This study compares the perceived body image of female college students in Korea and Japan as well as explains the difference in the level of self-esteem, body cathexis, body image and fashion leadership based on nationality and body. The sense of fashion leadership affected by these factors was also analyzed. A high ratio of Korean and Japanese female students perceived themselves as obese compared to actual body physique. It was shown that body was highly distorted. They showed a comparatively low level of satisfaction with appearance in contrast to their high interest in their appearance and weight. Thin bodied individuals showed a high level of self-esteem and body cathexis; however, persons with an obese body showed a low level of body cathexis. They showed high interest in appearance regardless of body physique; however, they remain unsatisfied with their appearance. Individuals with an obese body and a standard somatotype showed a high concern with weight. A high fashion opinion leadership was reciprocal to a high interest in appearance and satisfaction with appearance. Korean female students showed an indirect positive effect on fashion opinion leadership through body cathexis, self-esteem, interest in appearance, and satisfaction with appearance. A thin body showed a positive effect on fashion opinion leadership and an obese body had a negative effect. Fashion innovativeness was directly influenced persons with a high degree of self-esteem and interest in appearance. Japanese female students were directly affected by fashion innovativeness; however, Korean female students were indirectly affected by fashion innovativeness through self-esteem and interest in appearance.