The Great HRT Weight Debate

[Stephanie]

I have had nothing but weight problems since I first started hrt back on 1st October 2010.   Right from the start I experienced noticeable bloating and weight gain.   I had to come off hrt by the end of the first week in November because I had gained so much weight.   I was depressed about my appearance and my mother was consulting the medical books looking for an explanation for my terrific weight gain, she didn't know anything about my taking oestrogen. During this 35 day period I gain 28lbs in weight(that is TWO stones).

I started taking oestrogen daily again on the 23rd of March 2011 and stopped again on the 21st of April as once more I was bloated and piling on the pounds.   During this period I gained 14lbs in weight.

I did understand that weight gain was something that could happen on hrt and I was prepared for it.  However, I keep reading accounts of people who write ' I have been on hrt for 1 year now and I can't seem to stop losing weight.   I want to look curvy and have good sized breasts, can anyone tell me how to gain weight?'   Others reply ' It is the same with me.  I am smaller, slimmer and losing upper body strength.   I am a B cup but if I could just gain weight I know I could have C cup breasts.'



This is an opportunity to debate a very important question as I am sure that the serious weight gain may well put people off hrt as it has me.  Perhaps by sharing our experiences we can come to some sort of plausible explanation as to why many transgender people gain so much weight and gain it so quickly.   



UPDATE:  Since stopping hrt on Wednesday I no longer feel bloated and I have lost 5lbs of the 14lbs gained.

[girl_ashley]

Sounds like you are having a profound issue with the hormones.  I suggest you best consult with your doctor about this issue.  I haven't noticed myself having lost any weight since beginning HRT, my body continues to perfectly maintain a set weight.

[Ann Onymous]

Everybody has different metabolisms.  In my case, the HRT did not contribute to either weight gain or weight loss.  I cannot attribute going from 125 to 155 even on being post-op and full loss of natural T.  Rather, it was a lot more about spending more time sitting on my butt in an office and exercising a lot less (to include even recreational leagues or swimming in the backyard). 

As I got beyond 40, I did notice a slowing of the metabolism, which is something I fully expected to occur just as part of the aging process. 

For the amounts being discussed by the OP, it sounds as though there is a possibility of other issues being at play.  That much gain is something to discuss with a doctor...seriously. 

[JungianZoe]

I'd suggest what everyone else here has suggested... see a doctor about that one.  It sounds rather out of the ordinary.

I've also gained weight, but through conscientious effort of eating 4000 to 5000 calories a day.  Even with that, I've gained only 15 pounds in the last two months (nearing my goal of 20 pounds so I can be back into the normal weight for my height and for some body fat that estrogen can redistribute).  Nothing like the serious weight gain in a short time that the OP reports.

[Jameve]

I'd suggest what everyone else here has suggested... see a doctor about that one.  It sounds rather out of the ordinary.

I've also gained weight, but through conscientious effort of eating 4000 to 5000 calories a day.  Even with that, I've gained only 15 pounds in the last two months (nearing my goal of 20 pounds so I can be back into the normal weight for my height and for some body fat that estrogen can redistribute).  Nothing like the serious weight gain in a short time that the OP reports.

I'm really interested in knowing what weight gain supplement you take, if any. I lost a few pounds since starting hormones about 6 months ago and that's not a good thing for me because I was already underweight to begin with. I literally (okay, not quite literally, but almost) have no appetite. 

[MarinaM]

HRT makes me as hungry as a pregnant woman.

After 6 weeks I feel like I've gained weight, but I've actually lost 1.5 lbs. Weird!

[JungianZoe]

I'm really interested in knowing what weight gain supplement you take, if any. I lost a few pounds since starting hormones about 6 months ago and that's not a good thing for me because I was already underweight to begin with. I literally (okay, not quite literally, but almost) have no appetite. 

No supplement... I take a multivitamin, but I've been mostly on a peanut, pizza, ice cream, and powerbar diet.    Also, another reason I can eat so many calories is that, since I began recovery from anorexia three years ago (when I was 5'11" and 100 lbs.) I haven't been able to tell when I'm full.  My stomach and my brain literally don't register that feeling.  Just last Tuesday, within one hour after getting a blood test for which I had to fast, I drank two 24 oz. bottles of diet Mountain Dew (breaking off of that though) and a bottle of water, ate two powerbars, a 400-calorie bag of Sun Chips, a sandwich, and then went for a scoop at Baskin Robbins.

