Self-perception of body weight, management practices and goals, and other weight-related factors were assessed among a sample of 2,566 adolescents from 30 high schools in Hungary, Slovakia, Czech Republic, Romania, Ukraine, and Poland. Students who perceived themselves as much too fat were more likely than those with other weight perceptions to engage in weight management practices to lose weight, have higher body mass index, rate themselves lower on physical attractiveness, and estimate higher percentages of their same-sex friends as trying to lose weight. Similar to other research, boys and girls differed on self-perception of weight and other weight-related factors. Cross-cultural comparisons between central and eastern European adolescents and U.S. adolescents, as well as east and southeast Asian youth are made. Implications for health education practice are discussed.