Exploring the Experiences of Gay Men with Regards to Eating, Exercise, and Mindfulness-Based Concepts.

Existing research investigating gay men's eating behavior has focused on stereotypes and body image, rather than to understand why disordered eating is prevalent in gay men. The current study adopted a qualitative approach and employed interview methodology to explore gay men's attitudes, feelings and experiences of their eating behavior, and the potential link to mindfulness and self-compassion. Twenty gay men aged from 21 to 51 years were interviewed using an interview schedule with open-ended questions. Three main themes emerged from the transcript data sets: "Lean to be Seen," "Sod it 'I'll Have a Pizza," and "You Can't Sit with Us." The first theme was developed following responses that participant's eating behavior and exercise engagement were influenced by their perceived attractiveness by the gay community. All participants spoke of achieving or maintaining a slim or muscular body type and adopted their eating behavior or exercise regime to reach corresponding goals. The second theme relates to the lack of acceptance felt from the gay community upon not conforming to the bodily expectations set out by the community. The third theme relates to the conflicts in participants' attitudes around how exercising and eating healthily would improve their mental well-being; but that they also would give preference to calorie dense foods to reduce stress. These reflections are observed through a context of self-kindness and self-compassion and are seen to be related to increased feelings of self-criticism and body dissatisfaction. The limitations and implication for this research and suggestions for future research are discussed.

Research indicates that 42% of men diagnosed with an eating disorder (or disordered eating) identify as gay (e.g., McClain & Peebles, 2016 has been cited in text but not provided in the list. Please supply reference details or delete the reference citation from the text.]). Body dissatisfaction, body image, appearance and self-criticism are factors that lead to changes in gay men’s eating habits (Levesque & Vichesky, 2006; Readdy & Wallhead, 2016; Schaefer et al., 2018; Wyssen et al., 2016), with research suggesting that gay men are at a higher risk of being underweight than heterosexual men (Semlyen et al., 2020; Williamson, 1999).

Research by Smith et al. (2011) concludes that heterosexual men strive for muscularity, whereas gay men aspire to conform to a lean body type. To meet these expectations, gay men are more likely to engage in strict dieting and extreme exercise (Blashill & Vander Wal, 2009), with gay men being more likely to experience stigma and become more susceptible to societal stereotypes, leading to more pressure and self-consciousness (Smith et al., 2011). Divertingly, Boisvert and Harrell (2010) suggested that older gay men are less likely to aspire to a lean, muscular body, with social class and education impacting attitudes and behaviors. Gay men from lower socioeconomic backgrounds who experience more social stress are reported to be more prone to unhealthy eating (Meyer, 2003).

There is a poor conceptualization and analysis of body image and behavioral changes among gay men (McArdle & Hill, 2009), with research concluding that the gay body ideal includes two distinct components; muscularity and thinness (e.g., Kane, 2009), with Duncan (2010) suggesting that the idealized muscular and sexualized body ideal has been the main factor causing body dissatisfaction and maladaptive eating behavior due to gay men adopting a discourse where this body ideal generates high self-esteem and social status. Regardless of the body ideal the gap between current body state to the idealized might cause psychological problems for gay men, consisting of anxiety and dangerous health behaviors (Kane, 2009). Considering the diversity in appearance and classification of a gay men (e.g., bear, jocks and circuit boys), masculinity and leanness could both contribute toward perceptions of self and others, and influence eating in different ways.

Traditional gender norms are prevalent within the gay community with part of the gay male identity involving the desire to look masculine and the belief that masculine behavior is important (Sánchez & Vilain, 2012). This drive to be muscular can be attributed to experiencing alienation as a child for being too feminine and therefore is an attempt to avoid similar rejection in adulthood; thus impacting negatively upon eating behaviors and self-compassion (Sánchez & Vilain, 2012). Research conducted by Ravenhill and de Visser (2018) investigated the identity perceptions of three younger participants ages 20–24 and three older participants ages 30–42 in relation to their masculinity. The older participants stated that they were more affected by the discourse of hegemonic masculinity, that they would try to emphasize their masculine attributes and to distain effeminacy in non-gay spaces (Ravenhill & de Visser, 2018). Lack of acceptance of homosexuality in previous generations meant a suppression of culture, where older populations may be less influenced by current body ideals and therefore it may have less influence on their eating behaviors and exercise engagement.

