This study compared body image concerns among adolescents from different geographic locations in Brazil, and the influence of sex and nutritional status. Seven hundred eighty-eight adolescents completed the Body Shape Questionnaire (BSQ) and had their weight and height measured. There were significant cross-regional differences in BSQ scores. Also, body image concerns were more prevalent among girls and among overweight adolescents. It is suggested that sex and nutritional status may play an important role in body image concerns, which is more common between adolescents from urban areas. Furthermore, our findings contribute to the literature by examining patterns of body image concerns within subgroups of adolescents who have received little research attention on these issues.