avoid starchy food after lunch. The key to weight loss is finding something you want more than whatever you were eating too much of in the first place. Also it can help to weigh yourself everyday. I do it right after I get up/ brush my teeth etc so it's uniform. It's very common to have a pattern where you lose during the week but gain it back on the weekends. Also, while I wouldn't count on it estrogen isn't automatic weight gain. I'm a day shy of 1 month hrt and I'm losing 2-3 pounds per week without changing anything. I'm guessing I was just full of stress hormones beforehand.

[Artesia]

For me it became a little harder to lose weight.  The plateaus last a little longer, and when the weight comes off, it is in smaller increments.  Some is probably my inability to remove some items from my food rotation, and some from the fact that I haven't increased my exercise past the 30 minutes of walking 4 times per week, and 120 minutes of biking a week.  I need to increase my exercise more.  I am on a 1400 calorie diet, but my fluid intake is high.

[Becca Kay]

Not sure whether I should even comment.  I have an eating disorder.  However, i'm of the opinion that it's the ED girls who know what works and what doesn't.

I second the suggestion regarding myfitnesspal.  weight loss is simply a question of calories in vs calories burned.  And the best way to know whether your eating too much or too little is to keep track of your calories.  Most people tend to think they eat less (in terms of calories) than they actually do.  What i found from calorie counting is that I was able to find the foods that fill me up but don't break my calorie budget. 

[Gertrude]

Deborah turned me on to keto and I've lost 52lbs in 13.5 weeks now.  I got my diet macros from a website I'll pm you with. I'm 6'5 and now weigh 330. 220 is my target. I don't really purposely exercise yet as I want to be careful with my knees until I get to around 300. My macros are 2373cal 176g fat, 30g carbs and 168g protein a day. Once in a blue moon I'm over, most of the time I'm a little under. I don't get the hunger pangs I would with VLCDs. All I can say is that it's worked so far. I hope to be at my target sometime in March. The best part and the worst part is I need new clothes. At a smaller size, there will be better choices. I've already had to donate some clothes.


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[brandyvgs]

I also started on keto back in May of 2017, I started HRT in jan 2017, I was at 293 when I started and I just weighed myself being at 232lbs as of now. I rarely break keto now but it is all about around 20g of carbs or lower and high fat and I avg about 2 - 4 lbs a week in the loss but there is alot you can do just alot of research with both keto and eating high fat low carb style diet and treat it as a life style.

Don't necessary need to be on full on Keto, but there is some good stuff and eating on a budget too.

[Roll]

Not sure whether I should even comment.  I have an eating disorder.  However, i'm of the opinion that it's the ED girls who know what works and what doesn't.

I second the suggestion regarding myfitnesspal.  weight loss is simply a question of calories in vs calories burned.  And the best way to know whether your eating too much or too little is to keep track of your calories.  Most people tend to think they eat less (in terms of calories) than they actually do.  What i found from calorie counting is that I was able to find the foods that fill me up but don't break my calorie budget.

While I can't comment on the weight loss during HRT part of this thread (I asked a similar question a while back actually), there are two little tidbits I wanted to add to what Becca Kay and others have said about weight loss in general...

If you are like me and find myfitnesspal and similar apps or sites to be too cumbersome, it works to also just make a random text document and jot your calories down in there. It's a bit faster and doesn't require dealing with imperfect and incomplete databases. The downside is you have to actually know how many calories you ate when "manually" recording things, but even then i feel just googling a food tends to be faster for me than dealing with the apps. (And while it doesn't have a handy "calories left" feature obviously, it's pretty simple math once you know what you are aiming for.)

As for foods that fill you up and dont break calorie budget... POPCORN! Seriously, air popped or only lightly oiled homemade popcorn is insane. It's so low for the shear volume. (Well, as long as you don't add butter obviously.) I use a whirliepop (on amazon) and Flavocol seasoning for capturing the movie theater taste (no added calories but it's pure sodium, but if you are good in that department I've had many physicians just say stop worrying about sodium content while losing weight unless you already have a condition, or ethnic/familial predispoisition to being, sensitive to it). I've also fallen in love with zone bars lately. (Edit: Huh, somehow part of my post was truncated.) Normally I despise protein/fiber/nutrition bars, but some of the zone flavors just taste like candy bars and are extremely filling. (Double chocolate, cinnamon bun, peanut butter chocolate, fudge graham are the best in that order. The other flavors are disgusting.)

