Gynecomastia as a precipitant of eating disorders in adolescent males

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.