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It was the latest in a series of comments from men that Jakeb says made him feel worthless. Last summer, following the comments, he tried to kill himself. Manchester-based charity the LGBT Foundation has warned that body image issues are becoming more widespread in gay communities. It says gay and bisexual men are "much more likely" than heterosexual men to struggle with them.

A number of gay men have told the BBC they are going to extreme lengths to change their bodies - including using steroids and having plastic surgery - just to become "accepted" by others in the LGBT community. Several said pressure from social media platforms and dating apps was exacerbating their body issues. I would honestly have plastic surgery if I could afford it.

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Instead of surgery, a few years ago Jakeb turned to anabolic steroids - class C drugs that can be misused to increase muscle mass. It was like there was a harsh voice telling me I'm skinny. Jakeb had his second near-death experience in November last year when - after several years of heavy steroid use - he suffered heart failure.

Months later, Jakeb has stopped taking steroids and has lost the extra muscle he gained, but he continues to have health problems for which he is receiving hospital support. James Brumpton - a software engineer from Lincoln - found himself "catapulted into this world of self-consciousness", after he hooked up with a man at a local gay bar. When James went back to the man's house and took off his T-shirt, his date looked at him and made a disgusted noise.

Low self-esteem

Eventually, the experience led to James deciding to have an abdominoplasty - otherwise known as a tummy tuck. Prof Afshin Mosahebi, of Baaps, says gay men are currently having more cosmetic procedures done than straight men, although he notes that women have more procedures than men overall. After James's tummy tuck went wrong, he was left with permanent scarring, which made him even more conscious of his body.

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Dating apps have fuelled body image concerns, he says. Images on social media and in leading gay magazines have also led James to feel he is an "invader in the space". Photos of "sexy bodies" drive sales of gay magazines, according to Matthew Todd, a former editor of one such publication, Attitude. When Matthew put a photo of Stephen Fry on the front of the magazine in , "it was one of the worst selling editions ever", he says. Matthew, the author of Straight Jacket: How to be gay and happy, says homophobia has fuelled gay men's body issues.

If you don't like yourself, that manifests as not being happy with the way you look.


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