Susan's Place Transgender Resources

Community Conversation => Transitioning => Hormone replacement therapy => Topic started by: sap on February 23, 2016, 12:13:12 AM

Title: Fat on HRT
Post by: sap on February 23, 2016, 12:13:12 AM
Hey everyone I have some questions about fat during HRT..
sooo


Thanks :)
Title: Re: Fat on HRT
Post by: Deborah on February 23, 2016, 03:50:43 AM
My experience so far is that fat you have now on your belly won't just go away.  However, new fat will be deposited according to the HRT and individual genetics.

To get rid of the belly fat you have to eat less than you burn so like always - diet and exercise.

Again in my experience, at first the belly fat does seem to melt away pretty quickly.  But the last few inches of it are proving very difficult to lose.  Getting below 25 BMI was surprisingly fast and easy.  But each point below that gets harder.

Running burns calories.  If you are eating more than you burn you won't lose anything.  I have gained weight before when running marathons by eating too much.  You need to track your diet.  That's really the most important thing.  Myfitnesspal is an excellent tool for that.

I'm not positive about the weight training but once your testosterone levels are low you shouldn't be able to build male pattern bulk anymore.


Sapere Aude
Title: Re: Fat on HRT
Post by: V M on February 23, 2016, 04:38:05 AM
HRT will redistribute certain types of fat, but imo exercise and diet are still the best ways to achieve a nice lean body shape  :icon_chick:
Title: Re: Fat on HRT
Post by: Ms Grace on February 23, 2016, 04:55:21 AM
Don't be fooled by the concept of fat redistribution. Fat does not move around! It's either in one place or it is not. And generally belly fat is one of the hardest to get rid of without a lot of specific attention and exercise and diet. It's a shame it won't just travel up to the boobs or down to the hips but that's reality.
Title: Re: Fat on HRT
Post by: KayXo on February 23, 2016, 11:06:16 AM
I seriously question the assertion that exercice will help burn belly fat. We have been conditioned to believe this but I doubt if this is in fact true. I think the more important factors are diet and HRT. Don't eat too many carbs, especially refined and junk food, avoid fruit juices and sodas. Estrogen alone should also help with belly fat. Progestogens, on the other hand, might increase it. Restricting calories is not necessary either (it will only make you hungrier and more miserable), it's the type of food you put in your mouth that matters most.

Exercise is good for other things, like muscle tone, mood and cardiovascular health but unlikely to help with belly fat, IMHO.

I'm basing my assertions on science as I have extensively read the literature pertaining to this matter.
Title: Re: Fat on HRT
Post by: Stevie on February 23, 2016, 12:25:50 PM
 I have been wearing size 12 jeans since I started HRT last june, I have lost a about 10 lbs since starting and the same jeans are getting tighter.
Title: Re: Fat on HRT
Post by: RobynD on February 23, 2016, 12:30:00 PM
I've lost waist size and gained butt and hip size, all the while my weight has remained within a 3-4 pound swing. I have paid attention to decreasing my calorie intake though, I am consistently at about 1600 per day for at least 5-6 days per week. My metabolism has definitely slowed, i believe that i could gain very easily if i allowed myself to.
Title: Fat on HRT
Post by: Deborah on February 23, 2016, 12:34:33 PM
Exercise has to burn calories that come from somewhere.  So if your daily calorie balance is negative that somewhere is in energy stored in the body.  That will be a mix of glycogen and fat with the proportions heavily dependent on cardiovascular fitness and exercise intensity.

It is true though that you can't target the fat from one specific area, belly or otherwise.  But it will come off of the belly eventually if one remains persistent.

And diet is an important part of the equation.  Skip the processed junk and eat real food.  Hunger is much less of a problem that way.  It also eliminates the "sugar" highs and lows. 

As I have recently learned from KayXo and tried on myself you need far fewer carbs each day than you probably think.  So eat lots of protein, don't worry about the fat, and eat only unprocessed natural carbs.  Everything seems to come into balance then.


Sapere Aude
Title: Re: Fat on HRT
Post by: KayXo on February 23, 2016, 01:18:21 PM
Quote from: Deborah on February 23, 2016, 12:34:33 PM
Exercise has to burn calories that come from somewhere.  So if your daily calorie balance is negative that somewhere is in energy stored in the body.  That will be a mix of glycogen and fat with the proportions heavily dependent on cardiovascular fitness and exercise intensity.