In comparison to heterosexual men, gay men are more at risk of self-objectification due to the sexualized subculture of the gay community with concomitant body shame and disordered eating (Lanzieri & Hildebrandt, 2016; Schaefer et al., 2018). This contributes to a more critical perception of self-appearance and bodies, particularly in relation to body shape and weight gain (Peplau et al., 2009), with higher rates of anti-fat bias being reported in the gay community (Bailey et al., 1997; Foster-Gimbel & Engeln, 2016).

Mindfulness as a construct has been explored in relation to health behaviors and well-being in psychological literature (e.g., Ilies et al., 2019; Keyte, Mullis, et al., 2020). This construct derives from Buddhist practices, including concepts such as awareness, acceptance and self-compassion (Mantzios and Egan (2017), and Egan and Mantzios (2018). While research which explores how mindfulness-based concepts may affect the well-being of gay men (Beard et al., 2017); there is a lack of research illustrating how gay men think and feel about eating healthily and how this relates to acceptance, self-acceptance, self-compassion and self-judgment. (Lingiardi et al., 2012; Morgan & Arcelus, 2009). Self-compassion is a method of directing compassion toward oneself and includes three interrelated components: self-kindness, mindfulness and common humanity (Neff, 2003a).

Self-compassion has been linked to disordered eating within the general population, whereby individuals with lower self-compassion have shown higher rates of disordered eating (Thogersen-Ntoumani et al., 2017) and a negative impact on well-being (e.g., Ilies et al., 2019; Keyte, Mullis, et al., 2020; Rizal et al., 2020). While a large amount of previous research has investigated the relationships between self-compassion and eating behaviors and attitudes, few studies have taken a qualitative approach to study how mindful eating and self-compassion shape eating behavior, with even fewer studies investigating disordered eating, body shame, and self-compassion among gay men.

The current study aims to qualitatively explore the unique experiences specific to gay men and how these may shape their eating, body ideals and the influences of mindfulness-based concepts. The eating and exercise behaviors used by gay men to either attain or maintain their body ideals will be explored. Exploration of these concepts in this population will allow insight into the experiences of gay men, providing depth and understanding which could inform future research and interventions.

Methodology

Participants

Twenty cis-gendered men aged between 21 and 51 years (Mean = 29.3) who self-identified as “Gay” were recruited (see Table 1) by volunteer and opportunity sampling. An advert was placed in the Birmingham LGBT Association’s notice board and those interested contacted the researcher directly. Some participants were known to the researchers, and therefore, were recruited through word of mouth. Individuals were excluded from the research if they were under the age of 18 years, or if they had received a diagnosis of an eating disorder within the past 2 years.

Table 1.

Participant Pseudonyms and Demographic Data.

Pseudonyms	Age	Ethnicity	Height	Weight
Dave	21	White British	1.7 m	88 kg
Connor	28	White British	1.9 m	89 kg
James	51	White British	1.8 m	76 kg
Charles	31	Black-Caucasian Mixed	1.8 m	85 kg
Mason	41	White British	1.7 m	71 kg
Chris	25	White British	1.8 m	76 kg
Jonathon	40	Black British	1.8 m	85 kg
Travis	21	White British	1.9 m	83 kg
Joe	26	British Asian	1.8 m	147 kg
Callum	29	Greek Cypriot	1.9 m	109 kg
Tony	25	White Portuguese	1.8 m	85 kg
Matt	37	Black-Caucasian Mixed	1.8 m	93 kg
Craig	25	White British	1.7 m	68 kg
Sam	34	White British	1.8 m	70 kg
George	25	White South African	1.8 m	70 kg
Stefan	20	Black-Caucasian Mixed	1.9 m	87 kg
Richard	23	Black-Caucasian Mixed	1.8 m	95 kg
Albi	28	Black British	1.7 m	60 kg
James	25	White British	1.9 m	127 kg
John	26	White British	1.8 m	76 kg

Semi-structured Interview

Semi-structured interviews investigated the thoughts, feelings and experiences of gay men in relation to their eating behavior and exercise engagement (Reczek & Umberson, 2012), with the interviews focusing upon appetite, social eating, the use of supplements, kindness and self-compassion.

