The appearance of enlarged breast tissue in men can be either due to the true enlargement of actual breast tissue or a result of deposition of fat in the pectoral area of the chest. True enlargement of the gland tissue of the breast is due to hormonal fluctuations or imbalances. Breast enlargement in men due to this condition is referred to as gynecomastia. However, especially in obese or overweight men, there can be an increase in fatty tissue over the breast area. This condition, which is not the same as true enlargement of male breast tissue, creates an appearance of enlarged breasts and is known as pseudogynecomastia.
Doctors can usually tell whether or not enlarged breasts in men are due to true gynecomastia by the physical examination, but sometimes other testing is required. True gynecomastia (enlargement of breast tissue), in men is not uncommon and can be seen in normal, healthy boys during puberty or in men as they age. Medical conditions that interfere with the body's hormonal balance can also cause breast enlargement in men.
The greatest risk factor for the development of fatty tissue in the breast area is obesity and weight gain. Obesity is defined by the body mass index; adults with a BMI between 25 and 30 are considered overweight; those with a BMI >30 are considered to be obese. Obesity is a major public health problem in the U.S. and accounts for significant morbidity (disease states with reduced quality of life) and mortality (deaths).
Pseudogynecomastia is not a sign of a hormonal imbalance and does not require treatment. Weight reduction can lead to a reduction in the size of the breasts. However, a man who notices breast enlargement and is unsure of the cause should seek medical evaluation to determine whether true gynecomastia is present and if so, whether a serious medical condition is the cause.
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While the appearance of enlarged breasts can be a psychological or cosmetic problem, it is actually of minor significance when compared with the other diseases and conditions that are either caused or worsened by obesity, including diabetes mellitus, high blood pressure (hypertension), heart disease, stroke, sleep apnea, and some types of cancer.