I can also get away with this diet because, like both of my parents, I have non-existent bad cholesterol levels and a corpse's blood pressure.

Another factor might be that I had laparoscopic Nissen fundoplication surgery on my stomach four years ago to control the severe stomach acid problems I had since the age of 13.  It's basically the opposite of gastic bypass surgery in terms of what part of the stomach remains for digestion after the procedure.  Due to complications (some of the same ones gastic bypass patients have) my diet is severely limited to a few foods that don't cause severe digestive distress, a list which only includes four foods, none of which are particularly healthy.

[JennX]

Genetics, metabolism, and physiology. Everyone is different.

It's not a 100% guarantee you'll either gain or loose weight on HRT. I've actually lost quiet a few pounds while on HRT through conscious diet and exercise. I've heard the same from some other MTFs on HRT as well, so it's definitely not impossible. It just takes hard work, constant effort, and dedication.

[japple]

My doctor warned me that most of her MTF patients gain weight, some very significantly.

Hormones effect your carbohydrate and insulin sensitivity and mess with your metabolism.

Only way to combat it is radical changes in diet.  You can't eat what you used to.  Eat like a girl.

[Ann Onymous]

Only way to combat it is radical changes in diet.  You can't eat what you used to.  Eat like a girl.

not always an accurate statement...and I have known natal women who could always put away far more than I used to put away when I had the metabolism from hell. 

as to diet...I am still eating much the same as I did years ago when I was a wafer-thin baby dyke.  Have I put on a few pounds in the intervening 20+ years of adulthood?  yeah.  but diet has far less to do with it than me being incredibly lazy and doing next to no exercising.  As JennX noted, everyone is different.  There are no blanket statements that can be made...

[Adabelle]

HRT is definitely affecting me.

I'm a pretty dedicated calorie counter, and until about two weeks ago was very good at keeping a mental tab on where I was at any given time during the day.

Since starting HRT though I feel like I have an idea of how many calories I've eaten, but when I sit down at night to enter them into my journal I realize I've gone over my goal by 20-40% on most days! This is unheard of for me.

I think HRT is making me more hungry, and helping me sort of 'forget' how many calories I'm eating. I haven't gained weight yet while on HRT, but I need to be losing weight - not staying at my current levels. I'm still overweight.

Anyway, it's a fascinating topic.

[Joelene9]

  I am slowing down at the trough after the GI tract bug I had last week.  However, my cholestoral levels are back within the normal range after 5 months on HRT. 
  Joelene

[V M]

The weight gain is probably my biggest issue with HRT    I don't eat even half as much as I use too but I've gained weight... I'm not particularly heavy looking but when I look at the scale the number is much bigger than I'd like to see

I have been mentally debating though that maybe my metabolism is slowing down because I'm getting older... But whether it's the HRT, getting older or a combination of the two, I don't like it 

[RabbitsOfTheWorldUnite]

I'd suggest what everyone else here has suggested... see a doctor about that one.  It sounds rather out of the ordinary.

I've also gained weight, but through conscientious effort of eating 4000 to 5000 calories a day.  Even with that, I've gained only 15 pounds in the last two months (nearing my goal of 20 pounds so I can be back into the normal weight for my height and for some body fat that estrogen can redistribute).  Nothing like the serious weight gain in a short time that the OP reports.

I'm in the same circumstance as you!! I've been 145 lb and 6'1" for half my life (based on school records) and have recent resumed all the good hormones with a goal to get to 160 lb finally. It may be biased but I am of the opinion that when you don't eat, you don't gain weight. I have been, at times, borderline anorexic; so eating enough calories to actually gain weight has been somewhat of a challenge. Remember: drinking = eating. I'm somewhat thankful that my body can't tolerate carbonated beverages (sodas make me stop breathing for just a bit) so I drink very few calories. My plain advice to those who want to lose weight: drink nothing but plain water and eat nothing but raw fresh veggies. I'm also thankful that my body isn't addicted to anything nor does it require meat to function properly. So people do need meat though, while plenty of others are addicted to drinking their calories. Oh well. Different people is what makes society better. There's no good, there's no bad, there's just different. And when people want to change, people can change.

