BACKGROUND: Mental health issues in adolescents have recently emerged as a social concern. Previous studies reported that there was a relationship between body image perception and mental health. The purpose of this study was to determine the correlations between actual or perceptional weight status and mental health issues in adolescents in Korea. METHODS: Data was based on the 5th National Health and Nutrition Examination Survey Data (2010-2012). The subjects were 1989 adolescents aged 12 to 18 years. Depending on the actual or perceptional weight status, participants were divided into several groups. Mental health indicators included experiencing stress, depressed mood and suicidal ideation. RESULTS: The multiple logistic regression analysis was conducted controlling for age, abdominal obesity, smoking and alcohol use, potency of exercises, and household income. Although this study did not find a correlation between actual weight status and mental health variables, it did find that girls who perceived themselves as overweight were more likely to experience stress (odds ratio, 2.24; 95% CI, 1.41-3.56) and depressed mood (odds ratio, 1.91; 95% CI, 1.01-3.62). CONCLUSIONS: Adolescent females in Korea who perceived themselves as overweight experienced significantly more stress and depressed mood.