Explored the relationship between obesity and psychosocial adjustment in a combined clinical and nonclinical sample of 139 obese children and 150 nonobese children (ages from 9 to 12 years and matched for age, socioeconomic status, and gender) who filled out the Perceived Competence Scale for Children; their parents completed the Child Behavior Checklist. All obese children, independent of their help-seeking status, reported more negative physical self-perceptions than their nonobese peers and they scored lower on general self-worth. According to their parents, the obese children of the clinical sample appeared to have more behavior problems. Findings suggest that psychopathology depends on a clinical obese status, and they provide evidence for a psychosocial at-risk profile for a subgroup of obese children.