The interviews were conducted by two members of the research team (age, 21 and 26, both White British), who both identify as cis-gender gay men, consequently the researchers were able to converse with participants on a level of mutual understanding of the gay community and gay culture, thus attaining a greater depth into these topics.

Fourteen of the interviews were conducted in a quiet but public place, for example, coffee shop, restaurant, bar, and six interviews were conducted online using Microsoft Teams due to the implications of COVID-19 on face-to-face research. The interview duration varied from 20 to 60 min and concluded naturally once all questions and topics on the interview schedule (see Appendix A) had been explored. Interviews were audio recorded using a dictaphone and transcribed verbatim. Demographic information was collected from participants (see Table 1) via a form which was either presented to them or sent online. Data collection continued until data saturation occurred, whereby, a lack of “new” information was presented within the interviews Braun and Clarke (2006). All participation was voluntary and confidential, with participants being provided pseudonyms, as used in the results section of this article. Participants could withdraw from the research at any time, though none did so.

Ethical Considerations

Ethical approval was obtained by the Business, Law and Social Sciences Ethics Committee at Birmingham City University (application reference: PSY_BSc_Jun19_001_am and PSY_BSc_JUN19_003_am), with participants providing written informed consent (informed consent was provided via email from March 2020 due to COVID-19) prior to the interview being conducted.

The Research Team

The research team consisted of five individuals who all engaged the research proposal, analysis, and write-up. The two aforementioned researchers conducted the interviews. The final three researchers describe themselves as heterosexual cis-gendered individuals (two female and one male). The two female researchers are White British and White Irish, and the male is European.

Analysis

Thematic analysis (TA) was used to analyze data following the appropriate steps described by Braun and Clarke (2006). TA is a constructivist approach, which investigates an understanding of the perceptions of participants’ thoughts, feelings and experiences (Braun & Clarke, 2006).

Familiarization of the data occurred when the researcher transcribed the data from the recordings and read through them thoroughly. Once each member of the research team had completed the initial coding, the researchers collaborated together, allowing their initial codes to be evaluated and revised to ensure they were representing the content of the data (Braun & Clarke, 2019). The researchers assigned two raters who were coding the transcripts to form the themes of the data. The validity of the codes were ensured when the researchers were in agreement regarding each code.

To create the themes, the researchers categorized the codes into meaningful groups of codes, with the themes identifying major patterns which emerged from the codes (Braun & Clarke, 2019). During this process the researchers collaborated together, allowing the two raters to reflect and revise upon the early categorization of codes, ensuring the validity of this process. The validity of the themes were confirmed when the researchers both agreed on the themes of the data and which codes should be represented within each theme, with these collaborations helping to ensure the inter-rater reliability of the data generated.

Results

Thematic analysis identified three themes within the data set. This provided explorations into participants attitudes and experiences of gay men and how this influences their eating behaviors and exercise engagement. Mindfulness-based concepts were also explored including self-compassion, self-kindness and self-criticism. It is recognized that there are aspects of participants’ experiences and understandings that overlap across these themes; however, this was to be expected.

“Lean” to be Seen

This initial theme highlights the perceived importance of engaging in exercise and maintaining a healthy diet in order to achieve a slim, muscular body and be perceived as attractive by potential partners. Craig, a 25-year-old hairdresser who describes himself as being medium build, attends the gym regularly and maintains a balanced diet, explains how his eating behavior, is influenced by what is deemed as attractive in the gay community.

Craig “gays are just so much more conscious as well, of being really skinny, like being really skinny or really muscly, and that’s what’s considered attractive [. . .] I always feel like even if you got like a little bit of meat on you, in the day world you’re perceived to be fat”

It is suggested here that two extremes of body types are deemed attractive, and those who do not possess these body types are not. The perception that those who have “a little bit of meat” on them are “fat” highlights the extent to which gay men give preference to those who are “really skinny” or “really muscly” by ostracizing those who fall even slightly out of this category. This is an absolute way of thinking of perceived attractiveness by the gay community, as you are either “really skinny or really muscly” and attractive, or you are not.