Exercise will burn calories but will also increase appetite as a result, so you end up recuperating back these calories. If you don't, you will end up tired. A negative caloric balance will sap your energy away, reduce your metabolism, make you hungrier and more tired. It never works and people end up giving up, bingeing and gaining even more weight in the long-term as metabolism is slowed down for awhile.

Just read about the Minnesota Starving Experiment OR ... read the entire chapter dedicated to exercise in "Why we get fat" where this is explained in detail. Or the article entitled "The Scientist and the Stairmaster", or the article "Why Exercise Won't Make You Thin" in Times magazine (Aug 9, 2009).

Also, this study

J Am Diet Assoc. 2007 Oct;107(10):1755-67.
Weight-loss outcomes: a systematic review and meta-analysis of weight-loss clinical trials with a minimum 1-year follow-up.


"advice-only and exercise-alone groups experienced minimal weight loss at any time point."

Excerpts from Gary Taubes' other book (Good Calories, Bad Calories)...

"his patients tended to lose more weight with bed rest, "while unusually strenuous physical exercise slows the rate of loss."

"He will have to climb twenty flights of stairs to rid himself of the energy contained in one slice of bread!"

"Though more strenuous exercise would burn more calories, it would also lead to a significant increase in appetite. This is the implication of the phrase "working up an appetite""

"Thus men doing very heavy physical work spontaneously eat more than men engaged in sedentary occupations."

"Statistics show that the average daily caloric intake of lumberjacks is more than 5,000 calories while that of tailors is only about 2,500 calories."

"when the epidemiologist Alvan Feinstein examined the efficacy of various obesity treatments in a lengthy review in the Journal of Chronic Diseases, he dismissed exercise in a single paragraph. "There has been ample demonstration that exercise is an ineffective method at increasing energy output," Feinstein noted, "since it takes far too much activity to burn up enough calories for a significant weight loss. In addition, physical exertion may evoke a desire for food so that the subsequent intake of calories may exceed what was lost during the exercise.""
 
Title: Re: Fat on HRT
Post by: Deborah on February 23, 2016, 01:24:22 PM
I agree.  Diet tracking and self discipline both are important. 

Also, as I have found out recently, controlling sugar intake greatly reduces felt hunger as well as getting enough fiber.

Exercise also allows you to eat more while maintaining a calorie deficit.  But I am talking about a rather significant amount of exercise too.  Right now I'm getting about 12 miles walking and some running a day.  That adds up to about 1000 extra calories burned.  It helps a lot that I enjoy it and listen to audiobooks on my phone.


Sapere Aude
Title: Re: Fat on HRT
Post by: KayXo on February 23, 2016, 01:51:01 PM
Quote from: Deborah on February 23, 2016, 01:24:22 PM
Exercise also allows you to eat more while maintaining a calorie deficit.

If a caloric deficit leads to hunger and less energy, makes you miserable it's just not worth it. There are other, easier, more enjoyable ways to go about it that have been shown to be effective.

QuoteBut I am talking about a rather significant amount of exercise too.  Right now I'm getting about 12 miles walking and some running a day.  That adds up to about 1000 extra calories burned.

I believe some of the above excerpts mention "strenuous exercise" as well and the problem with this as it significantly increases appetite and actually may slow rate of loss compared to bed rest.


Title: Re: Fat on HRT
Post by: Deborah on February 23, 2016, 01:54:03 PM
Yes, high intensity exercise burns predominantly glycogen which will cause a sugar low and a hunger spike.  What I'm doing right now is predominantly low intensity which burns mostly fat for energy and does not cause an uncomfortable hunger spike.


Sapere Aude
Title: Re: Fat on HRT
Post by: sap on February 24, 2016, 12:06:40 AM
Thanks everyone I didn't expect so much replies! :)

KayXo, I didn't understand you, how would I lose fat if I don't have calorie deficit?

And I understood that what I eat is more important that how much I exercise but there's a problem,
In my office we get a magnetic card that lets us eat outside so almost everyday is junk food... sometimes I choose a big salad but it's depressing to eat it everyday.
I'm also addicted to cola  :(

Currently I'm running about 6km+ every week.
Title: Re: Fat on HRT
Post by: Lucie on February 24, 2016, 04:49:56 AM
Quote from: sap on February 24, 2016, 12:06:40 AM
KayXo, I didn't understand you, how would I lose fat if I don't have calorie deficit?

