Rationale: Body-shape preference is an important determinant of obesity and underweight, but studies on body image among females in the Arab region are, at most, scanty. The aim of this study was to describe the prevalence of underweight and overweight/obesity among Saudi Arabian female university students, and to investigate discrepancies between their actual, perceived and ideal body shape.

Methods: This cross sectional study included 663  female students in a university centre in Saudi Arabia. Anthropometric measurements including weight, height, BMI and body image scale (9-figures silhouette) were used. A cross-tabulation was made between “warped self-image” against “subjective goal image”. Regression analysis was used to predict variables related to body image perception.

Results: The participants had a mean age of 20.4 years (SD 1.5), 16% were underweight and 25% were over- weight/obese.Discrepancy in subjective goal image: 44% wished they were slimmer and 20% that they were heavier than what they perceived themselves. Thus, 36% were happy with their current body shape.Warped self-image: It was 16% that thought they were slimmer and 18% that they were heavier than what they actually were. Thus, in 61% of cases the perceived body image was in agreement with their actual body shape. Cross-tabulation showed that only 23% had an agreemen tbetween their actual, perceived and ideal body shape. Of all variables entered into the regression analysis, only BMI was able to predict how the subject perceives herself in the body image scale (R square = 0.676; p < 0.000). None of the variables entered was significant enough to predict how the subject wishes to look like.

Conclusion: Discrepancies between actual, perceived and ideal body image is common among the Saudi Arabian female students and can possibly lead to eating disorders and increased  prevalence of underweight oroverweight/obesity.