Background <p>The complications of obesity are far beyond just physical health. We assessed body perceptions and satisfaction among adults with excess weight in the Kolkata metropolitan area. Evidence on body perceptions and satisfaction among adults with excess weight in India remains limited.</p> Methods <p>We adopted a concurrent mixed methods design among adults aged 25–54&#xa0;years with excess weight in the Kolkata metropolitan area. Quantitative data were collected through surveys from 120 participants using Likert-scale items and the Stunkard Figural Rating Scale. In-depth interviews were conducted with 18 participants. Quantitative and qualitative data were analysed separately and integrated during interpretation.</p> Results <p>Most participants expressed concern about their body weight, and a substantial proportion had inaccurate perceptions of their weight status. Visual body figures improved the accuracy of body size perception. Female participants demonstrated better awareness of their weight status and preferred slimmer body ideals compared to males. High levels of body dissatisfaction and low self-esteem were commonly reported. Qualitative findings highlighted gender-based body disapproval and the influential role of media in shaping ideals of the ‘beautiful body’.</p> Conclusions <p>Public health efforts should prioritise awareness, media literacy, and educational strategies that emphasise holistic health rather than appearance-focused ideals.</p>