sorry to be the bearer of bad news.. but i think you got it.
i think you have a case of both real + pseudo gynecomastia..
one way you can tell that you have gland is by looking at your nipples.. you have the typical 'puffy nipples' something a lot of the people on this board share in common. however due to your weight, you also have a plethora of fat stored up in your chest..
i wouldn't recommend that you go to a PS just yet. i say you lose some poundage first. try goign on a low car (NOT ATKINS!!) a low carb diet. i used to be VERY obese, and i'm now pretty ripped with muscle, besides my gyne.. hence this is my advise to you:
try spacing out small meals, instead of having 2 realy large ones..
but here:
breakfast: most important meal of the day. a lot of people trying to lose weight skip breakfast... i don't know why they do that, breakfast is the one meal that you *should* eat.. skip any other meal, not breakfast. its what keeps you going for the rest of the day.. what you eat at night may be stored, but breakfast.. thats the stuff you burn.. don't go crazy on breakfast though. eat rationally. controll yourself.
lunch: lower your carbs, focus on a high protein diet. primarily eggwhites, chicken/turkey (no skin), lean beef, tofu, milk (2% not whole cream)..
evening: have a bowl of chopped fruits. bannanas, apples, papayas, whatever you fancy. you need the vitamins, and face it.. you need *some* sweetness in life
dinner: have 2 scoops of protein shake mixed with skim milk/water.. whatever you preffer.
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ground rules:
1. no in between snacking (that is your enemy)
2. for the next 6 months, control the fatty substances, control the carbs, no candybars, no pop - and that includes diet soda.. aspartame, the artificial sweetener can phuck you up pretty bad, give you craving for more food, and screw up your thyroid..
3. 4-5 days a week, do 30-45 mins of cardio work.. as you start losing weight, make your workouts more and more intense.. push yourself to the maximum.
if you follow these rules, and are committed to yourself. you WILL lose weight.
best of luck.
may you be rid of this gyne very soon.