Participants illustrated that they consciously strive for a lean body type through dieting and exercising, with individuals such as Charles and Tony explaining that they feel they will be unable to attract other men and engage in a sexual relationship if they are not considered attractive. Tony made reference to Grindr, a geolocation-based dating app where users rely on pictures to preference the profiles they engage with.

Tony “Yeah it [exercise] was more about validation of you know being able to go on a night out and like flirt with guys and show someone a shirtless pic on Grindr and them not run away like that sort of stuff.”

The validation Tony made reference to suggest that gay men predominantly exercise and eat healthily to feel attractive, with their behaviors being reinforced by the attention they receive. Callum describes himself as a lover of food and a consistent gym goer. It was apparent from the interview with Callum that he really enjoys food of all types, particularly “indulgent food.”

Callum “I really enjoy pasta, I enjoy bread, I enjoy all the things I’m not allowed to eat so I can have results at the gym.”

“Basically, I cannot eat too many carbs, I cannot eat too many fast foods because I put on weight very easily, so I eat very high protein and as much vegetables as possible but it’s horrible because the chicken is disgusting.”

Callum describes food that is high in carbohydrates such as pasta and bread as food he is “not allowed to eat.” This is a specific way of thinking about food, the language he used to describe this, suggests the way he feels about high carb food is absolute. It also highlights his desire to have it, as much as he wants it, he is “not allowed” to have it. Callum deprives himself of the food he enjoys so it does not have a detrimental effect on his progress at the gym. His desire to stay slim and muscular means he monitors his diet to correspond with his body type and to maintain his body ideal. Participants’ experiences of attending gay spaces further affects their perceptions of themselves which intern, informs their decisions around eating and exercise. This leads to a lack of feeling accepted when their perception of themselves does not align with that of the perceived ‘norm’ of the gay community, as explored in the following theme.

“You Can’t Sit with Us”

This theme discusses the judgment gay men experience if they do not fit the body ideals set by the gay community and how these experiences can lead to self-criticism. The importance of being attractive in the gay community was highlighted by all participants when asked questions about identity and how being a gay man may influence their eating behavior or exercise engagement. Attractiveness was further explored when participants spoke about their experiences of going out in LGBT establishments, events or nights out whereby participants felt they were being judged based on appearance by other gay men.

Joe is a 26-year-old professional from Birmingham who owns an independent cakes business. Joe explains that gay men who do not meet the “norm” are regarded as different and may have trouble fitting into the gay community. The judgmental attitudes held by the gay community lowered self-esteem and encouraged self-criticism of the appearance and body shape and gay men.

Joe “The gay community is very judgemental because people will judge you on what you are wearing, how you are dressed, how you talk, how feminine or camp you are so you get judged straight away and then it comes down to like looks [. . .] when you go out on a night out like the gay community you see all these like skinny guys with their tops off, abs people that work in bars, like you never really see a big person behind a bar, like bar staff or dancers that they have on stage they never really have a big person”

This emphasizes the pressure put on gay men to evaluate their appearance and gain acceptance by conforming to the body ideals set by the gay community, with Joe explaining the impact this has on his attitudes toward food, reporting feelings of guilt for eating calorie dense foods as it may lead to weight gain reducing his perceived attractiveness and acceptance by the gay community.

Jonathon illustrated the differences in attitudes gay men held toward those who do not fit the “skinny” ideal, with Jonathon engaging in exercise to prevent weight gain.

Jonathon “I was very young, quite skinny back then, and I noticed that when people who had weight on them were treated very differently, to those of us who didn’t.”

This resonates with the lack of acceptance of “big people” that Joe experienced. Now that Johnathon is older, he feels more self-worth but blames the gay community for having a negative view of his body and a self-critical element of his personality.

Participants reported that appearing attractive is important, with this increasing confidence and social status in the gay community. This emphasis on physical attractiveness resulted in some participants, such as Charles, feeling worthless, critical, and judgmental about their physical appearance.

