Man boobs are an embarrassing condition that's becoming more and more common. Up to 10 percent of the male population that's a million Australian blokes will develop man boobs at some stage in their life.
So what causes them and what can you do about them? Also, can hormones in our food be causing the outbreak?
It's not a topic that men feel comfortable talking about, but 48-year-old Californian, Merle Yost, remembers his school days well, mainly because as an 11-year-old he started growing breasts.
"I was this tiny, skinny little boy who all of a sudden started sprouting breasts and they were large enough that they were noticed by everybody. The more they developed the more I got harassed. The guys were constantly grabbing at my chest and the girls were offering me their bras," says Merle.
The condition that Merle is talking about has a medical name gynecomastia. It works like this female breast growth is stimulated by oestrogen, for male breasts it's testosterone. The problem with boys who develop gynecomastia is their bodies somehow start producing more oestrogen than testosterone and that turns into man boobs.
Merle tried to eliminate his problem surgically back in the early nineties: "I would guess that by the time that I ended up having surgery in 1993 that I was probably in the neighbourhood of a B-cup."
But the operation wasn't a complete success, so he's backing up to finish the job by having a second operation at a private hospital in San Francisco.
Dr Miguel Delgado has done breast reductions on more than a thousand men like Merle. Merle is also taking this opportunity to get his love handles removed.
With the preliminaries over, it's time for the operation. Last year alone, 17,000 American men stepped up to have breast reductions and it's mostly about getting rid of excess fatty tissue. Dr Delgado's uses a tool that literally melts the fat away.
"So you have to be fairly cautious not to over use it," says the doctor. Once the fat's turned to liquid, it's liposuctioned out.
After four hours the operation comes to an end and went well.
"This was definitely a great success," says Dr Delgado. "He'll have somewhat of a rough ride home, but he'll get in his bed, take a sleeping pill and he'll be fine."
Five weeks after the operation Merle is still wearing a compression garment but when he takes it off, the shape of things to come is clear to see.
"I'm actually feeling really optimistic about the surgery, my chest looks dramatically different and it's only going to get better as the swelling continues to go down," says Merle. "One of the most exciting or the best parts about this is the increased freedom, the freedom to be me. I don't have to be self conscious about what I'm wearing and that I feel attractive to people … it gives me a whole new lease on life and the way that I can be more exciting and have a lot more fun."
Merle is keen to be cast as a poster boy for all those guys out there who suffer man boobs. He's written a book on the subject and he's set up a website, gynecomastica.org which is getting a million-and-a-half hits a year on it.
"Somebody has to be talking about it because so many men are walking around in shame and nobody's willing to talk about what's going on. And the only way to work through that shame is to bring it into the light and have a discussion so people know what it is and what it isn't," he says.
Now earlier we said that gynecomastia is caused by a hormonal imbalance in men but is it possible that hormones added to food could contribute to a build up of oestrogen?
Chicken and hormones
Way back in the 1950s chicken farmers decided they wanted bigger, meatier, faster growing chooks. Scientists came up with a solution: "Chicken was treated with very large amounts of female hormones or oestrogen. And there were examples in that case of men having some breast development, or young children having breast development," says Professor George Werther.
In fact, in Milan in 1977, a study pointed to poultry as the prime suspect in an outbreak of breast enlargement amongst schoolboys.
So are hormones still added to chicken to make them grow bigger?
"No, absolutely not," says Andreas Dub from the Australian Chicken Meat Federation.
Truth is, hormones haven't been added to Australian chickens for over 40 years. Yet since the mid '60s, soon after the hormone ban came into effect, the size of your average shop-bought chook has gone from 1.1 kilograms to nearly 1.8 kilograms. What's going on there?
"Well, the main reason is essentially selective breeding, so we use the biggest and best chooks to grow the next generation of chickens," Andreas says.
But is this really the only reason Chicken Little morphed into chicken big? A lot of farmers treat their chickens with antibiotics from birth so are they de facto growth promoters?
"Antibiotics prevent growth from being stunted. If we don't use antibiotics and the chickens are sick, they wouldn't grow as well," says Andreas.
