The Road to GCS: Nutrition and Weight Loss

In the last segment of The Road to GCS we stressed that an important thing to consider while you prepare for gender confirmation surgery is nutrition and shedding excess pounds.  What you eat can and will be a factor in your recovery.  There is also a chance that you can be denied surgery based on your health.  Montreal, for example, does not have the resources to provide emergency support and as a result will deny people who’s health poses a serious risk for complications during the procedure. Some doctors are less stringent because they do have the capabilities to deal with serious complications.  It is best to eliminate those risks yourself well in advance of surgery if possible. Also, anything that will improve your recovery and promote a healthier new life is always a plus in my book.

Before we get into specific strategies for losing weight, I want to talk a wee bit about sugar.  Sugar in all its forms is one of the biggest contributors to weight gain and any successful strategy will have to include reducing your sugar intake.  For years we have been hearing that a calorie is a calorie no matter where it comes from and to lose weight you just need to burn more than you eat.  This is not actually true and if it were, weight loss would be very easy.  The reason this is not true is because of sugar and what it does to your body when you eat it.  Sugars and carbohydrates will be broken down in the liver to form glucose which then circulates in your blood enters cells and makes its way into your mitochondrion where it enters a complex chain of reactions that results in storing energy in a molecule called ATP for the body to use when it needs to.  The excess glucose then needs to be dealt with and another organ comes into play. Your pancreas, in response to higher glucose levels,  releases insulin which tells your body to focus on burning glucose.  As a result of insulin’s preference for glucose burning, any fats in your meal will go straight to your fat cells to be stored minus any fat needed for biological processes.  Once your body is burning as much glucose as you can, the remaining glucose is converted to lipids via a process called de novo lipogenesis and these are stored as fat. It no surprising that some people like to call insulin the fat storage molecule.

Sugar is quite literally everywhere and all you need to do is look at food labels of your favorite foods to see this.  Two huge sources of unnecessary sugar are soda pop and fruit juices which can easily contain the equivalent of 9-10 teaspoons of sugar.  In the case of switching to diet soda to eliminate the sugar, there are brand new issues. I won’t get into the chemicals that create the sweetness as they can be problematic and result in some long term effects. Phosphoric acid, found in diet soda is another major concern in regards to bone loss. It will cause your body to excrete calcium from your bloodstream at a higher rate than normal.  As a result, to maintain the proper calcium concentrations in your blood, your body will pull it out of your bones.  In the case of fruit juice, it is high sugar without the fiber to slow it’s absorption which will lead to insulin spikes.  It is much better for you to eat the actual fruit and get the fiber which will slow down the absorption and prevent insulin spikes.

Whatever strategy you employ to lose weight, sugar reduction will have to be a component.  In addition to just reducing sugar, there are other factors you need to take into account.  Is the diet sustainable?  One of the things you do not want is to lose the 40 pounds then go back to how you ate before as you will put it all back on and maybe add a few extra pounds in the process.  You need a diet that can be maintained in some form for the rest of your life.  The maintenance period after you complete your weight loss goals will certainly have more food than the weight loss portion of your diet, but it still needs to remain healthy and you never want to become overconfident in your success to the point where you think you can just eat anything.

Normal Carbs, Low Fat diets, Moderate Protein

Most of the diets out there fall into this category and they can be successful though a lot of people do gain their weight back.  Organizations such as Weight Watchers loves that fact as it drives repeat business.  Losing weight ideally should not be a life long journey.  This diet also relies on a good exercise regiment as you need to be sure to deplete the glycogen (energy storage molecules) in the muscles so the carbs you are eating not only get burned for energy, also get converted into glycogen.  It is also super important to ensure your diet has a lot of fiber to slow down glucose absorption and minimize insulin spikes.  Remember, the insulin spikes will stop all fat burning. The low fat part is very interesting as a lot of times low fat processed foot will actually have more sugar in the food to substitute for the lost flavor the fat gave to the food. Low fat versions of food definitely help you reduce the size of your pocket book.

Low Carb, Low Fat, High Protein

The Atkins diet became very popular as people liked the idea of eating as much lean meat as they wanted and losing weight at the same time.  In reality, they were actually eating less than they thought due to the protein making them feel full.  Eating less does indeed result in weight loss which is part of the success of the high protein diets.  Sustainability wise, these diets tend to be very restrictive and can be a challenge to maintain.  They can also be very easy to cheat on. Another factor is that they can also stall very easily if the protein amounts get too high.  Once your body uses all of the protein it needs, it can then convert left over protein into glucose via a process called gluconeogensis.  The glucose will then result in an increase in insulin and we all know where that leads to.  In most cases, if the dieter is working out in addition to the diet, they usually do not have to worry as much about gluconeogenesis. With low carbs, the body burns does need to burn some glucose from gluconeogensis and also from ketones from the break down of fat.

Low Carb, High Fat, Moderate Protein

The last diet type we will look at is the diet often referred to as nutritional ketosis. The idea behind this diet is to derive almost all of your energy from fat.  On this diet you are keeping your carbs very low, even lower than with the high protein diet.  You are keeping your protein at a moderate level as you do not want any glugoneogensis to occur as you attempt to keep yourself in optimal ketosis. You do consume a lot of saturated fat which you are going to break down in the liver into ketones which are high energy molecules and can easily be utilized by the body for energy.  The advantages to nutritional ketosis is that once you have moved into optimal ketosis, hunger is much less severe between meals and as a result, it is easier to not cheat.  Weight loss can be quick and you tend to have a lot of energy. This diet works fine with minimal exercise though the health benefits of exercise should not be overlooked. On the downside, if you cheat you can throw yourself out of optimal ketosis and it can take you a week or more to get back there. Initially, the first week or two can be tough on this diet as your body switched from a glucose burning machine to a fat burning one via ketones. Also, being the new kid on the block, the research into this diet is still ongoing and there is always the possibility that we could find a downside that no one is aware of yet.

Before you decide which diet is best for you, it never hurts to do more research and it is also a good idea to check with your doctor before making any major changes.  This is especially true if you already have a preexisting medical condition.  In the end, you need to choose the diet that you can turn into a lifestyle and not just a quick fix to get you past surgery.

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