Physical activity plays an important role in child development. The purpose of this study was to compare body image, self-esteem, cardio-metabolic risk and physical performance of children by nutritional status and frequency of physical activity. We studied 208 children (115 men and 93 women) 11.9 +/- 1.2 years of age. Participants were divided by frequency of physical activity per week: Group 1 (n=87) was not physically active; Group 2 (n=64) was physically active 1 or 2 times per week; Group 3 (n=57) was physically active 3 or 4 times a week. We observed that 51 children were overweight and 40 obese. Children who were physically active 3 or 4 times per week, were less concerned about their body image and had higher self-esteem scores (both p < 0.05). These children also reported lower cardio-metabolic risk and better physical performance. We conclude that there are overall developmental benefits for children who are more physically active.