Gay guy with some image issues

I am 42 years old. I've pretty much got a happy life - good job, great husband, wonderful friends, live in a nice area - but my one huge gigantic problem is body image/self esteem issues. Otherwise in good health, I am 5'10", 200 pounds, and run or workout 3 to 4 days a week. I mostly eat right and I socially drink. I am not looking for advice about eating or exercising but I'd like to hear from others who are having similar challenges. This is seriously the hardest thing, mentally, I am dealing with and it's very depressing.