Introduction: In a society where 'plumpness' is traditionally favoured, it is imperative to examine the impact of sociocultural factors on the rising
overweight/obesity problem. The study was designed to assess the preferred body size among women in Kumasi metropolis, Ghana. Methods: A
cross-sectional survey was conducted among 394 women, aged 20 years and above, in 6 randomly selected churches in the Kumasi metropolis.
Subjects were asked to select their preferred body size from photographic silhouettes consisting of six images of women of known BMI (20, 24, 28,
30, 33 and 38kg/m2
) arranged in random order. Participants were asked to associate items concerning body size preference, health, social and
individual attributes to one of the six silhouettes. Participants' BMI were assessed. Independent samples t-test and analysis of variance were used
to assess differences in preferred body size across categories of BMI and socio-demographic characteristics. Results: The prevalence of
overweight/obesity among the women was 68.4%. The respondents preferred a large (overweight) body size. They associated silhouette of large
(overweight) body size with eating well, affluence and high social value. Though the overweight/obese respondents associated normal body size
with health they preferred a large (overweight) body size. Conclusion: Sociocultural ideals for body size override health reasons for the women's
preferred body size. This study shows that tackling the overweight/obesity problem solely from nutrition and health perspective may not be
adequate. A holistic interdisciplinary strategy involving nutrition, health, social and behavioural science is needed to develop culturally-sensitive
interventions against the emerging obesity problem.