Nigel Hawkes, Health Editor
We've made some changes
to The Sunday Times

Obesity has been blamed for the growing problem of “boy-boobs” – cases of teenage boys with breasts so well developed that surgery is needed to reduce them.
Doctors at Alder Hey Hospital in Liverpool say that they are seeing dozens of teenagers every year with gynaecomastia, the condition in which males develop breasts.
Christian Duncan, a plastic surgeon specialising in obesity-related surgery, said that in the past 12 months he had performed at least 20 breast-reduction operations on young boys who had developed the condition.
Mr Duncan is treating others who do not yet qualify for surgery by encouraging them to make changes to their lifestyle, such as starting a healthy diet or beginning an exercise programme.
He believes that the condition is becoming more common among teenage boys in Liverpool, and that it can cause “terrible damage” to their lives and their self-esteem.
While some boys are simply fat, giving the appearance that they have breasts, those who develop gynaecomastia face a greater problem: the growth of firm female breast tissue under the nipples, Mr Duncan said. This condition is caused by a hormone imbalance during adolescence and in many cases resolves itself naturally. There is some evidence that the imbalance can be triggered by obesity.
Mr Duncan said: “This is different to someone just being overweight. These are firm female breasts, something that any woman would be proud of. There isn’t one month that has passed in the past 12 months where I have not seen a new patient with this condition. It used to be much less common and I am afraid it is a sign of the growing problem of childhood obesity.
“We try to teach these boys about making lifestyle adjustments, like getting them to go to the gym, but they just won’t go. They become very self-conscious and it can start to affect their ability to socialise and concentrate at school. Often they are bullied. To rectify the problem for them we basically use liposuction to remove the glandular and breast tissue and fat from around the chest to give a flatter appearance.”
Mr Duncan said he believed that the boys’ poor diet was causing an imbalance in their hormones, resulting in their developing breasts.
He said: “Both men and women have breast tissue but there is something about obesity that triggers hormone imbalances and causes an unnatural growth in these boys.
“If nothing is done to stop the growing tide of childhood obesity in the city I expect to see more cases year-on-year.”
More than one cause
— Breast reduction operations in men have increased sharply in recent years. Whether this increase is because of a greater incidence of gynaecomastia or a greater availability of cosmetic surgery is unclear
— In men the condition can have a number of causes, including body-building drugs, recreational drugs, cancer, diseases of the liver or kidney, and obesity. It may affect one breast, or both
— Some doctors have blamed increased levels of female hormones, or chemicals that mimic their effect, that are in the environment. In boys, the condition is very common but usually resolves itself without treatment as the hormone balance in the body stabilises at the end of adolescence
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I ballooned to over 13 stones whilst depressed a couple of years ago. Last year, I managed to diet and now weigh 11 and 1/2 stones. My waist went from 36'' to 32''. However, my chest is STILL large. I have a sit-down office job, but make sure I walk to and from my workplace each day. Fed-up with it.
Justin, Manchester, UK
If blame is to be handed out, lets first start with the parents. They are the ones that actually purchase the foods, and bring the foods into the homes of these kids. I would bet these parents are also on the extra-large size also. Don't make is an option, the entire family needs to exercise.
Brian, Fort Worth, Texas
I had this problem and did the surgery when I was in early 20's. Had my parents been brave enough to do this for me before I was old enough myself, it would have saved me years of pain. Any parents with children in this boat would be very smart to bring this up with their child as soon as possible.
B, Ny, USA
rarely occurs in males of the correct weight unless they have overdone the Steriods in which case testesterone may shift to Estrogen - Simple - Catch it early enough and take Tamoxifen, anto-estrogen drug - Taken early enough kills estrogen dead - you lot waited TOO LONG to seek help - simple as..
matt harding - Personal Trainer, Brighton, UK
Gynaecomastia has nothing to do with obesity. It can occur in any teenage boy. I was not overweight but required surgery to remove developing breasts (bilateral mastectomy) 55 years ago when I was 18. My youngest son required the surgery when he was 19. This problem is related to testosterone level.