You must (re)teach your body to burn fats instead of carbs when you exercise. This means eating more fats and less carbs. If you have sufficient proteins intake at the same time you will gain muscle mass and maintain your overall calorie intake and body weight while losing undesirable fat. Furthermore this will reduce your blood insuline which is beneficial to general health.

That said, Kay will probably be able to give a lot more details on this subject.
Title: Re: Fat on HRT
Post by: Claire_Sydney on February 24, 2016, 06:44:52 AM

Quote from: Lucie on February 24, 2016, 04:49:56 AM
You must (re)teach your body to burn fats instead of carbs when you exercise.

I'm confused. I didn't think it was possible to train your body to change the catabolic priority?

I understood that fat is always oxidised the most towards the lower end of the aerobic range.

I also understood that at the higher end of the aerobic range, and in the anaerobic range, liver and muscle glycogen are the dominant contributors to blood glucose.

Finally, I thought that protein is only catabolised when glycogen stores are depleted, or nearing depletion (or in the aerobic range when lipids are also depleted).

I don't see how you can train your body to alter this process? Or are you talking about interval training to try and modify the aerobic and anaerobic thresholds?

[ Given the number of individuals here that have regular contact with an endocrinologist, we could probably ask one! ]
Title: Re: Fat on HRT
Post by: Lucie on February 24, 2016, 07:26:08 AM
Quote from: Claire_Sydney on February 24, 2016, 06:44:52 AM
I'm confused. I didn't think it was possible to train your body to change the catabolic priority?

I understood that fat is always oxidised the most towards the lower end of the aerobic range.

I also understood that at the higher end of the aerobic range, and in the anaerobic range, liver and muscle glycogen are the dominant contributors to blood glucose.

Finally, I thought that protein is only catabolised when glycogen stores are depleted, or nearing depletion (or in the aerobic range when lipids are also depleted).

I don't see how you can train your body to alter this process? Or are you talking about interval training to try and modify the aerobic and anaerobic thresholds?

[ Given the number of individuals here that have regular contact with an endocrinologist, we could probably ask one! ]

Sorry, I can't have a more in depth discussion on this subject as I have unsufficient english language skills and also a too much superficial understanding of metabolisms of carbohydrates, proteins and fats.
See information from Nora T. Gedgaudas, Robb Wolf, Mark Sisson, Mary G. Enig, among numerous others.
I assume that Kay and/or other girls (or guys) will give more details with more pertinence and clarity than I can do.
Title: Fat on HRT
Post by: Deborah on February 24, 2016, 09:00:43 AM
A good book on this subject is: The Big Book of Endurance Training and Racing by Dr. Phillip Maffetone and Mark Allen.

Among other things covered in the book is diet and its effect on metabolism, health, and endurance.  The point the book makes is that carbohydrates are not bad and are in fact necessary.  However, the highly refined carbohydrates that most people consume in abundance are bad.  The reason is that they cause a quick rise in blood sugar which triggers a big release of insulin.  The insulin causes body fat stores to increase, causes blood sugar to crash thus triggering intense hunger, and prompt the body to burn increased amounts of glycogen and less fat at all times.

So the solution is to not eat processed carbohydrates.  I have been trying this for the past 3 1/2 weeks and I'll say the results are pretty astounding to me.  My blood pressure has dropped significantly throughout the day,  and I do not suffer from any intense hunger despite eating at a 900 to 1000 calorie deficit each day, generally 1600 to 1900 calories eaten.  Sugar spikes and crashes are a thing of the past and my energy seems to remain consistently high.

I am still eating around 150 to 180g of carbs a day but they are all natural, fruit, grains, vegetables, etc.  I have stopped processed carbs entirely.  I used to eat 300 to 500 carbs a day of which a lot of them were processed and full of sugar.

The book recommends a two week trial eating this way without any other specific dietary or calorie constraint.  It takes about two weeks for the body to readjust to the new diet and begin functioning in a supercharged mode.  It did work for me and while I will eventually increase my calories overall I don't think I'll be going back to the old way of eating ever.  This just feels too good.


Sapere Aude
Title: Re: Fat on HRT
Post by: Lucie on February 24, 2016, 09:37:01 AM
Quote from: Deborah on February 24, 2016, 09:00:43 AM
I am still eating around 150 to 180g of carbs a day but they are all natural, fruit, grains, vegetables, etc.  I have stopped processed carbs entirely.  I used to eat 300 to 500 carbs a day of which a lot of them were processed and full of sugar.

