Background: Body image, although used in previous obesity research, has relied on generic, whole body outlines and images, which may not be ideally suited to obese individuals. The development of more sophisticated and individualized digital images to represent body image may be more effective. Objective: The primary aim was to assess body image in obese subjects utilising a novel, digital assessment method and to compare these data with established questionnaire-based methods of assessing body image dissatisfaction. Methods: Sixty volunteers (30 male and female) were recruited, with three categories of subject established: lean (BMI<23kg.m-2), obese (BMI>30kg.m-2), and lean regular exercisers (3hr cardiovascular physical activity, weekly). Body image was assessed using a digital morphing technique in comparison to two standard paper questionnaires. The morphing technique utilises the subject's own digital photo image to produce an individual computerised, distorted image which can then be re-aligned by each subject to assess both body perception and satisfaction. Results: Using the novel digital morphing tool, obese subjects displayed poorer body awareness (perception) than their lean counterparts (p=0.03), significantly over-estimating their actual body size. Both genders overestimated body size to a similar degree. For body satisfaction, females wished to be smaller and males to be larger, identifying gender-specific body regions (p<0.001). Obese subjects showed greatest dissatisfaction (p<0.001) with body image. There was significant correlation for body image dissatisfaction (p<0.05) between the digital technique and the questionnaires, which was highest for the figural stimuli questionnaire (r=0.80, p<0.001). Discussion: This method represents a novel and alternative approach to rating body image perception and satisfaction in obese subjects, particularly providing data on specific regional areas. In obesity, body image dissatisfaction appears to be both due to poor body image perception compounded with the desire to be smaller.