Globally, heart disease is still a major public health problem. In developed countries, this is due to an ageing population, and in developing countries, like Uganda, it is due to increasing negative lifestyles. Many women in Uganda move from rural to urban areas, thereby changing their diet, reducing their level of physical activity, and increasing their weight as well as their risk of myocardial infarction. Method The qualitative method was used in this study. Twelve women aged over 40 years, who within 10 years had moved from the countryside, into the city of Kampala, were interviewed by the use of a semi-structured question guide. Data were analyzed by means of Burnard’s content analysis method and by using the Theory of Reasoned Action.The aim was to examine women’s experiences and perceptions of body image, lifestyles and overweight in relation to a change of living conditions, and, furthermore, to examine their knowledge of the risks of heart disease. The results showed the following themes: body image, overweight, physical inactivity, culture, transition, women’s needs, concerns and lack of knowledge about the risk of heart disease. The core finding was that in spite of an income increase, a reduced health situation was described. All the interviewees reported increased body weight, encouraged by their surroundings. Lack of knowledge about nutrition and risk factors for heart disease, i.e., overweight and inactivity, and the fact that being obese was perceived, by themselves and others, as beautiful, were reported. Conclusion Important knowledge gained for public health measures was that interventions increasing women’s heart health should be geared towards women’s empowerment. Strategies ought to raise knowledge and awareness of forces and structures in Ugandan women’s surroundings that keep them inactive and make them increase their body weight. It is important to give the women support in taking charge of their own body and health.