Body image disturbance ('dysmorphic concern') is a key diagnostic criterion for anorexia nervosa (AN). While dysmorphic concern has been described as a relapse predictor, relatively little is understood about the prevalence in AN, and the consequences upon wellbeing. The present study examined the rates of dysmorphic concern in a sample of treatment-seeking adults with AN (N = 39), and explored the associations with general mental health, disability and eating disorder symptoms. The majority of participants (61.5%) had clinically significant levels of dysmorphic concern. Furthermore, higher dysmorphic concern scores were associated with increased symptoms of anxiety, depression and eating disorder symptomatology. There was also a trend towards associations between dysmorphic concern and age of onset and stages of change (pre-contemplation, contemplation, preparation, action, maintenance), although replication is required. These findings suggest that strategies which specifically address body image distortions should be a key feature of treatment for anorexia nervosa to support long-term recovery and wellbeing.