The authors investigated the prevalence of body image concerns, body dysmorphic disorder, and related psychiatric symptoms in a group of 101 American students. Results were compared with data from a group of 133 German students. Survey data were collected on body image concerns, self-esteem, depression, anxiety, obsessive-compulsive symptoms, and skin picking. A total of 74.3% of the American students endorsed body image concerns, and 28.7% were preoccupied by them; 4.0% appeared to meet DSM-IV criteria for body dysmorphic disorder. Body esteem was significantly correlated with self-esteem and depressive, anxiety, and obsessive-compulsive symptoms. Body image concerns and preoccupation were significantly greater in American than in German students, although the prevalence of probable body dysmorphic disorder was not.