I'm by no means discouraging the gym, he already seems to be going there regulary without any results. I also wont put into his head that the more he works out and goes to the gym that his gyne will go away, because I know from first hand experiance that it does not, and I see no use in passing the advice along since I know its not true.
And I'm by no means encouraging surgery at such a young age, I'm just saying he should start considering it for the future. I know the truth hurts, but he has to hear it from someone. I'm sure he gets enough "Oh it looks fine, hardely noticable" from alot of people already, he's coming here for an honest opinion on what he should be doing.
I also agree that now he should maybe be seeing doctors and getting himself checked for underlying problems, all that junk.
I also think its a bad idea to start a thread asking if he needs surgery. It has no doubt started something between pro surgery and non surgery. I cant tell him if he needs it or not, if hes anything like Blatino maybe he can live with it. Maybe he cant live with it and needs it cut out, fine either way. The only thing I can tell him for sure is that if he looses weight and they still remain prominent at 180LB then he will need surgery to have them removed. We shouldent jump the surgery gun yet, but right now its not looking good.
One more thing for the OP, if you are feeling isolated and alone you need not be. Evreyone here can share many of the same stories its a very sad condition. I suggest you go read up some stories in various sections of these forums. We are all in this together, if you are interested in pursuing surgery I back you 100%. If you chose to just live with your condition maybe you would find a place in the "acceptance forum" where I'm sure many others could help you.
It may yet go away on its own, but I dont think so. I'm sorry if I came off as negative I'm only trying to paint a more realistic picture for you. Best of luck in whichever option you wish to pursure, ultimately the decision is up to you and you alone.
EDIT- I withdraw some of my previous comments as they came off to harsh and it was not constructive posting.