Objective: to evaluate body image with an emphasis on the perceptive dimension of body size and body satisfaction of obese patients attended at a Hospital University. Methodology: A crosssectional, analytical and descriptive study performed with patients attended in a program for obese people. The body image perception and satisfaction was investigated using the Scale of Silhouette Pictures (SSP), developed and validated according to the physical structure of the Brazilian population. The scale is composed of 15 silhouettes of each gender and each figure is assigned a mean Body Mass Index (BMI) value with a range of 12,5 to 47,5 kg / m², with a continuous increase of 2,5 kg / m², between each silhouette. The scale is presented to the patient in the form of cards sorted upwards from the thinner figure to the highest BMI. It was asked to indicate the silhouette that best represented its current body shape, desired physical shape and that considered as ideal. Accuracy in body perception is obtained by the difference between the BMI value presented by the participant at the time of the research and the mean BMI value of the figure chosen as representative of the interviewee's current form. Positive values indicate overestimation of body size, negatives demonstrate body underestimation and if equal to zero, absence of body distortion. While body satisfaction is measured by the difference between the mean BMI of the figure chosen as desired shape and that of the current silhouette. Positive results indicate dissatisfaction with the desire to increase body size; negative, dissatisfaction with the desire to reduce body size; and if equal to zero, indicates satisfaction with the physical form. Statistical analyzes were performed using SPSS software (version 20.0), adopting the level of significance p < 0,05. Results: 75 patients with a mean age of 35,86 (± 10,98) years and a mean BMI of 38,30 (± 5,01) kg / m² participated in the study. Regarding the accuracy of body image perception, 89,3% (n = 67) presented some type of distortion, with physical overestimation being the most prevalent regardless of gender (p = 0,040). As well as the body dissatisfaction due to the desire to reduce the physical structure, present in 97,3% (n = 73) of the sample, of which the women were completely dissatisfied (p = 0,02). Conclusion: The obese are less precise in the perception of body size and present a high degree of body dissatisfaction regardless of gender. Knowledge of these factors has fundamental importance for better adherence to strategies of healthy habits and success in the nutritional management of obesity in these individuals.
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