The purpose of this study was to determine Zulu women's perceptions of their body image relative to weight status attending a noncommunicable disease (NCD) clinic in South Africa. A cross-sectional exploratory study design was used and included 328 (91%) Zulu women who were sampled systematically. The women were subjected to anthropometric measurements and engaged the Stunkard's body image figures to determine perception. The study showed that 61% of the sample was in the 40-59 age strata. The mean body mass index (BMI) was 37kg/m 2 (AE9.41 kg/m 2), with over 90% being overweight or obese. A discrepancy between Zulu women's perceived body image and actual BMI existed in all weight status categories with overweight and obesity demonstrating the widest variations (p < 0.000). Women perceived themselves to be thinner than their actual BMI. More than 99% associated an underweight body image to one with disease. Diabetes mellitus (72%) was the most frequent NCD encountered. Only 23% with this condition correctly perceived their body image. It was shown that the negative impact of preferring a larger body image in Zulu women with preexisting NCDs could be refueling their existing comorbidities.