OBJECTIVE: The present study uses longitudinal data to examine changes in body satisfaction among male and female adolescents from baseline to 5 years. METHODS: A diverse sample of 2,516 adolescents completed surveys in 1999 and 2004, reporting satisfaction with 10 body parts or attributes, height/weight, and other characteristics. Multivariable general linear modeling was used to estimate change in body satisfaction from Time 1 to Time 2, by age group, race, and change in body mass index (BMI) category. RESULTS: Body satisfaction decreased over 5 years (mean satisfaction change=-0.79) in all groups except older adolescent females. Scores decreased significantly more among younger adolescents than older adolescents, among some racial/ethnic groups of males, and among those whose BMI increased. However, among males, change in body satisfaction depended on BMI category at baseline. CONCLUSIONS: Different types of prevention programs addressing body image may be needed for males and females at different developmental stages and may need to address changes in BMI.