BBC - Just what is it about moobs?

Man-boobs, or moobs, are becoming much more evident that in years past. The combination of obesity, xenoestrogens, and lack of exercise all serve to allow (even encourage) male breast tissue. While this is mostly a cosmetic issue, it is also becoming a health issue.

In gym language, this is called "bitch tits" and used to be associated primarily with steroid abuse (not using an aromatase inhibitor to stop the conversion of steroids into estrogens). Now it's a common sight on new members.

From a male perspective, this is also a self-esteem issue - and therefore a psychological issue. And one that is in the control of every man to do something about.

Just what is it about moobs?

By Finlo Rohrer
BBC News Magazine

The number of men having breast reduction operations in the UK is rising dramatically, but is this really the result of the media spotlighting the physical flaws of male celebrities?

This is an era when glossy magazines and tabloids delight in the most minor flaw of the female celebrity.

The actress with bags under her eyes, the singer with an untrimmed armpit, the model with a sweat patch, all are presented blinking in the paparazzo's flashbulb as their imperfections are chronicled.

All are highlighted with red circles and magnification. And the same process has been applied to male celebrities in recent years.

When both the then Prime Minister Tony Blair and leader of the opposition David Cameron were pictured enjoying the sun in the summer of 2006, newspapers from tabloid to broadsheet passed comment on their "moobs".

Every man has breast tissue, but some have excessive breasts. This ranges from classical cases of gynaecomastia, prompted by a range of causes, to breasts enlarged entirely by deposits of fat over the pectoral muscles. But whatever the cause British men seem to be increasingly concerned over the state of their chests.

The latest figures from the British Association of Aesthetic Plastic Surgeons (Baaps) seem to bear out this obsession.

Surgeons carried out 323 male breast reduction procedures in 2008, up a staggering 44% from 2007.

It would be easy to assume that the UK is a nation where men are rapidly becoming more obese, and they are taking a surgical shortcut to get rid of male breasts that are merely deposits of fat on top of their pectoral muscles.

Simon Cowell was mercilessly ribbed for his physique, but has since embarked on a fitness regime

But this is not the full picture says consultant plastic surgeon and Baaps member Dalia Nield.

She concedes that anything up to a third of the men seeking breast reductions are simply obese. But she says the rest of the rising numbers of operations are people who are suffering gynaecomastia - excessive breasts - caused by other factors, such as a hormonal imbalance.

Among these, a common type is pubertal gynaecomastia, where boys develop the excessive breast tissue during adolescence.

"Many of those young men if they don't have a very marked gynaecomastia they don't necessarily seek help," says Ms Nield. "But I see many of these pubertal cases later in life when they put on weight and it becomes more obvious."

Genetic disorders like Klinefelter's Syndrome - having an extra "X" chromosome - also account for some cases, and there are a rising number of men suffering from excessive breast tissue as a side effect of drugs prescribed for prostate cancer. Treatment of this type of cancer has improved in recent years, says Mrs Nield, leading to more cases.

But how can one explain the dramatic upwards trajectory for male breast reduction procedures? In 2005, only 22 were performed.

'Tremendous distress'

Mrs Nield suggests that much of the increase may be due to the media publicising the surgery option.

Many of those pieces mocking the imperfections of the middle-aged celebrity also contain a factbox that talks about non-obesity gynaecomastia and explains that surgery is an option.

The effect, Mrs Nield suggests, is that men who might have been suffering in silence for years, realise they are not alone and are spurred on to seek out surgery.

"It is a cause of tremendous distress," says the surgeon.

And there is no doubting that the last few years have seen an increasing attention to this particular physical flaw.

A search of the LexisNexis newspaper databases suggests the word made its debut in a British newspaper in June 2004. Since then it has been used 161 times. There have been more than 350 references to "man boobs" over the same period. "Moobs" clocks up 281,000 hits on Google.

Kerri McPherson, a chartered health psychologist at Glasgow Caledonian University and a member of the men's health group, Scotland, is an expert on male body image.

"I would argue that what the media is really discussing is just representing the growing concerns of everyday men. This concern has always been there but they have not been able to articulate it."

And it could be argued that media mockery reinforces the negative body image of the excessive male breast sufferer, it also might free some from isolation and paranoia that they could have been burdened with a decade ago.

John McCririck was also mocked after appearing on Celebrity Big Brother

The presentation of "moobs" as something suffered by a slew of male celebrities might make life easier for the ordinary bloke sitting in a pub discussing his problem with his mates.

"More and more people are being given a language to talk about concerns about their body," says Dr McPherson.

"Particularly with what is a very feminine [characteristic] if a man was talking about [having] breasts [decades ago] they would have been a source of ridicule."

Paula Singleton, a researcher in the health faculty at Leeds Metropolitan University, is doing a PhD on the attitudes shown by men planning to have breast reduction surgery, entitled "Bruises heal but moobs last forever - men's account of cosmetic surgery for gynaecomastia."

"It seems like you can hardly turn on the telly and open a newspaper without it being mentioned," she says.

"[Those planning surgery] described feelings of shame, anxiety and embarrassment. They had suffered everything from being shouted at from a bus to teasing from work colleagues… doctors smirking and laughing at them and saying 'get down the gym'."

Of course, it would be wrong to group men with excessive breasts into justifiable "moobs" - ie a hormonal, chemical or genetic cause - and unjustifiable "moobs" - those caused primarily by obesity.

Both sets of men may be suffering psychologically at a time when the male body is under increasing scrutiny.

In the academic world, most of the theorising about body image has traditionally been about women, but now researchers are starting to look at changing attitudes among men.

"Men are starting to feel those appearance pressures more and more," says Ms Singleton.

And this growing body consciousness could lead to more men making their way through the surgeon's doors.

Tags: masculinity, self esteem, fitness, health, moobs, man-boobs, gynaecomastia, bitch tits, Finlo Rohrer, BBC, Klinefelter's Syndrome