OBJECTIVE: To analyse overweight, obesity and central fat patterning among the Inuit of Greenland and Inuit migrants in Denmark and their relation to Westernization. DESIGN: Cross-sectional, population-based epidemiological study. SUBJECTS: A total of 2046 adult Greenlanders (Inuit), 61% of those invited to participate, living in three areas of Greenland and in Denmark. MEASUREMENTS: Height, weight, waist and hip circumferences were measured and body mass index (BMI in kg/m2) and waist-hip ratio calculated. Sociocultural information was obtained by questionnaire and interview. Westernization was estimated by language and place of residence. RESULTS: The prevalence of obesity (≥ 30 kg/m2) was 16 and 22% among men and women in Greenland (P = 0.004), and 12 and 11%, respectively, in Denmark (NS). Westernization was accompanied by a decrease in the proportion of obese people, in particular among women. Adjusted for BMI, age and Inuit heritage waist circumference decreased with Westernization (among women), while hip circumference did not change. The differences were particularly pronounced for migrants compared with residents of Greenland. CONCLUSION: BMI and central fat patterning decrease with Westernization among Greenland Inuit women contrary to most studies of migrants. The changes were less prominent among men. This suggests a reduced cardiovascular risk profile with Westernization among Greenland Inuit.