Gynecomastia as a precipitant of eating disorders in adolescent males

Abstract

Two male adolescents with gynecomastia, who engaged in daily self‐induced vomiting in an attempt to decrease their breast size, are presented. Both adolescents had previously used exercise and dieting in initial attempts at weight control, and one of the adolescents appeared to have some questions regarding his sexual identity. These are the first two cases reporting an association between gynecomastia and eating disorders in males. Relevance of this association to the understanding of eating disorders in males, implications for screening and management, and etiologic considerations are discussed.

Psychosocial Impact of Adolescent Gynecomastia

“…9,16 In our cohort, participants with gynecomastia scored higher than controls did on the Eating Attitudes Test-26, suggesting greater levels of distress with regard to eating and weight concerns. However, once body mass index category was taken into consideration, differences in Eating Attitudes Test-26 scores were no longer significant.…”

“…Published work consists largely of single case reports using psychological assessments and retrospective chart reviews. [12][13][14][15][16] These studies suggest a considerable impact on younger patients with gynecomastia, but prospective data will better inform patients, families, and providers when making treatment decisions. In the current study, we sought to evaluate the physical and psychological impact of gynecomastia on adolescent males using a prospective study design.…”

The Psychological Burden of Idiopathic Adolescent Gynecomastia

“…2,3,5 It was, however, a surprising finding that the severity of this emotional and social stressor caused every patient in this study to present with psychological stress. This finding confirms the earlier suspicion of Storch et al that psychosocial maladjustment in this population is significantly different from the norm.…”

Psychosocial Adjustment of Two Boys With Gynecomastia

“…Although this condition typically resolves by age 18 years when adult androgen/estrogen ratios are achieved, it has been documented that boys experience significant psychosocial distress related to their perceptions about their appearance and internalization of others’ negative reactions 1,2 . Indeed, the extant literature examining the psychosocial adjustment of boys with gynecomastia is quite sparse, consisting of single case reports that do not incorporate psychometrically sound measures of adjustment 3,4 . As such, we report quantitative data on the psychosocial adjustment of two boys seen consecutively in our Pediatric Endocrinology service.…”