Abstract Childhood obesity has become an international concern. Our objective was to construct a scale for assessing obesity-related distress among Lebanese boys and girls and to study the relationship between obesity-associated behaviours and distress. Across-sectional study was conducted in 2009 on a sample of 1933 adolescents aged 12-18 years. Questions were asked about personal and family characteristics, satisfaction with weight, frequency of consumption of selected food groups, eating and dieting habits, physical activity behaviour [‎current and during childhood]‎, attitudes towards obesity, and obesity-related distress. In the factor analysis, all 8 items of the obesity distress scale loaded onto 1 factor. Boys were significantly less likely than girls to be distressed by their obesity. Obesity-related distress, particularly when related to family and media pressure to lose weight; increased the risk of using weight-loss diets and drugs but was not associated with healthy dietary habits or participation in physical activity