Wnz Bnz, Fairfax, Virginia, USA
I thought they were commonly known as 'Moobs' now?
RB, Gloucester,
As am Male aged 31. I have had my man boobs since age 14/ 15 and they dissapeared only at age 19 and 29 when i was exercising and eating healthy.
Whatever hormones may or may not be in our food exercise and diet play a certain part I am sure otherwise how do we explain flat chested women.
anwar, Birmingham, Uk
Children that sit on their bums, stuff their mouths with fat riddled food, and watch the telly, and play video games, WILL be fat.
So get off their bums, turn off the telly and go out and exercise. There will be less, fat brits, and no expensive surgery to correct mouths full of chips.
John (Brit exp pat), Phoenix, USA
A man on the Howard Stern show recently won $5000.00 for having the biggest man boobs.
Jeff, Sacramento / CA, USA
I do not think that cutting boobs is going to solve self-esteem problems that many obese boys or children are already experiencing just for being obese. The main issue to tackle here is the obesity epidemic. Overweight and obesity cost more than 92 billions per year of taxpayers money! Amazing!!!!
Florence Messi, Rockville, USA
Teeage boys may respond better to healthy eating if the strict diets of professional sportsmen were promoted more publicly. They know how many goals they have scored or which car they drive but not what they eat for lunch/dinner. You dont see Ronaldo or Lampard tucking into a Big Mac during season.
Stuart, London,
I was actually attacked by a man with breasts on a football pitch last week. He was someone i'd always felt sorry for as, although he's fat , I always presumed his breasts were due to a medical condition. Not so it seems: they're just due to overeating- making him a fat, violent pig, with boobs.
Tom, London,
check the meats your eating... there filled with hormones... mostly estrogen which is poison to the male body. this is a very wide problem
Scott Slone, arlington, us
Laura - no, it's not. Gynecomastia is usually permanent. If it is breast tissue, it isn't going anywhere. If it is fat, even losing the fat will often leave the skin permanently stretched, creating a sagging appearance. I've lived with this all my life, and for years after a major weight loss.
Jim, Chicago, USA
Don't eat so much; get more exercise.
Or, to put it another way, get more exercise; don't eat so much.
Geoff, Vancouver, Canada
Oh Yeah, the eco-trolls and the genuinely misinformed are out in force posting comments; despite the evidence offered by the professionals here, these trolls MUST blame it on "non-natural" food or chemicals in plastics...and NOT on the lack of excercise and GENERALLY poor diet of youth today...
Kirk, California, USA
Speaking as someone who has had this surgery,
true gynaecomastia has nothing to due with weight. It's actual breast tissue. I lost 40lbs and it only made my condition look worse.
Pseudo gynaecomastia is fat deposits around the breast area
and can be reduced by diet.
F. Leonardo, Union Beach, N.J., USA
Not just the meat and the milk, there is also a deluge of estrogen being dumped into water supplies due to the high use of birth control pills, threatening natural species and contaminating our drinking supplies. Worse, people are fretting over the myth of global warming to do anything about it.
RJ, WI, USA
I had it and it drove me crazy enough to have plastic surgeon take it out. Still fibrous in there, but shape is totally normal now....My buddy had it like 3 years after I did. My doctor was speculating about the Tagament acid reducing drugs I have taken most of my life.....
vernon dozier, Phx , az
My brother had this condition when he was younger, despite being very active and playing sports his entire life. He ultimately got surgery to remove them, mainly because of the social stigmas attached to his condition. I find it closed-minded to attribute this to "fat kids and lazy parents".
b, long island, usa
It's so sad. Teenagers under the knive. You know what you have to do, don't you?
Eat less and don't take a taxi to get to the fridge, that's the only diet that works. In my view, anything else is cheating.