Deborah, when you say 150 to 180g of carbs, is this the weight of food containing carbs or the weight of pure carbohydrates contained in that food ?
Title: Fat on HRT
Post by: Deborah on February 24, 2016, 09:49:07 AM
Quote from: Lucie on February 24, 2016, 09:37:01 AM
Deborah, when you say 150 to 180g of carbs, is this the weight of food containing carbs or the weight of pure carbohydrates contained in that food ?
That's the carbohydrate content.  I use Myfitnesspal to track diet and use the values in their database.  So yesterday my diet was Protein 121g, Fat 60g, Carbs 163g, Fiber 39g.  Total sugar was 62g which is ideal according to medical articles I have read on the Internet.


Sapere Aude
Title: Re: Fat on HRT
Post by: KayXo on February 24, 2016, 10:11:23 AM
You should always subtract fiber (not absorbed) from carbs to get the real value of carbs.

The key is INSULIN, other hormones also matter, like estradiol, progesterone, testosterone, growth hormones, cortisol, etc. These will dictate how your body burns and stores fat, uses sugar and protein. Furthermore, these effects will determine how much fuel is available to you and not stored away, what type of fuel you are using (carbs vs. fats), etc AND your appetite, your body weight, your lean mass, etc.

It's not how much you eat that matters but WHAT you eat as different foods affects differently hormones in the body, namely insulin. Genetics have an important role to play as well.

Carbs have the greatest effect on insulin secretion because insulin helps to decrease blood glucose levels which are increased when you consume carbs. Insulin is a fat storing hormone.

Gary Taubes' books, "Good Calories, Bad Calories" and "Why we get fat" explains it in more detail, with a ton of scientific references. You can also check him out on Youtube. Others include Peter Attia, Jeff Volek, involved in various studies done, Stephen Phinney, etc.
Title: Re: Fat on HRT
Post by: Lucie on February 24, 2016, 10:18:13 AM
Quote from: Deborah on February 24, 2016, 09:49:07 AM
That's the carbohydrate content.  I use Myfitnesspal to track diet and use the values in their database.  So yesterday my diet was Protein 121g, Fat 60g, Carbs 163g.  Total sugar was 62g which is ideal according to medical articles I have read on the Internet.

I could not eat as much proteins and carbs as you. I understand that you exercise a lot (in any case a lot more than I do) so I am surprised by your calorie intake which is less than 1700 calories: it's rather low, even for an inactive woman. But I assume that your diet is well suited to your lifestyle and your well being.
Title: Fat on HRT
Post by: Deborah on February 24, 2016, 10:24:29 AM
Quote from: Lucie on February 24, 2016, 10:18:13 AM
I could not eat as much proteins and carbs as you. I understand that you exercise a lot (in any case a lot more than I do) so I am surprised by your calorie intake which is less than 1700 calories: it's rather low, even for an inactive woman. But I assume that your diet is well suited to your lifestyle and your well being.
The protein I get by eating a protein only breakfast, 3 to 4 oz ham slice pan fried in coconut oil, topped with a tbsp of cream cheese and two fried eggs.  Then for lunch I have lentils and quinoa which are both high in protein.  Supper is some moderate portion of meat and vegetables then later a half cup of cottage cheese with an apple and a cup of Greek yogurt with added chia seeds.  The last three are dependent on how many calories I have left.  I also eat some peanuts if the calorie balance allows it.  So the protein just adds up throughout the day.


Sapere Aude
Title: Re: Fat on HRT
Post by: KayXo on February 24, 2016, 10:36:45 AM
If you are consuming chia seeds for their omega-3, do realize that what you get in your body is a precursor to DHA and EPA, called ALA (alpha-linoleic acid) and is not efficiently metabolized/converted to what your body needs. Vegetable omega-3 is just not as efficient as getting it from animal foods (i.e. fish). But, if you like it, then enjoy. :)

I would encourage you to read about the potential hazards of peanuts as well due to lectins, aflatoxin, etc. Contains a whole lot of omega-6 as well so potentially inflammatory. Peanuts are actually a legume, not a nut.
Title: Re: Fat on HRT
Post by: Deborah on February 24, 2016, 10:42:58 AM

