I am often asked if HRT (Hormone Replacement Therapy) truly redistribution fat from typical male areas (shoulders, stomach, etc) to a typical female areas (thighs, hips, butt, & breast). Once a you start HRT weight cycling can help speed up the fat redistribution process.
The human body is the ultimate machine and adapts quickly for survival. This allows us to live in extreme environments (Arctic to Sahara), allows us to go weeks without eating, but also allows us to be obese. Therefore our bodies can adapt and become stagnate and to create change we must SHOCK our system. Bodybuilders will never do the same routine week and week out as our muscle adapt to and will not grow. By changing the workout exercises, positive to negative, weight versus reps, etc SHOCKS our muscle and metabolism thereby creating change.
Hormones may act like a gating system exerting local effects on adipocytes in transgender people. When X hormone is present, gates for fat burning are open in Y location and closed in Z location. If fat resources are consumed, they will be pulled from the areas opposite that of the normal distribution of the adipose for that hormone. If fat resources are added, they will go where “the gates are open” based on local signaling from hormones.
Maintaining a static weight during transition may result in poor breast development simply due to the fact that all that is grown is mammary gland, and fat re-distribution may not occur in some patients without larger shifts in their total body weight.
When your blood sugar is high, your pancreas releases insulin which stimulates increased fat storage. After you go on HRT, estrogen promotes growth of fat in your butt, thighs and breasts and discourages belly fat. When your blood sugar is low, your insulin levels fall and the lack of insulin causes fat that is stored in your fat cells to be released into your blood to maintain homeostasis. Your equilibrium fat distribution is strongly influenced by sex hormones. If you deliberately go through periods of high and low blood sugar through weight cycling or intermittent fasting then you will reach the new equilibrium faster.
Weight cycling works, it’s just biological dynamics at play induced through HRT. Obviously if you have a history of eating disorders it’s something you should avoid, but it is not inherently dangerous or bad. If you want to increase the speed of redistribution without weight cycling, exercise is a great alternative.
Here are some things that helped me:
- Daily exercise. Doesn’t matter what you do, but if you have a sedentary lifestyle, just do something active every day. (I run at least five miles 4 days a week for a few month, then I cycle to lifting weights for a few months). Remember it’s all about shocking the body.
- Intuitive eating: pay close attention to your body and eat what it tells you to (and how much it tells you to). It’s sometimes easy to make substitutions. For instance, if you’re craving ice cream, pay attention to if your body wants the sugar, the fat, or the cold and then choose something healthier that still hits that craving (e.g. fruit, cheese, or a just hydration). If it doesn’t fill the craving after a while, have a serving of ice cream and see if that hits the craving. Intuitive eating also means paying attention to how you feel during and after eating: did the empty calories actually taste good? Did it make you feel good after or does your stomach hurt?
- Focus on having a healthy lifestyle that you can keep up with (instead of focusing on losing weight). There’s no evidence that “dieting” helps you lose weight.
- Cook your own meals. You can control portions better and home-cooked food is generally healthier than restaurant food. If you’re not sure how to cook or you’re not sure how to pick healthy meals, try to find a dietitian if you have access to one.
- Focus on eating healthy foods (rather than stopping eating “unhealthy” foods). e.g. If you fill yourself up on veggies, you won’t be as hungry for everything else.
- Make changes slowly: what’s the absolute smallest thing you can do starting today to be just a little bit healthier? Do that for a week then make another tiny change.
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