Charles “if you go out on the scene its quite superficial so people will judge you purely based on how you look [. . .] when I was a lot larger weight, I was sort of invisible and people didn’t talk to me[. . .]I was I obsessed that if I stopped dieting I was gonna put on the weight back [. . .] it was Christmas day and I was still at the gym and then I still refused to eat Christmas dinner because I was still adamant that I needed to stick to my regime”

Participants illustrated how they have been treated differently when higher weight in comparison to at a lighter weight, with this resulting in Charles restricting himself from eating food with high calories, alcohol and anything which could increase his body weight. The fear of gaining weight influenced the way in which Charles felt about his body, and therefore his eating behavior and self-criticism. The extent to which Charles adhered to his regime to maintain his body ideal is reflective of his strong desire to maintain his body ideal and avoid judgment.

This theme outlines how the experiences unique to gay men affect their eating behaviors, attitudes toward their bodies and can encourage self-critical perceptions of themselves. These attitudes were met with disparity when participants were asked questions which related to self-compassion and self-kindness as explored in the following theme.

Sod it, I’ll Have a Pizza

This final theme illustrates the disparity of attitudes participants had regarding their perceptions of self-compassion. Participants reported the positive impact exercise had on their physical and mental well-being, however, they also reported that they would use food with low nutritional value such as pizza to cope with stress.

In regards to exercise, participants reported how it boosted their mood, increased their motivation and instilled a sense of achievement. Travis speaks about the “euphoric” feeling he experiences when he meets his personal targets when he exercises and how this motivates him to push himself.

Travis “I’m like oo I’ve done ten minutes on the tread mill and like I’ll do another ten minutes to make it up to twenty [. . .] I’m happy I’m excited like I’ll feel euphoric [. . .] I’ll feel less critical of myself as well I’ll feel more motivated and happier with myself and my body”

This illustrates the impact exercise can have upon self-esteem, and body satisfaction, reducing critical thoughts individuals can have about their body. However, when discussing food as a treat, Travis’s response conflicted with what he had previously stated

Travis “if I am having a bad day and I’m demotivated then I try to fill the emotional gap with eating loads of food because that makes me feel better”

This shows a conflict in attitudes toward his self-esteem and being kind to his body, as he presented the positive affect exercising and treating his body well had on his outlook, but also would choose overeating to feel better after a bad day.

When asked about how one treats themselves, as with Travis, participants often reported using food as a treat. Despite Matt reporting that exercise improves both his body satisfaction and psychological well-being, when treating himself he would always use calorie dense food.

Matt “Yeah, I’d like to think my treat to myself would be like going to the gym and rewarding myself by being healthy, but that’s never crossed my mind like it’s always eat something naughty.”

Despite participants being aware of what is rewarding in terms of self-care, when it comes to treating oneself, individuals often do not consider what is best for their physical health, instead participants report making a choice based on the immediate gratification of enjoying food that is not healthy (e.g., high in fat and sugar), often to relieve feelings of stress. Nonetheless, the same participants often reported feelings of guilt and self-criticism when eating calorie dense foods due to fear of weight gain, with participants such as Craig, Tony, and Chris explaining that the short-term pleasure of treating oneself with calorie dense foods does not override the guilt and negative feelings associated with eating unhealthily, thus impacting upon self-esteem and body image.

Chris “yeah the next day or even after like a few hours after [emotional eating], my belly is going to be huge like I said that’s where I tend to put most of my weight, I would feel more bloated from pasta and will feel like huge feel like a whale huge potato, it’s not like a good feeling”

Chris is a 25-year-old student who spoke of not gaining weight regardless of his dietary choices, although in recent years has noticed a change in his metabolism. Chris makes the acknowledgement that eating food that is high in carbs will make him feel “bloated” and “like a huge potato,” the interesting point here is that he makes a conscious choice to do this anyway to relieve stress. The attitudes participants had regarding their choices when relieving stress, despite their acknowledgement of how exercise is good for their mental health presents interesting comparisons when considering self-compassion and self-kindness. This also provides a further point of interest when reflecting on the strict attitude’s participants had of their eating and exercise behaviors.