Javier, Toledo,
The doctor said I had fibrous tissue under my nipple, not just fat. During liposuction, he said it was difficult to break up; but he was successful. Interestingly, it seems for me that the excess estrogenic level delayed aging. I'm 48, but have the body of a 35 year old.
PJ, New Orleans, USA
I was a skinny boy of 11 when i developed the problem. I played sport (football, rugby, tennis) every day until I was 16 when the problem became too embarassing. The fitter i was the more the breasts stood out. I ended up 6 ft 1, 12 and 1/2 stone, with massive breasts. Obesity is not the problem.
John, London, England
This is a real self esteme booster -getting your man boobs removed. Try admitting that one 5 years up the road.
bob, gabriola, canada
Having spoke with someone who works at a water treatment facility, I think I might know the reason. He said there is not a filter to clean up the birth control pills that end up in the sewage, going back into the water supply.
Angel, Brownsville, USA
It's fat kids. Simple. It's parents that shut their kids up by stuffing them with fast foods and plopping them on the floor to play video games because they're too lazy to take them to soccer or football practice. It's lazy parents appeasing their lazy kids. Kids, exercise. Parents, lead by example
Patrick, Atlanta, USA
This is obviously the result of global warming...and ultimately Bush's fault!
Don, Atlanta, USA
Wow, it's BPA, excess phytoestrogens, other chemicals in the food supply and environment..it's pretty much everything but parents who feed their kids junk, see using the word 'No' as tantamount to child abuse and won't unplug the computer and video game and send the little darlings outside to play.
Ruth , Glasgow, Scotland
Jones, you are incorrect about the actions of hormones being "species specific"...ever hear of Premarin?
It is used in hormone therapy for humans and is quite effective despite its active ingredients being derived from pregnant mare's urine.
Tina, SoCal, USA,
Stop blaming the food industry, advertising, schools, the NHS, the government; the problem is utterly, utterly simple. Many kids, and a huge number of adults simply eat more food than they need. The answer is comparably simple: improve your diet, exercise more, and the problem goes away.
Nick Beard, Rotherham, UK
I bet eating less, excercising more and playing less Xbox would do wonders.
TIm, Nolensville, USA
Time to start-up my "Manzier" business.
Pete, North of Boston, USA
There are also female hormones in a vegetarian diet. Doctors have found pre-pubescent breast development in children fed vegetarian diets.
Lee, Kim,
interesting proportion of comments from the USA.
CArolyn Rhodes, Belfast,
I had the surgery and love it. It was really an issue for me. I think they developed around the time I started taking creatine in my early 20's, now I am 31. To give you a reference of the size of my chest, it was the same size as an 36 A cup.
I exercised, eat healthy, and they never left.....
Mike, Chicago, United States
Let's just back up a bit here. Hormones in milk, chicken and food packaging plastics? All food we eat (most comments here are from US and UK) has to meet stringent standards. Even the cheapest Tesco or Iceland mince is free from toxic levels of oestrogens or other hormones. Obesity IS the cause.
Sanjay (physician), wolverhampton,
Men always look at boobs. About time they had their own.
Cari, detroit,
Rick, spoken like a typical Rhode Islander, you obviously have no idea what you're talking about, especially when it comes to actual diet and nutrition.
Max, Minneapolis,
Many of you are incorrect. This has nothing to do with female hormones in either food or plastic. The biggest cause of increased gynecomastia in our society is the alarming increase in obesity. Adipose tissue produces aromatases which in turn produce estrogen. This is why fat leads to man boobs
Dr. Johnson, Texas, USA
I've had breast reduction surgery. It definately makes a difference in your self-esteem. I was lucky I found a good lipoman. Dr. Barry Miller of Honolulu. He was a pro, and now I love going around with no shirt. I am now 48 and had the surgery when I was 33.
PJ, Honolulu, USA
I eat the same stuff everyone else does. No special organic or natural diets here. But I don't have man boobs. Simple solution: Stop eating.
