Although an increasing number of children and adolescents are becoming obese, the psychological morbidities associated with obesity are not well established. Existing reviews report modest associations between obesity and global self-esteem. However, none have examined how this affects multi-component assessments of self-esteem and quality of life in young people with defined obesity. A literature search identified 17 self-esteem and 25 quality of life studies of cross-sectional, longitudinal or intervention design published since 1994. Child-completed and parent-proxy assessments were consistent in showing significant reductions in global self-esteem and quality of life in obese youth. Competences particularly affected were physical competence, appearance and social functioning. There were no clear differences in effects between children and adolescents, and evidence on gender and ethnicity was lacking. Competency improvements occurred in the presence and absence of weight loss, suggesting their value as intervention outcomes and the need for further investigation.