have questions...need advice

[sebrof11]

Hello,

I have been looking into why I can't seem loose what my friends and brother like to call my "man boobs" and my weight in general. I have spoken with my doctor several times regarding my chest and weight issues but all he says is I need to exercise more. I currently run 15-20km/week and weight lift 3 times/week as well as play sports year round. I have lost roughly 25 lbs in the last few years but I still have them and can't seem to loose any more weight. I'm currently 30, 5'9 and weigh 202 lbs.
 
I had a pretty serious inguinal hernia when I was 19 and noticed several lumps on my right testicle and one on my left when I was 21. I have been told they are cysts and not cancerous and I have it checked yearly. I read somewhere that testicular cysts may increase estrogen levels in males which then may cause gynecomastia. My doctor seems unwilling to look outside the box, which is why I'm doing the research myself.

I'm a pretty confident person but do consider what shirts I'm wearing daily and if they are too tight around my chest. Please let me know what your thoughts are and what my next steps could be.

Thanks for taking the time to read this and for your help.

[Dr. Elliot Jacobs]

Congrats on your weight loss so far.  Your height and weight calculate to a BMI of 29.8, which is high level overweight and close to being considered obese.  Therefore, you should continue to work out and watch your diet.  At age 30, your metabolism should allow for further weight loss unless you have some underlying endocrinologic disorder.

Would recommend seeing an endocrine doc for a general evaluation of your hormones, including thyroid, prolactin, estrogen and testosterone, among others.  If all is OK, then consider consulting a weight loss specialist.  Remember, weight loss is simple -- it is a matter of calories and everyone can lose weight.  Increase your caloric usage with exercise and decrease your caloric intake by watching what you eat.  Simple -- but extremely difficult as we mortal humans know.  However, by being careful and patient, and never losing sight of the goal, you should be able to drop more weight.  Your goal should be about 175 lbs or better.

In the meantime, why not feel and look better with a snug compression shirt to give you a better shape?

However, once you have lost the weight, be prepared to see some residual tissue on your chest -- it will probably not all go away.  The breast tissue previously formed will not disappear with weight loss -- but the fat of the chest will diminish.  You will then be faced with a decision to live with it or perhaps consider surgery.

Good luck!

Dr Jacobs

[Litlriki]

Dr. Jacobs has made several important points, and I would echo his recommendation to have an evaluation by an endocrinologist to put your concerns over your hormones at ease--or perhaps to identify a problem that can be treated.  Similarly, pending that evaluation and any further weight loss, you may still require treatment of your gynecomastia. 

I wanted to chime in regarding weight loss.  In most cases, exercise alone will not lead to weight loss, unless you're starting from a sedentary lifestyle, and the amount of weight you need to lose is minimal.  In most cases, dietary management is a vital ingredient.  Most people consume far more than they really need with no idea of how much exercise is required to burn a given number of calories.  The classic example I give to my patients to explain this is a piece of cake.  To use up the calories in one piece of cake would require a six mile run in the average person.  If you aren't gaining weight with your current diet and exercise program, a slight adjustment--even eliminating 200 - 300 calories a day--will gradually result in weight loss. In most cases, however, more caloric restriction is required, and this can be accomplished by cutting a little bit at each meal.  Similarly, you should divide the amount of food you eat in 3 meals into 5 or 6 meals, spaced out evenly over the day.  This also helps with weight loss by keeping your metabolism more even.  The last thing I suggest to my patients is that they write down everything they eat and drink.  You'd be surprised how much you actually consume each day.

Good luck,

Rick Silverman

[Dr Kapoor]

I would agree with the recommendations of Drs Jacobs and Silverman. With that said, it sounds like you probably do have some degree of the condition. Any pictures would be helpful if possible. Weight loss will help somewhat but if you truly have gynecomastia, then surgery will probably be your best option.