Body misperception could predispose to obesity, by masking excess weight and/or hunger and satiety signals, and by promoting emotional eating and difficulties engaging in physical activity. Thus, it may also be an obstacle to the management of persons with obesity. This narrative review describes the different types of troubles of the relationship with the body that can be encountered in obese subjects, and groups them into three main categories, namely: silhouette distortion, alteration of internal bodily signals pertaining to food, and impaired perception of interoceptive input. Each of these categories is detailed in terms of its clinical phenotypes and potential mechanisms involved. The therapeutic challenges posed by these various disorders are also developed, as well as the limitations of the main instruments available to identify them. The authors conclude that body misperception should be systematically investigated in the clinical management of obesity.