Rick, Smithfield, RI,
The human fat cell produces the aromatase enzyme that converts testosterone to estrogen, so it is quite possible that excess obesity can raise estrogen levels and cause the growth of breast tissue in boys. Male teens generate lots of testosterone, and fat teens can convert it to lots of estrogen.
Frank, Florida, USA
I think it is difficult to cull out one cause but diet and the products in food, whether it's BPA, excess phytoestrogens, all contibute to the problem. Buck up - be better parents-stop eating packaged crap and eat real food that you make yourselves. Stop killing yourselves and your kids.
Joyce B, Springboro, USA
Too much fat produces too much estrogen, but what is the real problem are the chemicals in the environment and the food supply because these sexual errors are occuring in species untainted by the food industry.
Remember when they said marijuana made men grow breasts? They lied. Psych drugs do.
rc, washington dc, usa
Hi all-I am be no means a nutritionist/scientist; so I am no qualified authority on this subject. However, perhaps hormones in the the milk, meat, and processed foods are causing the problem. Sure obesity can irritate conditions, but to cause this? I don't know, it sounds kind of iffy to me. Thanks!
Renee, Woodbury, MN
Mark, London
Well said.
marianne, Virginia, USA
Benjamin - hormones are species-specific: those of a bovine variety have no effect on human beings.
Jones, Olympia, Wa, USA
"breasts so well developed that surgery is needed to reduce them."
No.
What is *needed* (for most) is for them to stop stuffing their faces and forcing their body to store more than it is using, and get off their backsides and exercise. Surgery is NOT needed. It's a false quick fix.
Laura Roberts, London, UK
This has nothing to do with obesity as so many of the cases I have seen are in thin and slimly built men.
It is to do with the large amounts of meat people eat that are pumped with female hormones, and also the large amount of soya and meat alternatives also full of hormones.
Benjamin Cohen, London,
The very sad part is, no matter what the problem is with someone's appearance, there is always someone out there who can alter it for a price.
Jennifer, Brooklyn, CT
Mike,You only really know what your US media has told you, right? You know that there is super high levels of BPA in tooth-colored fillings, and BPA really only leaches at over 120 degrees? Mercury amalgam leaches at over 220? High fat diet raises estrogen levels, so yes, it causes gynecomastia.
Jonathan visscher, Salmon Arm, Canada
We need to consider the lifestyle of which many of our children now live. Video games and the internet have made them life long couch potatoes. Further, a teenage boy with his own breast would have no reason to ever leave the house. Mr. Limpet would be proud!
Steve Sparkenickle, West Bumpgarten, USA
Idiots. It's the hormones in the food and milk.
Greg, Providence, RI, USA
Leave us rotund dudes alone...please! Why must everyone be perfect? I kinda like being "not you".
ragu4u, SAINT LOUIS, usa
Mark J in London has got much of it right, but part of the problem also is processed foods. Parents shouldn't buy them and should forbid them to their children in the same way they forbid them drugs and alcohol.
Craig Eliot, NYC, USA
The problem is selfish lazy parents annoyed that THEIR children act as an intrusion to their soulless, pointless, self-satisfying lives drive by celebrity "have it now" culture leading to the bare minimum time being spent on cooking properly or discpline in the home.
I call this "Modern Britain".
Mark J, London, UK
This story is factually incorrect. The higher incidence of gynecomastia in males (as well as early puberty in females) is the result of the omnipresence of the female hormone bisphenol A (BPA) in food packaging plastics. Obesity has little if anything to do with true gynecomastia.
Mike Silverstein, NYC, USA
The issue here is that hormones tend to be fat soluble so whether they are naturally produced or obtained from eating food they are staying in the bodies of obese children for much longer and in greater quantities than they ordinarily would.
Alylonna, Wales,
Increased levels of female hormones can cause both obesity and 'boy-boobs.' Many years ago a boy-boob problem was reported in South America. It was traced to eating chickens that had been dosed with large amounts of female hormones to make the chickens grow plumper faster. The UK should check food
Ray Pecaut, Florida, USA