Perfectionistic self-presentation defines the attempt at presenting the self as perfect through the public concealment of personal defects and/or through the display of attributes perceived as capable to gather positive attention of others. Although perfectionism has long been considered a central aspect of eating psychopathology mediational studies between this construct and these conditions are scarce. This study aimed at examining the mediational role of body image-related perfectionistic self-presentation in the effects of external shame and internal shame on drive for thinness, in a sample of young women. Results revealed body image-related perfectionistic self-presentation as a significant mediator (p < .05) of the relationships between external and internal shame, and drive for thinness. Furthermore, 86% and 69% of the effects of external shame and internal shame, respectively, were explained by their indirect effects through body image-related perfectionistic self-presentation on drive for thinness (95% CI). These results highlight that the control over eating may emerge as a maladaptive strategy to deal with shame when mediated by an endorsement in the belief that presenting a perfect body image is crucial to be accepted and valued by others. Study findings suggest that this perfectionistic strategy should be targeted while treating eating psychopathology.