[Gertrude]

I also started on keto back in May of 2017, I started HRT in jan 2017, I was at 293 when I started and I just weighed myself being at 232lbs as of now. I rarely break keto now but it is all about around 20g of carbs or lower and high fat and I avg about 2 - 4 lbs a week in the loss but there is alot you can do just alot of research with both keto and eating high fat low carb style diet and treat it as a life style.

Don't necessary need to be on full on Keto, but there is some good stuff and eating on a budget too.

20g is tough. Once in a while it happens, but as a daily target, for me, it's hard.


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[Nightwatch]

So what are the main benefits of a keto diet over a normal one, as far as being transgender is concerned? Or is it just a nifty way to lose weight with a few added health benefits?

I'm trying to pick out some foods that I can actually stomach (picky eater) that fit into the whole "20 carbs or under" thing but most of them are expensive.

Carbs are cheap, and I'm trying to save as much as I can for hormones and an endocrinologist and a therapist so I can actually get a prescription.

I just found out some good news though. I just measured my chest just under my manboobs and got 39". That's not even considering what I'll be after losing all the weight and extra muscle in there. And I have a lot of fat in that area, especially around the back and front of my chest.

I was extremely worried about my ribs themselves being too large, but after looking at how bra sizes work I'm just at one would consider a Large for women, and again that's at like 35% body fat in addition to muscle that I'll be losing.

I know that's off topic but hey it made me feel kinda good.

[Deborah]

Keto has no benefit specifically to transgender people.  However it does have a lot of health benefits if you at least do it for a few months to normalize your metabolism.  You don't necessarily need to do it forever but rather long enough to fix what's not working right.  After that a good diet with exercise will keep everything in order.

• It will greatly reduce insulin resistance and cure or at least greatly reduce metabolic disorder.  And yes, if you are obese you already have metabolic disorder.  In the long run metabolic disorder leads to obesity, diabetes, heart disease, and dementia.
• It fixes your metabolism so it favors burning fat instead of carbs.  This reduces hunger and allows you to go long periods without eating and without having a sugar and energy crash.

An additional option is intermittent fasting.  This is restricting your eating to a 8 or less hour window each day.  So every day you eat nothing for 16 or more hours.  This has the same benefits as keto plus:

• It normalizes your eating hormones ghrelin and leptin so your appetite signals do not signal hunger all the time.
• It encourages cellular autophagy so your body becomes much more efficient at repairing damaged cells each day.
  
• It causes a an increase in growth hormone.  This assists in increasing lean body mass and decreasing fat.
• There is evidence that in the long run it assists in lowering your setpoint weight so maintaining a lower weight becomes much easier.  This is due to the normalizing of insulin, ghrelin, and leptin that are disregulated due to metabolic disorder.
• It helps prevent cancer by preventing cancer cells from multiplying out of control.  They can only metabolize glucose so where there is no glucose there is no cancer growth.
• Mentally it puts you back in control as your appetite will no longer rage.  You can choose to eat or not to eat with minimal discomfort and no energy deficit.  This is due to the body's greatly increased ability to mobilize fat stores for constant energy.

[Roll]

An additional option is intermittent fasting.  This is restricting your eating to a 8 or less hour window each day.  So every day you eat nothing for 16 or more hours.  This has the same benefits as keto plus:

• It normalizes your eating hormones ghrelin and leptin so your appetite signals do not signal hunger all the time.
• It encourages cellular autophagy so your body becomes much more efficient at repairing damaged cells each day.
  
• It causes a an increase in growth hormone.  This assists in increasing lean body mass and decreasing fat.
• There is evidence that in the long run it assists in lowering your setpoint weight so maintaining a lower weight becomes much easier.  This is due to the normalizing of insulin, ghrelin, and leptin that are disregulated due to metabolic disorder.
• It helps prevent cancer by preventing cancer cells from multiplying out of control.  They can only metabolize glucose so where there is no glucose there is no cancer growth.
• Mentally it puts you back in control as your appetite will no longer rage.  You can choose to eat or not to eat with minimal discomfort and no energy deficit.  This is due to the body's greatly increased ability to mobilize fat stores for constant energy.

