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. A cross-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.