Perceptions of Obesity and Weight-Related Behaviors Among Adults With Type 2 Diabetes in Benin

OBJECTIVE: To explore body size perceptions, awareness of obesity-related risks, and weight loss willingness among adults with type 2 diabetes (T2D) in Cotonou, Benin. DESIGN: A descriptive qualitative study involving 4 focus group discussions. PARTICIPANTS: Forty-two purposively selected adults with T2D aged 40-65 years. PHENOMENON OF INTEREST: Perception of body size, obesity awareness, and willingness to lose weight. ANALYSIS: Data were thematically analyzed using MAXQDA 2020 and interpreted with the Prototype Willingness Model. RESULTS: Five themes emerged. Participants demonstrated limited awareness of obesity causes and related health risks. Cultural norms linking larger body sizes-especially for women-to health, fertility, respect, and social status shaped preferences and self-perceptions. Many overweight participants underestimated their body size. Men frequently preferred overweight female figures, whereas women favored normal to overweight male figures. Despite recognizing some health consequences, participants described challenges to weight loss, including sociocultural pressures, limited access to exercise opportunities, and insufficient counseling. CONCLUSIONS AND IMPLICATIONS: Findings provide insight into how adults with T2D in Benin perceive overweight and obesity. This work supports the need to develop and test culturally appropriate, weight-neutral community interventions to improve health literacy and promote healthier lifestyle behaviors.