This study examined the longitudinal relationship between self-esteem and body image distress, as well as the moderating effect of relationships with parents, among adolescents in Korea, using nationally representative prospective panel data. Regarding causal direction, the findings supported bi-directionality for girls, but for boys the association was unidirectional, in that their self-esteem predicted body image distress, but not vice versa. A gender difference also emerged in the moderating effect of quality of relationships with parents. For girls, relationships with parents moderated the effect of body image distress on self-esteem, such that when relationships with parents were better, the effect of greater body image distress on subsequent lower self-esteem was stronger than when relationships with parents were less positive. For boys, relationships with parents moderated the influence of self-esteem on body image distress, such that self-esteem reduced body image distress more when boys had better relationships with parents. (C) 2013 Published by Elsevier Ltd on behalf of The Foundation for Professionals in Services for Adolescents.