Medical Syndromes that May Cause Gynecomastia

NOTE: The following information is meant for educational and informational purposes only and is not intended as a tool to diagnosis or treat any medical condition.

Body Dysmorphic Disorder (BDD)

We have found over the years in dealing with gynecomastia that many men also suffer from BDD. They have the first surgery and then the second and often the third. No matter how much is taken away they still see breasts. In one case during the second surgery the young man had muscle removed and created a major distortion of his chest.

It is a fairly common condition and exists in various degrees. It is difficult to treat but the first option is drugs and for those that it helps it is a life saver. The most common treatment is Cognitive Behavior Therapy which reports good results for many. We believe that EMDR holds promise for many in the future.

What is Body Dysmorphic Disorder?

Also known as dysmorphobia or the fear of having a deformity, body dysmorphic disorder (BDD) is a chronic body-image disorder. It is characterized by an intrusive and persistent preoccupation with an imagined or possibly real but slight defect in one's appearance.

Individuals with BDD may find fault with virtually any part of their body—obsessions with skin, hair, chest, nose, or stomach are the most common. The defect or imperfection may be slight or even nonexistent. But for an individual with BDD, the perceived flaw is prominent and can often cause significant emotional distress, impacting normal daily functioning.

In some cases, men with gynecomastia also suffer from BDD and may seek out surgical treatment. However, often due to unrealistic expectations, they are never satisfied with the outcome. They may have the first surgery, and then a second, and often a third. Yet, no matter how much tissue is taken away, they still see breasts. In one instance, a young man had muscle removed during the second surgery, creating a major distortion of his chest.

Body dysmorphic disorder is most often seen in teens and adolescents. Research has shown that it affects women and men almost equally. BDD affects about one percent of the American population.

Causes

The cause of BDD is not clear; however, certain environmental and biological factors may contribute to the development of BDD. Other factors may include a genetic predisposition or neurobiological issues, such as personality traits, life experiences, and a malfunction of serotonin (the “feel good” hormone) in the brain.

Treatment

BDD is a fairly common condition and exists in varying degrees, however, it can be difficult to treat. Medication used to treat other conditions, such as depression, may be effective. Selective serotonin reuptake inhibitors (SSRIs) are typically prescribed. Cognitive behavior therapy—sometimes in combination with medication—has also produced good results. Cognitive behavioral therapy focuses on changing negative thoughts in order to modify feelings and behaviors.

Eye Movement Desensitization and Reprocessing, or EMDR holds promise for many people suffering from BDD. This is a fairly new, nontraditional psychotherapy technique that uses bilateral stimulation, right/left eye movement, or tactile stimulation to weaken negative emotions and gradually shift thoughts to more pleasant ones.

Resources and Support

To learn more about BDD, visit the Anxiety and Depression Association of America.

For information on children and teens with BDD, visit:
http://kidshealth.org/teen/your_mind/body_image/body_image_problem.html

In Pursuit of Perfection: A Primary Care Physician's Guide to Body Dysmorphic Disorder
http://www.aafp.org/afp/991015ap/1738.html

Recommended Reading

Body Image and Self-Esteem
http://kidshealth.org/en/teens/body-image.html

Recommended Reading

The Adonis Complex: How to Identify, Treat, and Prevent Body Obsession in Men and Boys: The Secret Crisis of Male Body Obsession by Pope, Harrison G. Jr., Phillips, Katharine A., Olivardia, Ro (2002)

The Adonis Complex offers readers an explanation of the underlying causes of the Adonis complex, together with hands-on advice for those who have experienced body obsessions themselves, or who see these problems in a boy or man they love.

Purchase from Amazon >

The Broken Mirror: Understanding and Treating Body Dysmorphic Disorder by Katharine A. Phillips M.D.

In The Broken Mirror, the first and most definitive book on BDD, Dr. Katharine A. Phillips provides a comprehensive manual for patients and their physicians by drawing on years of clinical practice, scientific research, and professional evaluations of over 1000 patients.

Purchase from Amazon >

Understanding Body Dysmorphic Disorder by Katharine A. Phillips M.D.

The world's leading authority on BDD reaches out to patients, their friends, and their families with this concise and updated handbook. Using stories and interviews to show the many different behaviors and symptoms of BDD, and a quick self-assessment questionnaire, Dr. Phillips guides readers through the basics of the disorder and through the many treatment options that work and don't work.

Purchase from Amazon >

The Body Image Workbook: An 8 Step Program for Learning to Like Your Looks by Thomas F. Cash, Ph.D.

The Body Image Workbook provides a comprehensive program to help readers stop focusing on their perceived imperfections and start feeling more confident about the way they look.

Purchase from Amazon >

Living With Body Dysmorphic Disorder (Biography Series Book 12) Kindle Edition by Lea Walker and Janet Lee

Living with BDD is a touching and honest account of one woman’s struggle to come to terms with the crushing low self-esteem and dysfunctional body image that have dominated her life. By telling her story, Lea hopes that she may be able to help others to face up to their own personal nightmares.

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