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Reducing weight. Fat from the chest doesn't get out and looks like moobs. How to get rid of it?

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Posted on Tue, 25 Jun 2013
Question: Dear Doctor,

i am having problem with my chest muscles, as i used to be fatty till last Dec, and after that i lost wieight thru proper Gym and diet. However, i am feeling terrible looking at my chest as the fat doesnt get out and it looks like a moobs.. :(

i am doing chest related workouts from last 2 weeks, but wanted to check with you what is the best way to get rid of this problem.
doctor
Answered by Dr. Omer (6 hours later)
Hello

I am Dr.Omer and I am here to help you with your query

As you have told that you are a young man of 26 years old , mildly obese , took gym and good diet to reduce the weight and now having problems of moobs , as they are causing discomfort

Moobs are known as Gynecomastia

Gynecomastia is a condition in which the breasts become enlarged in boys or men, sometimes causing discomfort or nipple tenderness. It is usually the result of a hormonal imbalance and typically occurs during infancy, adolescence, or mid- to late-life in men.

The condition often goes away on its own, but treatments are available for severe or persistent cases.

When gynecomastia is the result of an underlying health problem, treatment of that problem usually improves the gynecomastia as well (drugs like steroids , alcohol, marijauna , liver , testicular diseases etc)

Up to 70 percent of boys in mid-puberty till 30s , experience gynecomastia because of the normal hormonal changes that occur during puberty.

Gynecomastia, a benign proliferation of the glandular tissue of the male breast, is caused by an increase in the ratio of estrogen to androgen activity . It may be unilateral or bilateral and is diagnosed on exam as a palpable mass of tissue (usually underlying the nipple).

Pseudogynecomastia, which is often seen in obese young men or after moderate weight reduction, refers to fat deposition without glandular proliferation and does not require evaluation. Pseudogynaecomastia boys often have coexisting true gynaecomastia as well.

To differentiate true gynaecomastia from pseudogynaecomastia you need to get a physical examination + mammography

If the gynecomastia is of recent onset or is painful or tender, then serum concentrations of hCG, LH, testosterone, and estradiol should be measured

For boys with severe gynecomastia that is causing substantial tenderness or embarrassment, a short course of a drug called tamoxifen (Nolvadex) or raloxifene (Evista) may be recommended.

Although tamoxifen and raloxifene are effective for men and boys who have had enlarged breasts for a months , the drug is not effective in men who have had the condition for two to three years or more.

For these men, surgery is an option to reduce the size of the breasts.

The extent of surgery depends upon the severity of the breast enlargement and whether there is also excess fatty tissue. Many men are treated with a combination of surgical removal of the glandular tissue and liposuction.

More extensive cosmetic surgery by a plastic surgeon, including partial surgical removal of the breast skin, is required for men with more severe breast enlargement or those who have excessive sagging of the breast tissue, which may occur after weight loss.

As you are a patient of predominant pseudogynaecomastia I would recommend not to worry as you have just lost weight , as you were obese ,true gynaecomastia is common in your age as well with or without weight changes , if you are embarrassed then i would recommend weight loss, tamoxifene, and wait for surgery if this fails.

I hope I was helpful to you

Let me know if you need any further clarifications

Take care

Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Omer (16 hours later)
Hi Doctor,

Thank you so much for your the detailed explanation about Gynaecomastia. It seems to me that i have this problem since i was 13 year old, but i never took it very seriously as i thought it was a common thing among boys/Men. However, these days, it's become very inconveneint to me as i have almost lost 7 kgs and currently am at 69.5-70 Kgs. My height is 5.9 (175 Cms) and am i not be atleast at 72-73 Kgs, considering my Height, Age and weight? so i can loose lil more weight, but i am already lookinig thin and not sure, how it works if loose more weight.


Also, as i have already been doing Gym, can you please prescribe me how to take this medicine Tamoxifene. Also, i will soon be taking protiens for Gymming.. will this effect the Medicine?? Please advise.
doctor
Answered by Dr. Omer (8 hours later)
Hello XXXXXXX

Thanks for understanding the answer.

As you have said that your gynaecomastia started when you were 13 years old , this is the age when most of the gynaecomastia starts.

As you have told that your current weight is 69-70 kg , which is in perfect relation to your height that is 5 foot 9 inches , meaning your BMI(body mass index) is normal , and you are not over weight , this rules out the co-existing pseudogynaecomastia.