Discussion

The current study aimed to gain an insight into the experiences gay men have and how these affected their eating behavior and well-being. This research explored the feelings of self-criticism and how this influenced their perceptions of themselves with regards to their appearance. Self-compassion and self-kindness were also explored, revealing the relationship between these concepts and participant’s feelings toward their bodies.

Participants within the current research identified that the most desired body type that gay men aspired to be was slim and muscular. Participants believed that if they achieved one or both of these ideals then their chance of attracting a potential partner would increase in line with previous research (Dillon et al., 1999; Yelland & Tiggemann, 2003). In order to maintain a lean or muscular physique participants reported making undesirable food choices, with food being viewed as functional, to supplement their progress at the gym. This research supports the findings of Morrison et al. (2004) who reported that gay men with distorted cognitions were more likely to have inaccurate perceptions of their body shape, and therefore diet more frequently. One likely explanation for this is that weight stigma, sexual objectification and social comparison are common within the gay community (Filice et al., 2019).

The current research explores the experiences of gay men in relation to their attitudes toward eating and exercise. Engaging in exercise and diet was a method participant’s used to tackle the pressure and to conform to the expectations. There is theoretical evidence presented by Yoo et al. (2018) who suggest that health beliefs, media perceptions and communicative behavior can influence behavioral intention. The reported absence of “big people” in gay spaces reflects a lack of acceptance of this body type by other gay men. These findings are in line with Foster-Gimbel and Engeln (2016) who highlighted that the anti-fat bias led to more criticism in the gay community and gay men were solely judged on their weight, even if they had a healthy body mass index (BMI).

Participants desired a lean body and feared weight gain for different reasons. Some wanted to attract a sexual partner and others wanted to increase their self-worth. Younger participants experienced higher levels of self-criticism and self-judgment because they were more actively involved with the gay community and experienced more rejection from sexual partners. These participants were also more likely to use social media and dating apps which exposed them to images of unrealistic bodies.

Being older appeared to offer some benefits in terms of health and well-being, with older participants describing themselves as maintaining a healthy diet and being less inclined to engage in extreme exercise. They also were more inclined to balance their self-criticisms with self-compassion than younger participants and this is reflective of the findings of Boisvert and Harrell (2010) who suggested that younger gay men are more likely to aspire to a lean, muscular body, with social class and education having an impact on attitudes and behaviors. Regardless of age and level of engagement with the gay community, all participants fully understood and were in clearly articulated agreement on the expectations targeted at gay men.

Participants were Birmingham based and those aged 21 to 40 years were actively “out” as gay and were highly involved with the gay community and going out. Living in a big gay scene where youthfulness is favored could also explain why younger participants were more concerned with how they look. The present study further highlights how the gay community favors young and lean males and provides evidence that highlights that older gay men are more aware of the risks involved with restricted eating and so treat their inner self better.

It is important to note that all participants understood the context of this research, without the researcher’s explanation. When questions were asked regarding the influence of the gay community to their eating behavior, exercise, and body ideals, all participants alluded to the same constructs. The experiences specific to gay men which relate to the themes discussed were presented without prompts or reference to community-based constructs. The pressure for gay men to fit into the ideals set by the community were regarded as something they all accepted as the norm.

The findings of this study fit in with the data presented by past literature in regard to gay men being encouraged to adopt a masculine trait and a lean muscular body (Duncan, 2010). The results further contribute to Austin et al.’s (2009) argument that restrictive and binge eating can have a negative effect on mental health and self-compassion. The more self-compassionate gay men are, the more likely that they will engage in healthy eating behaviors, and those who engage in unhealthy eating behaviors experience less self-compassion. The researchers would however like to state that the notion of “healthy eating” can be detrimental to well-being when overly focused on (e.g., “Orthorexia” a problematic and obsessive focus on foods perceived as healthy, Stutts, 2020). Men who are unable or unwilling to conform to such goals are subject to rejection from potential partners and are at higher risk of developing maladaptive eating patterns (Austin et al., 2009).

