Children and adolescents with obesity face stigmatization and discrimination in many areas of their lives, and it has been assumed that their psychological well-being will be compromised as a result. This chapter examines the most recent empirical evidence on the relationship between childhood obesity and body dissatisfaction, self-esteem and depression. Studies of clinical samples typically report poorer psychological well-being in treatment seekers when compared with population-based obese and normal weight controls. However, research in community samples suggests that despite moderate levels of body dissatisfaction, few obese children are depressed or have low self-esteem. A number of important moderators and mediators of the association between obesity and well-being have emerged, with females, Caucasians and adolescents being particularly at risk. Implications for treatment and future research priorities are suggested.