OBJECTIVES: We examined the relative importance of physical health status, weight/shape concerns and binge eating as mediators of the association between obesity and psychosocial impairment in a community sample of women and men. METHODS: Self-report measures of eating disorder features, perceived physical health and psychosocial functioning were completed by a general population sample of women and men classified as obese or non-obese (women: obese = 276, nonobese = 1220; men: obese = 169, non-obese = 769). Moderated mediation analysis was used to assess the relative importance of each of the putative mediators in accounting for observed associations between obesity and each outcome measure and possible moderation of these effects by sex. RESULTS: Weight/shape concerns and physical health were equally strong mediators of the association between obesity and psychosocial impairment. This was the case for both men and women and for each of three measures of psychosocial functioning - general psychological distress, life satisfaction and social support - employed. The effects of binge eating were modest and reached statistical significance only for the life satisfaction measure in men. CONCLUSIONS: A greater focus on body acceptance may be indicated in obesity prevention and weight-management programs.