Hormone replacement therapy (HRT) can lead to changes in weight, but the effects vary considerably between individuals. Several key factors influence whether someone is likely to gain or lose weight on HRT: Testosterone - Increases muscle mass and decreases fat mass - May lead to slight weight loss in those assigned female at birth Estrogen - Increases body fat storage, particularly around the hips and thighs - May lead to slight weight gain in those assigned male at birth Progesterone - Can increase appetite and lead to water retention - Usually taken with estrogen, so can contribute to weight gain Age and genetics also impact how one's body responds to hormonal changes. Younger people tend to find it easier to lose/gain weight intentionally during their transition. Genetics play a key role in where fat is deposited.
People assigned male at birth who transition with estrogen HRT often experience:
This fat redistribution can lead to modest weight gain, although the amount varies.
Younger transgender women are more likely to lose weight intentionally during transition. However, genetics also play a big role - some deposit more fat in traditionally “feminine” areas vs. the abdomen.
Progesterone, often taken with estrogen, may also increase appetite and water retention, contributing to weight gain.
People assigned female at birth who transition with testosterone HRT often experience:
Especially in the first 3-6 months, testosterone has an anabolic, muscle-building effect. Lean mass increases while fat mass declines - leading many to lose weight.
However, some later regain weight as their appetite and calorie intake increases. To maintain weight loss, paying attention to diet and exercise is important.
Age and genetics again play a key role. Those with more muscular builds pre-transition are likely to gain more muscle mass on testosterone.
Here are some tips for managing weight during gender affirming HRT:
Monitor nutrition and activity levels. Being aware of diet and exercise helps maintain a healthy weight. Bulking up or slimming down must be balanced with adequate nourishment.
Make dietary changes gradually. Rapid changes can shock the system - make small, sustainable adjustments. Eliminate empty calories and maximize nutrient density.
Control portions. Use smaller plates, don't eat directly from packages, and avoid endless snacking. Quantify servings to avoid overeating.
Stay active. Weight training preserves/builds muscle mass. High Intensity Interval Training is excellent for burning fat. Mix up your workouts to keep your body guessing.
Give it time. It takes months-to-years for full effects of HRT to emerge. Be patient and focus on building healthy habits. Follow medical advice from your hormone therapy specialist.
New Beginnings HRT Clinic has decades of experience guiding transgender clients through safe, effective medical transition. () or book a consultation today to get started! Our compassionate care team is here to support you each step of the way.
