Mission Australia's annual youth report found approximately a third of more than 1400 participants had serious body image concerns, making it one of the top three personal concerns among men and women aged 15-19 for the fourth year in a row.
Butterfly Foundation CEO Christine Morgan has called on government portfolios to work together and make sure body image issues - a pre-cursor to eating disorders - are taken seriously.
"This is the fourth year in a row the survey has identified strong evidence of a serious public issue for young Australians," Ms Morgan said.
"A national evidence-based prevention initiative is required to elevate the community's understanding of the underlying causes of negative body image.
"Negative body image is not a youth pop-culture issue, it must be addressed as a serious population and mental health issue and can only be fixed when the health, youth and social services portfolios work together."
The report found body image to be a major concern for young people across cultural groups, with a large number of indigenous women (46.8 per cent) of young indigenous women identifying it as their highest concern.
Ms Morgan said it was necessary to talk to young indigenous Australians to understand what issues negative body image is raising for them, and also highlighted that the issue didn't exclude young men.
For the fourth year in a row young men (14.4 per cent) identified body image as an issue of concern.