Even mild gynecomastia can have negative effects on self-esteem and other aspects of mental and emotional health in adolescent males, according to a new study in the April 2013 issue of Plastic and Reconstructive Surgery.

In the new study, 47 healthy adolescent boys who were being evaluated for gynecomastia took a series of psychological tests. The results were compared to those of a group of boys without gynecomastia. According to the findings, 62% of the gynecomastia patients had mild to moderate breast enlargement. Many were also overweight or obese.

In general, boys with gynecomastia had lower scores on a standard quality of life assessment, indicating problems in several areas. When compared to their counterparts without gynecomastia, boys with the condition also had lower scores for general health, social functioning, and mental health even after adjustment for weight and body mass index (BMI). They also had lower scores for physical health, but this was attributed to being overweight.

Breast enlargement was also associated with lower scores for self-esteem. This, along with impairment in emotional areas of quality of life, appeared directly related to gynecomastia, rather than being overweight. Boys with gynecomastia also scored higher on a test of attitudes toward food and eating, but there was no difference in the rate of clinical eating disorders between groups, the study showed.

Even boys with mild gynecomastia were experiencing negative psychological effects, the researchers report. “Our results indicate that careful and regular evaluation for gynecomastia may benefit adolescents regardless of BMI status or severity of gynecomastia,” they conclude. Treatment for gynecomastia typically involves male breast reduction surgery.