So losing any further weight than your current BMI would not be recommended.

A photograph of your chest will be helpful

So the only thing left is true gynaecomastia , which you are having and it as been there for more than 10 years , i would suggest you to consult XXXXXXX medical specialist to rule out secondary causes of gynaecomastia (thyroid, liver , testicular diseases ) as i have described in my last message.

When your doctor has ruled out the above causes of true gynaecomastia , only then i would recommend to start tamoxifen ( 20mg /day , early morning) , but for tamoxifen you need doctor prescription

Keep on doing the gym , protein supplements do have a relation with increase in gynaecomastia but wont have any interaction with tamoxifen.

I hope I was helpful to you

If satisfied with the answers , kindly write a review , obliged

Take care


Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Omer (3 days later)
Hello Doctor,

Thank you so much for your help.. Sure, i will be sending a pic of my chest by tomorrow, post which i will take the medicines suggested by getting a doctor prescription.

Thank you!
doctor
Answered by Dr. Omer (29 hours later)
Hello

Nice to hear that you found a solution to your problem

The only Goal of mine and XXXXXXX is client's 100% satisfaction and we keep on answering till our client's fully understand and are satisfied

Waiting for your picture

Wishing you a speedy solution to your problem

Hope you have discussed all the points I told you to your physician

If satisfied by the answers , your feedback is very critical for US , kindly write a review , obliged

Take care




Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Dr. Omer

Internal Medicine Specialist

Practicing since :2005

Answered : 508 Questions

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Reducing weight. Fat from the chest doesn't get out and looks like moobs. How to get rid of it?

Hello

I am Dr.Omer and I am here to help you with your query

As you have told that you are a young man of 26 years old , mildly obese , took gym and good diet to reduce the weight and now having problems of moobs , as they are causing discomfort

Moobs are known as Gynecomastia

Gynecomastia is a condition in which the breasts become enlarged in boys or men, sometimes causing discomfort or nipple tenderness. It is usually the result of a hormonal imbalance and typically occurs during infancy, adolescence, or mid- to late-life in men.

The condition often goes away on its own, but treatments are available for severe or persistent cases.

When gynecomastia is the result of an underlying health problem, treatment of that problem usually improves the gynecomastia as well (drugs like steroids , alcohol, marijauna , liver , testicular diseases etc)

Up to 70 percent of boys in mid-puberty till 30s , experience gynecomastia because of the normal hormonal changes that occur during puberty.

Gynecomastia, a benign proliferation of the glandular tissue of the male breast, is caused by an increase in the ratio of estrogen to androgen activity . It may be unilateral or bilateral and is diagnosed on exam as a palpable mass of tissue (usually underlying the nipple).

Pseudogynecomastia, which is often seen in obese young men or after moderate weight reduction, refers to fat deposition without glandular proliferation and does not require evaluation. Pseudogynaecomastia boys often have coexisting true gynaecomastia as well.

To differentiate true gynaecomastia from pseudogynaecomastia you need to get a physical examination + mammography

If the gynecomastia is of recent onset or is painful or tender, then serum concentrations of hCG, LH, testosterone, and estradiol should be measured

For boys with severe gynecomastia that is causing substantial tenderness or embarrassment, a short course of a drug called tamoxifen (Nolvadex) or raloxifene (Evista) may be recommended.

Although tamoxifen and raloxifene are effective for men and boys who have had enlarged breasts for a months , the drug is not effective in men who have had the condition for two to three years or more.

For these men, surgery is an option to reduce the size of the breasts.

The extent of surgery depends upon the severity of the breast enlargement and whether there is also excess fatty tissue. Many men are treated with a combination of surgical removal of the glandular tissue and liposuction.

More extensive cosmetic surgery by a plastic surgeon, including partial surgical removal of the breast skin, is required for men with more severe breast enlargement or those who have excessive sagging of the breast tissue, which may occur after weight loss.

As you are a patient of predominant pseudogynaecomastia I would recommend not to worry as you have just lost weight , as you were obese ,true gynaecomastia is common in your age as well with or without weight changes , if you are embarrassed then i would recommend weight loss, tamoxifene, and wait for surgery if this fails.

I hope I was helpful to you

Let me know if you need any further clarifications

Take care