This study explored the perceptions of black South African women residing in Khayelitsha, Site B about thinness, HIV/AIDS and body image. Obesity is a major public health problem in developed as well as developing countries. The HIV/AIDS epidemic has been escalating in sub-Saharan Africa and has been said to be the leading cause of death in South Africa. This means that South Africa is being devastated by a double burden of two concurrent epidemics and these are having an effect on each other. Obesity is one of the risk factors for noncommunicable diseases (NCDs), while on the other side HIV/AIDS is characterized by severe weight loss and carries a stigma, which has been said to prevent women from adhering to lifestyle behavior modification especially weight loss, for the purpose of preventing non-communicable diseases (NCDs). This study was therefore conducted to explore these perceptions, beliefs and attitudes among black African women. Data was collected through interviews, direct measurements of weight and height and focus group discussions. The analysis was done using Microsoft excel and the statistical package of SAS version 8. More than 80% of the women who participated in the study were overweight or obese and thought that being overweight or obese was healthy. Large body size had many positive attributes such as dignity, attractiveness and having enough money to feed your family. Whilst some were aware .