It’s not a term recognized by the American Board of Plastic Surgery or the Surgeon General; you won’t find it indexed in any volume of Grey’s Anatomy nor uttered by a be-scrubbed Patrick Dempsey on any episode of the same.

Man boobs, moobs, and yes, the more crass bitch tits: colloquially diagnostic terms for the unfortunate incidence of breast enlargement in men. Known within the medical community as gynecomastia, this physiological phenomenon can be observed from Subways to GNC stores across the country.

Once reserved for the “performance”-enhanced, gynecomastia is now affecting more men than ever before. In 2011, over 20,000 men sought breast reduction procedures, an 8% increase in one year according to the American Society of Plastic Surgery.

What Causes Moobs?

Gynecomastia is defined as swelling of the breast tissue, involving one or both breasts, and occurring in males of all age ranges. Newborns, adolescent males and men (typically between the ages of 50 and 80) may develop gynecomastia as a result of normal changes in hormone levels, specifically testosterone and estrogen, though other causes also exist, some being sinister.

In general, gynecomastia is not a serious medical condition, although it can be difficult to cope with, especially in adolesecent males, who fall under the harsh scrutiny of the teenage sub-culture. Additionally, a significant percentage of males affected by this condition are over-weight, which contributes to the overall “enhancement” of the breasts.  Obese men, likewise, are even likelier to develop this condition as obesity can lead to an increase in estrogen production.

A number of prescription medications may put you at risk as well. Case in point:

The Curious Case of Bi-Polar Boobs

Ever heard of Risperdal? Probably not, unless you suffer from schizophrenia or bi-polar disorder. It is a psychotropic drug, manufactured and marketed by a company you probably have heard of – Johnson & Johnson. Yes, the same company that developed Head-To-Toe Baby Wash, a product that mommies all across America rely on to keep their progeny clean and fresh, was recently named in a suit.

This week, Johnson & Johnson quietly settled a case with a 21 year-old patient, who claimed that he developed breasts after taking the drug for several years as a child. The payout amount was undisclosed, but you can’t put a gag order on precedent.

There have been over 420 lawsuits against the pharmaceutical giant, about 130 of them related to instances of Risperdal and gynecomastia. In April of this year, a judge in Arkansas ordered J&J to pay fines totaling $1.2 billion in a jury’s findings that the company “had minimized or concealed the dangers associated with the antipsychotic drug,” according to The New York Times.

Besides being the largest recorded fine in a state fraud case involving a drug company, this was just the latest in a slew of civil complaints against J&J for marketing the drug for unapproved uses and to children without approval from regulators.

Going in Tit for Tat

Chances are, unless you’re a plaintiff in one of these cases, an adolescent or elderly male, or a card-carrying member of the NFL (allegedly), if you do suffer from male breast enlargement, it is likely related to two things: Lifestyle choices and diet. It’s time to fight back. Here are some obvious and not-so-obvious tips:

Step 1: Stop ‘roiding

The evidence linking anabolic steroid use and gynecomastia is practically irrefutable. When the body senses excess testosterone, it will begin to convert the excess into an estrogen-like substance through a process known as “aromatization.” This causes the male body to produce extra glandular tissue in the breast. Stop the ‘roids, shrink the breasts.

Step 2: Avoid soy

While a good source of protein, soy products also contain isoflavenoids, compounds that can have an estrogenic effect on the male body. Want to avoid going up a cup size? Stick to organic cow’s milk, and limit your intake of other soy products.

Step 3: I don’t take steroids – but my livestock does

There is a reason that cows grow as large as they do, and no, it’s not purely an effect of Darwinian selection. Nearly all livestock entering conventional beef feedlots in the U.S. are supplemented with performance-enhancing drugs, testosterone and estradiol among those. This means that the meat you eat and the milk you drink, and yes, whey protein supplements you consume, are tainted with unsafe drugs.

Avoid this problem altogether by choosing organic meats and milk. For athletes, there exists a selection of whey proteins that are likewise devoid of drugs and hormones. Slightly costlier, yes, but think of all the money you’ll save by foregoing regular trips to Victoria’s Secret to stock up on the latest “bro” fashions.

Step 4: Drop that J

Stoners, beware. Among the laundry list of deleterious effects of marijuana on the human body, smoking pot may increase your risk of developing gynecomastia. It’s unclear whether the correlation is with cannabis itself or the inordinate amount of snack foods consumed in conjunction (put down that edamame!), but either way: DARE to stay away.

Step 5: Fear the beer

Alcoholic beverages are well known to have pro-estrogenic effects, some more than others. Plants used in the development of alcoholic beverages contain estrogen-like substances known as congeners. These substances (notably phytoestrogens) exhibit pro-estrogenic effects even at moderate drinking levels. If you must drink, there are smarter choices.

Booze to Choose

• Red wine
• Vodka
• Gin

Booze to Ban

• Beer
• Rum
• Whiskey
• Cognac

While lifestyle changes can help address the issue, it may not always be effective in reversing a severe condition. In some cases, surgery may be the only way to remove the extra breast tissue.  When in doubt, consult with a qualified physician.

Glenn Vallecillos, M.D. | Elite.

Dr. Vallecillos is a board certified plastic surgeon in Beverly Hills, internationally known for his skill and expertise in the field. Visit Beverly Hills Cosmetic Surgeon