When participants spoke about exercise, they discussed the benefits to their mental well-being, stating how motivated they were to continue exercising. This theme is reflected in the literature whereby those who were more self-compassionate had a higher motivation for exercise and held positive attitudes toward their body image (Cox et al., 2019). Conflict of attitudes occurred when participants were asked about how they would treat themselves, the responses would often involve calorie dense food in the context of relieving stress. These findings correspond to research by Mantzios and Egan (2017), and Egan and Mantzios (2018), who proposed a rationale around self-kindness and indulgence, and the ability of self-compassion and self-kindness to propose a holistic self-care intervention of physiological and mental health. The authors proposed that many times physiological health depends on the priority that is given to psychological health, and that there were individual differences in self-caring included activities that cared for both mental and physical health, such as taking a walk, or activities that focused on caritng for the mind alone that included eating high fat and sugar foods, and other health risk behaviors such as use of alcohol and illicit drugs.

These findings should be interpreted while considering the limitations presented. The participants consisted of individuals who lived in a 30-mile radius of Birmingham City center, meaning that participants’ experiences could be attributed to this specific geographical location. The data relating to judgmental attitudes in “gay spaces” could therefore be in direct reference to the community specific to Birmingham or the surrounding areas. The study could have also recruited a larger sample of participants to provide a more inclusive and representative sample. Gaining insight into the experiences of gay men from a more varied age range, for example, could provide novel findings and insight into the experiences specific to gay men of that age group. It is noted that participants were largely younger (under age 40) which could provide an unbalanced representation of the experiences of gay men.

In conclusion, the overall aim was to explore gay men’s views of body image and eating behavior within the gay community. Three main aspects were elicited from the data. First, participants overwhelmingly reported that leanness and physical appearance is important. Second, participant’s pressure to conform to this body ideal and failure to do so would lead to self-critical attitudes of themselves. Third, self-compassion and low self-esteem was present across all age groups. The potential for providing interventions that are targeting at both physiological and psychological health for gay men appears relevant in a population that is struggling with acceptance and self-acceptance, as well as kindness and self-kindness, and subsequent corresponding maladaptive health behaviors. Investigating differences among a group that has been underrepresented in both the media, educational curriculum and academic research has provided an insight into their daily struggles and the responses to such struggles. More research is needed to raise awareness of such issues and to underpin the development of appropriate and effective interventions which will encourage the LGBTQ+ community to access services to support their well-being.

Appendices

Appendix A: Interview Schedule

Eating attitudes and behaviors in a male gay population: Interview Schedule

Icebreaker question: How did you feel when you agreed to take part in this study?

Influences on food

Including questions on influences on eating behaviors, for example media, popular diets, peers, gay community)

Exercise

Including questions on how participants feel about exercise, influence of mood on engaging (or not) in exercise and influences on exercise behavior.

Food preparation

How do you feel about preparing food? (For example, planning meals, food shopping, cooking)

Appetite and eating behaviors

How would you describe your appetite?

Do you sometimes eat when you are not feeling hungry?

Social/Pleasure and eating

Do you enjoy eating out, for example at friend’s houses, restaurants, celebrations (weddings birthday parties etc.?)

Additional nutritional support

Have you ever used additional support to your diet to achieve a body ideal or goal?

If so, how did/does this impact on your eating habits?

Kindness and eating

(Kindness: The quality of being friendly, generous and considerate)

What is kindness?

Including: What does kindness mean to you? Why are people kind? What about self-kindness? Self-compassion?

How do you feel when people are kind to you?

Why do you think people are kind? What do you think their motivations are for being kind?

Treating yourself

If you want to ‘treat’ yourself, what sort of things would you do? (Would you describe this as being kind?) Prompts for eating and exercise as treats or self-kindness.

Theme: Lean to be Seen.

Theme: You Can’t Sit with Us.

Theme: Sod it, I’ll Have a Pizza.

Table 2.

Development of Codes to Themes.

Lean to be Seen	You can’t sit with us(In reference to “Mean Girls”)	Sod it, I’ll have a pizza
Using the gym to attain or maintain body ideal	Being attractive to be accepted	Being “kind” to yourself is eating calorie dense food
Making less desirable food choices to maintain desired physique	Gay community is judgmental of those not regarded as attractive	Exercise is not a treat
Desire to be lean	Self-criticism	Exercise is good for your mental health