This study investigated variation in body dissatisfaction among obese women in relation to age of onset of obesity, and evaluated the contribution of teasing about weight and self-esteem as possible causes of higher body dissatisfaction in the early-onset group. One hundred and five obese women (body mass index [BMI] > or =30), recruited from clinical settings in England, completed a mailed questionnaire. The early-onset group (by age 16) had a higher BMI, greater body dissatisfaction, and lower self-esteem. Predictably, they also reported more childhood teasing. Path analyses confirmed our expectation that early onset of obesity has an adverse effect on body image, which is independent of current BMI. Regression analyses failed to support the hypothesized mediating role of either childhood teasing or lower self-esteem. The possible direction of causal effects between body dissatisfaction and self-esteem is discussed, with the suggestion that early onset of obesity increases the risk of body dissatisfaction, which in turn impairs self-esteem.