If, like increasing numbers of Australians, you are worried about the use of antibiotics in chicken rearing, then buy free-range or organically raised chickens both are free of antibiotics and not so difficult to find. But as to whether you'll get man boobs from eating your common garden variety chicken, we'll leave the final word to endocrinologist Professor Werther: "Chickens are no longer exposed to any oestrogen and haven't been for many, many years. With regard to a grown male developing breasts, it's extremely unlikely in our current society and to my knowledge there's been no recent example of that occurring."
But of course chicken's not the only source of protein found on our dinner plates. The good news is that lamb is totally hormone free so no worries there. But what about pork and beef?
Pork and hormones
Pork is well worth investigating, after all, it is the most widely consumed meat on the planet and the average Australian now consumes 23 kilos of pork per year.
There's this whole idea in the community that there's hormones and chemical's that are put in is there any truth to that?
"There are certain products that are used in pork production one of is called PST [porcine somatatropin]. PST is a copy of a natural hormone produced in the pig," says Andrew Spencer, CEO of Australia Pork Ltd who represents Australia's pork producers.
How do we know if the PST is doing anything to us?
"PST's been tested at great length to make sure it has no activity whatsoever in humans," he says.
PST is a protein-based hormone, not an oestrogen-based hormone, so we can cross pork off the list as well.
"The products we use to make pork in this country are all of no concern to human health," says Andrew.
Of course, that's the pork industry's view point. But if you have concerns about chemicals used in pork production you do have a choice. Scott Kinnear from Australian Certified Organics says go organic: "We should eat organic meat because it's produced in a natural system and it's sustainable, it takes care of the animals in an ethical manner and the food is produced without potential harmful additives that we see today."
Beef and hormones
What about Australia's most popular source of protein? Could beef be the reason for blokes with breasts?
Rockhampton is the beef capital of Australia, well that's what they tell us. The saleyards outside of town are the biggest in Queensland. So there's no better place to find out just how hormones are used in the production of beef.
Also just outside of town is CSIRO's Belmont research station the man in charge is Dr Bob Hunter.
Are there hormones used in beef?
"Yes, there are hormones used in beef cattle production and especially so in northern Australia," says Dr Hunter.
So we've finally tracked down a meat product with hormones. Not only that, Dr Hunter tells us they're oestrogen-based hormones: "A common implant that's used in northern Australia contains 43 milligrams of oestrogen."
That doesn't sound like much especially for such a large animal. But could hormone-enhanced beef be the man boob culprit. After all as pro-organic Scott Kinnear points out, the use of hormones in beef production has been banned in Europe since 1989.
"And that's something that was brought about by scientific evidence of concern and they have continued to maintain that ban against the pressure through the World Trade Organisation. It is outrageous that in Australia hormones in beef is allowed," he says.
But Dr Hunter says growth hormones are necessary for Australian conditions and they're harmless to our health. "The overwhelming evidence of every investigation has concluded that it's quite safe to eat the meat of the animals that have been treated with a growth hormone."
So if you want to ensure the beef you're buying is hormone-free ask your butcher. But if you're still uncertain go organic.
Even so, endocrinologist Professor George Werther says beef has too little oestrogen hormone to be a problem.
"The typical steak would contain such a small quantity that it's something like hundreds of the average daily exposure of oestrogen just from other sources," says the professor.
He also says we'll find way more oestrogen-based hormones in non-meat products, like vegetables. Plus, "You would need to eat many, many kilograms of meat per day to even be exposed to minimal quantities of oestrogen which might lead to breast development in men."
So there you go, men of Australia, eat meat but not too much, because the simple fact is the more overweight you are the more likely you are to have man boobs. Yes, the man boob epidemic is directly related to the obesity epidemic, so you should aim to eat healthy and get plenty of exercise.
- Are today's chooks fattier and less healthy than they used to be? No. The total fat content in chicken has decreased by 15 percent, mostly because of improvements in breeding stock. And if you're looking for the cut with the lowest fat, choose the skinless breast meat it has less than one percent total fat compared with 17 percent with chicken wings.