The role of health and physical education should be to instill in students the knowledge and appreciation of healthy lifestyles, but childhood obesity is becoming increasingly prevalent in non-Western as well as Western societies. We evaluated physical self-concepts (Physical Self Description Questionnaire, PSDQ) and body images (Silhouette Matching Task, SMT) for obese (clinical and non-clinical sample) and non-obese Chinese students (N = 763), and compared with Australian students (N = 1084). Psychometric properties were similar for Western and non-Western responses, but gender differences were generally much smaller for Chineese students. In particular, the SMT ideal body image was slightly fatter for Chineese girls than for Chineese boys. For Chineese students, objective and subjective measures of body fat (and corresponding obese/non-obese group differences) were negatively related to many components of physical self-concept, but were unrelated to global self-esteem and slightly positively related to health self-concept. However, consistent with Chinese value of moderation but in marked contrast to Western responses, being too thin relative to personal ideals was almost as detrimental as being too fat. The results reflect Chinese cultural values, in which obesity is more acceptable than in Western culture, and, perhaps, general inadequacies of health education.