Social appearance anxiety has been associated with many concepts, especially body image and self-esteem, and has a very high level of comorbidity. We aimed to examine the relationship between body mass index (BMI), body perception, social appearance anxiety and self-esteem among women, with a particular focus on the possible mediating effect of BMI regarding the relationship between social appearance anxiety and self-esteem. We included 1344 volunteer women in this study. The self-esteem scale scores of women differed significantly according to body image, BMI, and weighing frequency. Social appearance anxiety was found to be inversely associated with self-esteem, and this relationship remained significant when adjusted for BMI as a mediating parameter. As a result, it is expected that improving women's body perception and reducing social appearance anxiety are the foremost interventions to increase the self-esteem of these women.