Can Being Overweight Cause Gynecomastia?

doctor examining patient to determine if being overweight causes gynecomastia

There is very little written about the relationship between weight and gynecomastia. This is important because of the high rate of obesity in our society. Does weight gain cause gynecomastia? If so, does weight loss result in the disappearance of gynecomastia? As a very busy gynecomastia surgeon, I observe firsthand the relationship between weight gain and gynecomastia.

When a man gains weight it often accumulates in areas above their waists, like the abdomen, flanks, shoulders, face, and — yes — their chest area. This fullness can take on the appearance of female-like breasts and this is a source of distress. Since this process happens gradually, the appearance is not obvious until you notice others staring at your chest or maybe a friend comments on your “man boobs.” Your suspicions are now confirmed, and the burden of gynecomastia starts.

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Is it just fat or gynecomastia?

This process of fat accumulation is what coined the term “pseudogynecomastia” or “fake gynecomastia.” This is a confusing term and not helpful. It leads to the inquiry, “Doctor, is it just fat or is it gynecomastia?” If it is “just fat” then the assumption is that weight loss will result in the disappearance of the fat and the return of a normal chest. Unfortunately, this is not the case and I will explain why.

Timing is everything when it comes to weight gain and gynecomastia. We know that the area below your areolas has hormonally sensitive tissue. This tissue responds to the sex hormones testosterone and estrogen. As a reminder, the suspected cause of gynecomastia is an imbalance in the ratio of these hormones. Higher levels of estrogen in the sensitive area on the male chest cause the growth of breast tissue.

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Gynecomastia before and after weight loss

Fatty tissue excess in the chest after weight gain actually results in the local production of estrogens. This hormone then acts on the sensitive tissue causing overgrowth. This tissue that grows will become fibrotic and burned out with time and does not go away with weight loss. Therefore, I have serious concerns about weight gain as it relates to gynecomastia. Simply put, weight gain results in a fatty chest that then develops true gynecomastia tissue that can only be treated by surgical removal. Weight loss will make it appear worse!

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To conclude, and I know if you are reading this you do not want to hear this, significant weight gain will cause gynecomastia and the tissue that develops will not disappear with weight loss. The term pseudogynecomastia should be abolished, and the only treatment for established gynecomastia is expert removal. Then, and only then, can you live your life free from the burden of gynecomastia.

If you’ve gone through the struggle of losing weight, congratulations on your achievement! If you’re still in the process of reaching your goal, keep working, because it will definitely affect your life in a positive way. For those of you who have lost the weight but want to get rid of your gynecomastia, I can help. Schedule a free online consultation today, and we’ll help you get the results you’ve worked so hard to achieve.

Robert Caridi, MD
Diplomate of the American Board of Plastic Surgery
Fellow of the American College of Surgeons (FACS)
Member of the American Society of Plastic Surgeons (ASPS)
Member of the American Society for Aesthetic Plastic Surgery
Founder of the Austin Gynecomastia Center