Body Image Perception, Weight Status and Health Behaviours Among African Immigrant Women Living in Italy: A Cross-Sectional Comparative Study.

Background/Objectives: Body image is influenced by body weight, sociocultural norms, and weight-related behaviours. Migration has been associated with changes in body ideals, potentially through acculturation processes. This study investigated body image perception, weight status, and related behavioural and psychological factors among a group of African immigrant women living in Italy, comparing them with an Italian comparison group. Methods: This cross-sectional study included 131 women (60 African immigrants; 71 Italians). Body image perception was assessed using the Thompson and Gray silhouette scale. BMI-based weight status was derived from self-reported weight and height and compared with perceived weight status. Body dissatisfaction was calculated as the discrepancy between perceived and ideal body image. Additional measures included appearance-related anxiety (PASTAS), self-esteem, life satisfaction, physical activity, and adherence to the Mediterranean diet. Results: Immigrant women had significantly higher body weight and BMI (p < 0.001) and differed in distribution across weight status categories (p = 0.001). Although body dissatisfaction did not differ significantly between groups, immigrant women selected larger ideal body figures (p < 0.001). They also showed lower agreement between BMI-based and perceived weight-status, and higher appearance-related anxiety on the PASTAS Non-Weight subscale (p < 0.05). No significant differences were observed in self-esteem, life satisfaction, or adherence to the Mediterranean diet. Immigrant women were more likely to be sedentary (38.3% vs. 4.2%) and reported lower levels of physical activity (active: 25.0% vs. 54.9%). Conclusions: Compared with the Italian comparison group, African immigrant women in this study showed a greater prevalence of overweight and obesity, preference for larger body ideals, lower agreement between BMI-based and perceived weight status, and lower physical activity levels. Given the cross-sectional design and the characteristics of the recruited samples, these findings should be interpreted as associations rather than evidence of causal relationships. They support the need for culturally sensitive strategies to improve weight awareness and promote healthy lifestyles among African immigrant women.