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Background: Body concerns and its health consequences such as eating disorders and harmful body change activities are mentioned in Asian countries. This study evaluates factors contributing to body image/shape changes in an Iranian population. Methods: In this cross sectional study we focused on four main body change activity (diet, exercise, substance use, and surgery) and their risk factors such as demographic variables, Body Mass Index (BMI), Media, Body Esteem, Perceived Socio cultural Pressure, Body dissatisfaction and, Self Esteem. Approximately, 1,200 individuals between 14 55 years old participated in this study. We used a multistage sampling method. In each region, the first household was selected at random. The probability of outcomes was estimated from logistic models. Results: About 54.3% of respondents were females. The mean (SD) of age was 31.06 (10.24) years. Variables such as gender, age, BMI, use of media and socio cultural factors as, body dissatisfaction, body esteem and pressure by relatives were the main factors that influenced body change methods. In particular we have seen that male are 53% less likely to follow surgical treatments, but 125% were more likely to use substances. Conclusions: Investigation of body concern and its health related problem should be assessed in cultural context. For effectiveness of interventional programs and reducing harmful body image/shape changes activities, socio cultural background should be noted. [ABSTRACT FROM AUTHOR]