The opening statement represents some common thinking about those of us who have Gynecomastia.
The term Gynecomastia is not really all that specific, it refers to women-like breasts. I take this to include both the enlarged nipples and areolas as well as the rounder contoured breasts. The term does not distinguish between rounded breasts or puffy nipples.
Where fat is considered, obviously fat men have fatty breasts. The fat could be as a result of anything, but social isolation and lack of participation in sports certainly do not help matters. Neither does depression induced over eating.
Obesity is common among people with our condition, but I had well rounded breasts when in my teens when I was about 5' 9" and weighed only about 130 lbs.
The originator of this thread stated he'd already had surgery but gave height and weight figures which would indicate he was about 20 lbs overweight. He also admitted to wanting to lose some weight before swimsuit season. His excess weight would have made him (in my estimation) a less than ideal surgical candidate.
Propagating the misinformation that people with Gynecomastia are just a bunch of lazy fat boys contributes to the general lack of understanding about our condition.