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Can Nick Lachey’s Pic Bring More National Attention to Gynecomastia and Obesity in Men?

According to the Centers for Disease Control and Prevention (CDC) 34% of the US adult population aged 20 and over are obese. Furthermore, the CDC has ranked obesity as the number one health threat facing America (CDC, 2004, 2007). It has also been estimated that 400,000 deaths and subsequent costs at $122 billion are a result of obesity. As a result, America is confronting an obesity epidemic.

Obesity is defined as a body mass index (BMI) of 30 or greater. BMI is calculated from a person’s weight and height and provides a reasonable indicator of body fatness and weight categories that may lead to health problems.
Obesity also increases a person’s risk for developing a number of obesity related health conditions which may include, cardiovascular disease, hypertension, thyroid disease and diabetes. Lifestyle, self-esteem, discomfort, quality of life and depression; are indicators related to social and psychological stress associated with obesity.

“Among men, there was an increase in obesity prevalence between 1999 and 2006. However, there was no significant change in obesity prevalence between 2003-2004 and 2005-2006 for either men or women (CDC, 2004).” Adults aged 40-59 had the highest obesity prevalence compared with other age groups. “Approximately 40 percent of men in this age group were obese, compared with 28 percent of men aged 20-39, and 32 percent of men aged 60 and older. Among women, 41 percent of those aged 40-59 were obese compared with 30.5 percent of women aged 20-39. Women aged 65 and older had obesity prevalence rates comparable with women in the 20 to 39 age group. (CDC, 2004, 2007).”

In addition to the disturbing obesity trend in men aged from 40-59, cases of gynecomastia have increased nationwide. Gynecomastia is the development of abnormally large mammary glands in males that result in male breast enlargement. The condition can occur physiologically in adolescents, and in the elderly. Pubertal gynecomastia which is not associated with obesity, usually disappears within a couple of years in adolescents. The causes of common gynecomastia or physiological gynecomastia are uncertain, but has generally been attributed to an imbalance of sex hormones in males. The estrogen/testosterone ratio plays a significant part in adipose tissue responsiveness in males. Adipose tissue or fat is loose connective tissue composed of adipocytes. The primary role is to store energy in the form of fat. The issue of obesity in males does not necessarily depend on body weight, but the amount of body fat-specific adipose tissue. Other catalysts to physiological gynecomastia may be associated with certain medications like cimetidine, omeprazole, finasteride and certain antypsychotics. Several studies have established a direct relationship that some of these medications have on breast tissue in males. HIV medications may also have an indirect relationship with breast tissue in males.

In an environment where masculinity is exalted (gynecomastia.org) gynecomastia can bring feelings of embarrassment and humiliation. Furthermore, men may I have a difficult time discussing issues that relate to their gynecomastia. This observation is evidenced by the recent pictures taken by Star Magazine of Nick Lachey and his “man boobs.”
Due to the psychological stress that is associated with gynecomastia, it is recommended that a physician is contacted to rule out testicular or adrenal tumors, hyperthyroidism and liver cirrhosis (Braunstein, 1999; Glass, 1994). Moreover, www.gynecomastia.org is an excellent guide to refer for information, surgery options and physician consults. Clinical trials have recently focused their attention on adolescent boys (refer to clinicaltrials.gov); but, as gynecomastia becomes more prevalent, the promise of clinical trials in the future, may include a focus on adult gynecomastia.

References
Obesity In America. [Online]. Obesity: The Epidemic. Retrieved from http://www.obesityinamerica.org/obesitybasics.html on January 8, 2008.

National Center for Health Statistics. (2007). New CDC Study Finds No Increase in Obesity Among Adults; But Levels Still High. Retrieved from http://www.cdc.gov/nchs/pressroom/07newsreleases/obesity.htm on January 8, 2008.

Glass, AR (Dec 1994). “Gynecomastia”. Endocrinol Metab Clin North Am 23 (4): 825-37. PMID 7705322.

Braunstein, GD (Jun 1999). “Aromatase and Gynecomastia”. Endocr Relat Cancer 6 (2): 315-24. PMID 10731125.

Henley D, Lipson N, Korach K, Bloch C (2007). “Prepubertal gynecomastia linked to lavender and tea tree oils”. N Engl J Med 356 (5): 479-85. PMID 17267908.




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