Background: The current study examined the pathway from peer victimization to depressive symptoms and body mass index (BMI) as mediated by self-concept for physical appearance in both obese and non-obese adolescents. It was thought that this pathway would be particularly important for obese adolescents because, compared to non-obese adolescents, they are at risk for being victimized and because the victimization would be more likely to lead to lower self-concept. Method: Utilizing data from the National Longitudinal Survey of Children and Youth, the current study examined self-reports of peer victimization, self-concept for physical appearance, depressive symptoms, height, and weight in 1,287 adolescents at three time periods over four years starting when the participants were between the ages of 12 and 13. Results: For non-obese adolescents, victimization did not predict changes in depressive symptoms and body mass index (BMI) four years later. For obese females, the mediated pathway was found from victimization to self-concept to both depressive symptoms and increases in BMI. For obese males, the findings were more complicated. In this group, the mediated pathway was found from victimization to self-concept to decreases in BMI, but a mediated pathway was not found for depressive symptoms. Conclusions: The current study suggests that a risk-factor for being victimized, such as obesity, may play an important role in the long-term effects of victimization by making it more likely that the adolescent will be victimized over the long term but also that victimization can reinforce the negative self-perceptions that the adolescent already has. It is important to go beyond using obesity as a predictor of long-term adjustment and examine the processes and experiences of obese individuals that might more directly cause depression or changes in health.