Introduction: Weight dissatisfaction and misperception are widespread problems in the United States as are unhealthy weight loss practices. These negative body image issues can lead to eating disorders which have serious health and quality of life consequences. Objective: To evaluate the extent to which the prevalence of distorted body image and unhealthy dieting tactics exist in adults in the US and how these are related. Methods: Data from NHANES 2000-20006 on adults aged 20-59 was used. Weight perception was assessed with the physical exam measurements of weight status and the weight history questionnaire item asking if the person considered him or herself to be underweight, normal weight or overweight. Weight loss techniques were assessed with the weight history questionnaire items asking what methods they used if they tried to lose weight. Respondents were classified as having a weight perception discord if their perception was greater than actual weight status, and as having a concord in all other cases. Results: The total sample was 6,022. 10% had a perception discord and 15% used unhealthy weight loss practices. After adjustment, a significant relationship between a perception discord and behaviors was not found--this held true for both men and women. Discussion and Conclusion: Our results were similar overall to past studies; our inability to find a relationship could have been hampered by stigma associated with the subject matter. There are clearly other factors related to the adoption of unhealthy weight loss behaviors, which need to be determined.