This study investigated the relationship between self reported body weight and health perceptions and choice of seafood in a region with a traditionally high-level of fish consumption. A random sample of women aged 45-69 years who live in northern Norway answered a self-administrated questionnaire about eating habits, socioeconomic factors and questions related to health sent to them by mail; 7556 women answered the questionnaire (56.1% response rate) which was analyzed by logistic regression methods in which odds ratios (OR) were calculated. The mean frequency of consumption of seafood was 15 times a month. Some 46% of the respondents were overweight, 77% agreed that food is important for health and 55% had a desire to reduce weight. Overweight women consumed less lean fish than normal weight women (OR=0.8). Fish consumption was not associated with the desire to reduce weight. Fat and lean fish, but not processed fish, consumption are associated with the perception that food is important for health. A generally healthy food consumption pattern was strongly associated with weekly fish consumption, with normal weight and with the desire to reduce weight. Very high family income was associated with higher fat fish consumption (OR=1.9) normal body weight and for the desire to reduce weight (OR=2.1). High fish consumption in childhood and the belief that food is important for health were strongly associated with high fish consumption (OR=2.1 and 1.4 respectively for lean fish). Kids <7 years in the household are associated with processed fish consumption (OR=2.9) but not with the belief that food is important for health, that association is made by teenagers in the household (OR=1.4). Education is associated with high fat fish consumption, while increasing age is strong associated with high lean fish consumption (OR=1.88 for >60 years compared with 45-49 years). It is concluded that the desire to reduce weight does not influence fish consumption, but overweight women consume less lean fish than women of normal weight. Normal body weight and the desire to reduce overweight are associated with a broader healthy lifestyle pattern, in which seafood has a role in the diet. Higher fish consumption is associated with increasing consumers' belief and behavior according to food's importance to health, high fish consumption in childhood and a higher level of education and income.