The neck bulge is suggestive of goiter, but it probably eats enough salt with Iodine and seafood to counteract any hypothetical deficiency.  (I'm no medical or professional) http://www.thyroid.org/goiter/   Hashimoto’s thyroiditis, autoimmune condition, pituitary gland senses a low thyroid hormone level and secretes more TSH to stimulate the thyroid. This stimulation causes the thyroid to grow, which may produce a goiter.   Graves’ disease. In this case, one’s immune system produces a protein, called thyroid stimulating immunoglobulin (TSI). As with TSH, TSI stimulates the thyroid gland to enlarge producing a goiter.   Multinodular goiters are another common cause of goiters. Individuals with this disorder have one or more nodules within the gland which cause thyroid enlargement.   Tumors (both cancerous and benign tumors)    Alternate guess: fat clogging up the lymphatic system.