I second this. I've been doing this by shear happenstance even before I read about it, and might help explain why I do tend to drop weight reliably when I create a simple calorie deficiency. Anxiety issues started a habit in school that I didn't want anything on my stomach lest I get sick from nerves in the morning, so I just don't eat breakfast(or if I do, it's a very late one at around 10). Lunch usually falls at around noon, dinner at around 6, and I'm not inherently a late night snacker so my food is in a 6-8 hour window 99% of the time. Also helps to explain why I wasn't more overweight when by all rights I should have been.

I'm trying to pick out some foods that I can actually stomach (picky eater) that fit into the whole "20 carbs or under" thing but most of them are expensive.

That is something i ran into as well looking to doing no carbs at one point. I'd have to live off beef jerky and pistachios, and that isn't cheap. I think that is a problem with a lot of diets that rely on more than a calorie deficiency, you run up against costs and availability in many cases. Simply eating less is inherently cheaper on the other hand.

I just found out some good news though. I just measured my chest just under my manboobs and got 39". That's not even considering what I'll be after losing all the weight and extra muscle in there. And I have a lot of fat in that area, especially around the back and front of my chest.

I was extremely worried about my ribs themselves being too large, but after looking at how bra sizes work I'm just at one would consider a Large for women, and again that's at like 35% body fat in addition to muscle that I'll be losing.

I know that's off topic but hey it made me feel kinda good.

Not bad at all! Ribs/chest depth is my big worry right now, but I'm trying to make myself share the hope you have. I measure roughly 40-41, but I have a hard time figuring out how much around the ribs I still can go down because while there is some fat and muscle certainly, I feel mostly bone. I still have 40+ pounds to drop and a natural inclination to upper body muscle so I'm hoping I'm just not understanding how much of that is still muscle and fat. Pulling the fat around I could see dropping 2 more inches if stay perfectly lean later, but I'm nervous.

[brandyvgs]

20g is tough. Once in a while it happens, but as a daily target, for me, it's hard.


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Yeah it was the love for the cheese that did it for me though and seems that I can achieve between 18-25g of carbs per day with mostly fiber in the carb list.

But it is a bit hard at first and still is but being over 250+ for over 15 years since my cancer battle is the motivation I need as I have tried everything pre hrt for dieting and gym, this diet has been the right ticket for me and I kinda got a bit too strict on it for myself. I have been coaching others to keep around 50g for them and they don't need to be as extreme as I am and it seems to be working for them also even with a pizza break or a cheat day.

Fat head pizza is most my favorite, but also I tend to have normal pizza with Marcos 1 per week and doesn't break the strong keto phase I am in and still managing to loose the weight.



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[Roll]

Fat head pizza is most my favorite, but also I tend to have normal pizza with Marcos 1 per week and doesn't break the strong keto phase I am in and still managing to loose the weight.

Ugh, I love Marcos, so angry there isn't one near me anymore. But yeah, cheat days and the occasional lapse absolutely do not hurt, and can even provide benefit. One study I read said that people with cheat days once a week (as long as not too extreme) lost more weight than people who stuck to their diet religiously. One possible(probable really) reason for this is that cheat days with foods you love keep your body from going into starvation mode, so it continues to burn fat/calories properly the rest of the week instead of attempting to conserve them.

With keto diets specifically I'm assuming that your unconscious brain is smart enough to recognize an exception and not immediately exit that keto state.

[brandyvgs]

Ugh, I love Marcos, so angry there isn't one near me anymore. But yeah, cheat days and the occasional lapse absolutely do not hurt, and can even provide benefit. One study I read said that people with cheat days once a week (as long as not too extreme) lost more weight than people who stuck to their diet religiously. One possible(probable really) reason for this is that cheat days with foods you love keep your body from going into starvation mode, so it continues to burn fat/calories properly the rest of the week instead of attempting to conserve them.

With keto diets specifically I'm assuming that your unconscious brain is smart enough to recognize an exception and not immediately exit that keto state.

That probably explained a ton with the cheat day feels like it helps some. When I first started. I am going to experiment more with my birthday next week as I am going to grub at a fancy buffet.

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[Alicia Francesca]

Cool sculpting.Eat for fat you need to develope and lose it where you want to.I even use it in my face to lose the man fat on my jaw bone and neck area.Takes time and research but works.