Given the nexus between food insecurity and body dissatisfaction, a deeper understanding of this complex relationship in college students is needed. The purpose of this cross-sectional study, using the American College Health Association—National College and Health Assessment 2021 (n = 2003) at a large public university, was to explore the associations between food insecurity, personal appearance distress, and compensatory behaviors associated with body dissatisfaction. An analysis of variance with Tukey’s post hoc comparisons was performed to assess the relationship of outcomes associated with personal appearance distress by food security status. Structural equation modeling, using multivariable logistic and ordinal regression, were constructed to explore the impact of personal appearance distress, perception of body weight, weight control attempts, and dietary behaviors, adjusting for age, sex, race/ethnicity, body mass index, and food security status. Food insecurity was associated with lower grade point average, higher overall stress, and personal appearance distress. Personal appearance distress was associated with fewer servings of vegetables (p = 0.006) and fruits (p = 0.01), higher perceived body weight (p < 0.001), and more weight modification attempts (p < 0.05). The associations between food insecurity, personal appearance distress, and compensatory behaviors could extend to disordered eating behaviors, necessitating awareness and interventions from college campus programming and administration.