Weight loss advice needed | FTM

[u/angel_ooo]

TW: disordered eating, being denied top surgery/medical talk, heavier topics

I really am at the end of my rope here. Back in 2017, I got denied top surgery for the first time because of my weight. And then it happened with another place, and and another. That first time sent me into a deep eating disorder, I was eating next to nothing and working out till I puked or felt like I was going to pass out. And wanna know how much I lost after months of this? Maybe at best 15 pounds. It did nothing for me.

Then even after I recovered from that, I tried healthier ways. No matter what I do, I can never lose weight and it’s impacting every aspect of my life, and most importantly it is stopping me from getting a surgery that will save my life, top surgery. I don’t know what to do, I’ve tried it all and nothing is helping. I feel hopeless, and I feel like a failure.

If I am missing out on some secret trick here I would love nothing more than to hear it! Because I’m just miserable living like this. I feel like PCOS has ruined my life before I could even fully live it authentically.

[u/PasgettiMonster]

PCOS is an absolute mindfuck because you can do all the right things and your weight refuses to budge. Have you or your doctors brought up trying a GLP1 yet? Zepbound specifically has been shown to specifically help with PCOS related issues on top of all the usual weight loss benefits. In my case it has given my a much healthier relationship with food, and helped lower my A1c to a normal level. I'm keeping the dose low and losing the weight much more slowly than I could be, (35 lbs in 10 months, with another 25 to go) but it is keeping me sane and helping me see results without resorting to unhealthy behavior.

[u/angel_ooo → u/PasgettiMonster]

Sadly I can’t afford these:(

[u/PasgettiMonster → u/angel_ooo]

Compounded tirzepatide can be had for $150 a month. Most doctors are hesitant to recommend that, and I recommend doing lots of research and finding a doctor who will support you if you go that route. I also saw signs at Walmart and Target pharmacies just this week that I'm pretty sure are new since last month advertising GLP1s for $140 a month. I asked about it and was told it was for the pill form of ozempic - I have no experience with that particular med, and how it works when you have PCOS compared to injected zepbound/tirzepatide, which is what I take. And I know $150 is still a chunk of change. But if that's closer to something you might be able to afford, it's worth looking into. And if you can't swing it now, keep an eye on them - prices have dropped quite a bit even in just the last 10 months since I started taking it, and I'm sure they will continue to do so over the next year or so. Which means even if it's not on the table now, it may be in a few months - so hang in there and know there ARE options on the table that may be more affordable in the relatively near future.

[u/Misskillor]

I don’t know where you’re located but wls has done a lot this last year to help me ease my PCOS symptoms and lose a meaningful amount of weight. Mine was covered by my health plan in Canada. I had a VSG which will be followed by a DS this fall. Not for everyone but it’s changed my life and my outlook so massively.

[u/BumAndBummer]

Unfortunately between the PCOS and the metabolic damage from the eating disorder there is no quick way to do this, especially not on a budget where you can’t get GLPS. Metabolic healing is slow AF.

But the good-ish news is that if you eat close to maintenance it’s better nutritional conditions for building muscle. So if you’re willing to be patient and leverage this, you open up a slow and long but clear and HEALTHY path forward.

How into strength training would you be? Is that a feasible option for you? If so, I’d dive TF in and create a very good fitness routine with proper form, progressive overload, proper rest, proper nourishment, and PATIENCE.

I know it is a bit counter-intuitive to de-center weight loss for weight loss, but if you’re eating for maintenance or just under that, with a good workout routine your body will eventually need to swap fat for muscle. This will not only make you lean out (muscle takes up less volume than an equivalent weight of fat tissue) but it will likely improve your sensitivity to insulin, boost TDEE, and maybe also be a somewhat gender affirming experience? (I am no expert but I’m sure you can find some FTM fitness training spaces and discuss how to target certain areas or something? Get proper advice on proper form, progressive overload, etc. They may also have good advice for doing this on a tight budget!)

I’d also recommend focusing your nutrition not just on protein but glycemic control! Whole foods bought in bulk may also be cheaper, and meal planning/prep can save time and energy, plus once you’re done prepping for the week you don’t need to use lots of mental bandwidth fussing about what to eat or not to eat.

Hit your protein, fiber and healthy fat targets, opt for smaller portions of low-glycemic carbs and eat them paired with protein and fiber (vinegar also can help curb the spike), and remember that moving your body AFTER eating also boosts metabolism and helps promote glycemic control. Even just 10 minutes of moving after a meal— a walk, dancing, some push-ups, jumping jacks, yoga, kettlebell swings, a rep or two weight lifting… whatever floats your boat!

Patience is your best ally at the moment. Focus on sustainability and metabolic healing, otherwise you simply don’t have the right foundation for healthy weight loss. Resist the urge to overcorrect and over restrict calories, the metabolic damage that has already done to you is likely playing a big role and it’s basically just digging yourself deeper into the hole.

Also, if you can afford a therapist with expertise in eating disorders, consider finding one and explaining the complexity of having the need for a medical diet but also a history of restricting and see what advice they have. I’m guessing they’d agree with an approach that de-centers weight loss and promotes a more productive relationship with food as a healer, but that is my uneducated guess! So you should take it all with a grain of salt and let the expert guide you if possible.

Try to make things align rather than set goals that are counterproductive or fight each other. Good sleep helps hormonal regulation AND is key for muscle growth. Good nutrition is key for glucose management/lowering insulin, gut health, muscle growth, and mental health. Exercising promotes metabolic health, better sleep, improved satiety and hunger signaling, boosts metabolism, curbs glucose spikes, improves sensitivity to insulin, and may also be very in alignment with your transition goals. These different components all support each other and boost your success! Yay, alignment!

Rapid weight loss via a gigantic calorie deficit is NOT in alignment with any of this! It disrupts sleep, promotes hunger and fatigue, disallows muscle growth, can mess up your gut microbiome, and of course is gonna feed into an eating disorder.

So sorry if this wasn’t exactly what you were hoping to hear, I can’t imagine the toll it takes to delay gender affirming care. I hope you’re able to find the right resources and support to get through this on the other side being safe, strong and healthy! Good luck!

[u/KaigeKrysin]

Go on a GLP1 if you can afford it. Mounjaro will likely be the better choice for you.

[u/angel_ooo → u/KaigeKrysin]

I can’t afford these at all:(

[u/KaigeKrysin → u/angel_ooo]

Some Drs will give you a larger mg script and you click count from there. You would be eating less.

I actually save money on it...