The current study examined whether adolescent body weight dissatisfaction, self-perception of body weight, perceived physical attractiveness, and body msas related to the use of alcohol and illicit drugs in a sample of 1,915 adolescents. Generally adolescents who were dissatisfied with their weight and considered themselves as unattractive used illicit substances, drank alochol, and got drunk more often than those who were satisfied with their weight and considered themselves as attractive or average-looking. Underweight adolescents also used illicit drugs and alcohol more frequently than overweight and normal-weight adolescents. The results of this study may suggest that health promotion strategies which focus upon enhancing adolescent perceptions of body weight and attractiveness may provide an important potential pathway for reducing substance use.