Over-estimation of body size, a core feature of eating disorders (EDs), has been well-documented both in young healthy and ED individuals. Yet, evidence that altered body perception might also affect older women is limited. Here, we examined whether attitudinal components of body image (i.e. the feelings an individual has about their body size and shape) might affect perceived actual and ideal body shape self-estimates in midlife, similarly to younger women. Thirty-two younger (mean age, 24.22 years) and 33 middle-aged (mean age, 53.79 years) women took part to a computerized body perception assessment of perceived, actual and ideal aspects of body image. Body mass index (BMI), societal and interpersonal aspects of appearance ideals, measured by means of Sociocultural Attitudes towards Appearance Questionnaire (SATAQ-4), and assessment of body uneasiness and concerns for specific body parts, measured by Body Uneasiness Test (BUT-A/B) scales, were also investigated. Younger and middle-aged women with larger BMI showed greater discrepancy in perceptual distortions from their perceived actual body size. However, middle-aged women with greater body part concerns overestimated their perceived body size, as opposed to younger women who were almost accurate. Unlike middle-aged women, younger women with higher body part concerns desired slimmer ideal body image than their perceived actual. Results suggest that distortions in the perceived actual and ideal body size self-estimates of younger and middle-aged women are best explained by a combination of BMI, body part concerns and the particular age group to which a participant belonged. In the future, a personalized approach for the assessment of women’s perceptions and concerns of specific body areas during lifespan should be adopted.