Quote from: KayXo on February 24, 2016, 10:36:45 AM
If you are consuming chia seeds for their omega-3, do realize that what you get in your body is a precursor to DHA and EPA, called ALA (alpha-linoleic acid) and is not efficiently metabolized/converted to what your body needs. Vegetable omega-3 is just not as efficient as getting it from animal foods (i.e. fish). But, if you like it, then enjoy. :)

I would encourage you to read about the potential hazards of peanuts as well due to lectins, aflatoxin, etc. Contains a whole lot of omega-6 as well so potentially inflammatory.
my primary reason for the chia seeds is the added fiber, 8g in two tbsp.  Also, they have a mystique for me from reading the book Born to Run.  LOL

I didn't know that about the peanuts.  I'm not eating much though.  Usually 140 cal is my limit.


Sapere Aude
Title: Re: Fat on HRT
Post by: JessicaSondelli on February 24, 2016, 02:47:31 PM
I also highly recommend the book "The 4-Hour Body" by Tim Ferriss. I lost almost 50 pounds within about 4 months and was never hungry. The diet is called "Slow Carb Diet" and is - quire obviously- very protein driven and prohibits white carbs. If you don't like to eat eggs for breakfast then this diet is not suitable for you.

The only drawback for me was that I gained quite some muscles without much training but I hope HRT will take care of this. I'm set to start it in just 2 weeks!!! Yeahhhhhh [emoji18][emoji18][emoji18]

Love u all
-Jessie


Sent from my iPad using Tapatalk
Title: Re: Fat on HRT
Post by: Deborah on February 24, 2016, 03:06:54 PM
I began doing body weight push-ups, sit-ups, and squats along with some running and a lot of walking about six weeks ago.  My observation on HRT's effects is that core and lower body leg strength and speed of improvement is not really affected.  Ability to run is not really affected at lower intensities.  From last year's experience it is affected at higher intensities.  Upper body strength and rate of improvement is severely impacted.

Beyond that, even after a year on HRT I think I still have too much upper body mass.  It's starting to show definition again although it is smaller than before.

I have about concluded that my only two choices for the future are an athletic looking body or an overweight body.  Anything else seems kind of out of the question.  But more time on HRT might make more difference than I am expecting.


Sapere Aude
Title: Re: Fat on HRT
Post by: Lucie on February 25, 2016, 06:33:30 AM
Quote from: KayXo on February 24, 2016, 10:11:23 AM
You should always subtract fiber (not absorbed) from carbs to get the real value of carbs.

Kay, do you mean that carb contents weight which is given for each food in calorie tables includes fibers (which are not digestible) ?

EDIT: I think I've found the answer in a news article (in french) about a conference of the American Academy for the Advancement of Science held in 2013 in Boston. They tell that a part of fibers present in food are indeed digested and thus that fiber contribution should be added to calorie intake (1g fiber counting for 2 calories).
Title: Re: Fat on HRT
Post by: Lucie on February 25, 2016, 07:52:07 AM
More precisely, they tell that digestion of fibers produces (volatile) fatty acids the calorie load of which should be added to the overall calorie intake. Carbs contained in fibers are not absorbed and should not be accounted in carbohydrate and calorie intakes.
Title: Re: Fat on HRT
Post by: sap on February 28, 2016, 12:15:58 AM
I tried to use myfitnesspal multiple times but failed.
I really don't know how to do it while I eat lunch outside every day...
Do I give up on the free meal and bring mine from home?
Do I go and eat salad everyday insread of chicken/hamburger/sushi?
Is there a rule for how to choose food when you have no choice but to eat outside?
Title: Re: Fat on HRT
Post by: Deborah on February 28, 2016, 03:06:30 AM
Eating the free meal outside is fine if that's what you want to do.  But if you eat a high calorie meal outside you need to work around that by eating lower calorie meals at home.  What and how much you eat at one meal is relatively unimportant as long as the daily and weekly calorie and nutrient balances are where you want them to be.

The only rule is to keep the whole diet in balance.  When you're eating outside you may have to estimate.  That does get easier with time and experience.

In my opinion it is really important to track everything you eat.  It's really easy to eat too many daily and weekly calories if you don't.  It also really helps in building your knowledge of what foods and meals will keep you satisfied hunger wise without being too high in calories or unhealthy in their nutrient balance.  Myfitnesspal is the best I have ever used but there are many others.  Back in older days I used to do it with a book and a piece of paper.  That works too but is very tedious and time consuming.  So just find a method that works for you.


Sapere Aude