[Stephanie]

I think that diet plays an important part in hrt weight gain.    I don't drink alcohol nor do I drink soft drinks or fruit juices.   I am a tea and tap water girl.    Did you notice that the first time I was on hrt I gain 28lbs and only 14lbs the second time despite the time period being almost the same?   What is different this time is that I don't eat rice or pasta but I do eat a lot of bread.   I once ate 18 slices of bread in a single day.  All flour/starch based foods get turned into sugar by the body and if the body's muscles have no immediate need of this glucose this sugar gets sent to the body's fat storage areas and stored.    One good thing came of my weight gain I could definitely seen the beginnings of breasts, even though I developed a Buddha belly and a double chin.

[japple]

There are no blanket statements that can be made...

63 + % of Americans are overweight or obese.  So being normal weight or thin is less likely than not.

Diet and exercise matter for MOST people.

[JessicaH]

The only thing I can medically think of that could cause that sort of weight gain would be HRT causing a spike in cortisol levels and or thyroid functions.  It's possible that your E levels are/were too high and knocking everything out of whack. Hopefully, you are working with an endo that is monitoring your endocrine system. I would seek an endocrinologist that is experienced in treating transsexuals.

Good luck!
Stacy

[Ann Onymous]

63 + % of Americans are overweight or obese.  So being normal weight or thin is less likely than not.

Diet and exercise matter for MOST people.

which is different from your earlier post to which I had responded.  Radical changes in diet are NOT something that MOST people have to make and the 'eat like a girl' comment was, quite frankly, laughable.   

Regarding percentages of 'overweight or obese' it becomes necessary to look at what is being used as a standard.  Even with the pounds that I have added that were described earlier in this thread, I would still be underweight on a lot of charts but MIGHT have a caliper check that shows me with an off-kilter BMI despite the fact that I can still wrap my thumb and middle finger around my wrist and have space left under the circle created by the wrap. 

Sudden spikes like have been described in this thread are something that the physician needs to be made aware of. 

[Joelene9]

The only thing I can medically think of that could cause that sort of weight gain would be HRT causing a spike in cortisol levels and or thyroid functions.  It's possible that your E levels are/were too high and knocking everything out of whack. Hopefully, you are working with an endo that is monitoring your endocrine system. I would seek an endocrinologist that is experienced in treating transsexuals.

Good luck!
Stacy

Stacy,
  I think you're very close in most cases here.  I was on the herbal HRT version last year.  It only made the breasts grow to a sub-A cup, but after 3 months, that and the other things leveled off.  The chest hair that was thinning came back with a vengence.  At 5 months on the herbals, I had the blood draw done.  My thyroid indicated a hypo condition, my cholesterol was above the safe range and my PSA tied a high reading from a few years earlier. 
  This time after 5 months on HRT; EVERYTHING, I mean EVERYTHING returned to the normal readings, some of those that I've haven't seen in years!   Weight gain after eating like a pig and ingesting some caffeine drinks since November: -7 lbs.  I wasn't allowed any caffeine during my herbal time, including tea!  I purposely started HRT almost to the day, a year later, when I started the herbals to track my progress by the seasons as well.  I may have a complete month by month, one year comparison synopsis on herbal vs. HRT this coming November. 
  I am sitting here stunned by my realization that my physical as well as my mental health improved that much, the realization being triggered by Stacy's post above.  Thanks Stacy!  HUGS!
  Joelene

[JessicaH]

■In some individuals with depression, alcohol abuse, anorexia nervosa or high estrogen levels, cortisol levels may be chronically elevated. These patients with "pseudo-Cushing's" may be difficult to distinguish from those with true Cushing's. Additional hormonal tests are often needed to clarify the diagnosis.
http://neurosurgery.ucla.edu/body.cfm?id=1123&ref=33&action=detail

I did a little research and confirmed a link between HIGH estrogen levels and Cushing Syndrome symptoms which can include RAPID weight gain.