Obesity is a worldwide epidemic. Countries in the Middle East, Central and Eastern Europe, as well as North America have the highest prevalence of obesity in the world. Perimenopause is a transitional period in the life of a woman, occurring a few years before and a year after menopause or last menses. During this period, a woman may experience several physiological, psychological and socio-economical changes that may affect the health promotion efforts related to weight management. Perimenopausal obesity prevalence is high in Middle-Eastern countries and is a particular problem in Gulf Cooperation Council Countries (GCC). Despite the high prevalence of obesity in GCC countries and its comorbidities among the perimenopausal women, not much attention is given to it. There is lack of understanding regarding the perception of perimenopausal women of midlife weight gain. This study proposed a qualitative descriptive design that used semi-structured interviewing, and conventional content analysis. The purpose of this study was to examine the culturally specific views of perimenopausal GCC women concerning the causes and processes of midlife weight gain. Constructs derived from the health belief and explanatory models to identify and sort themes into conceptual categories were used. The themes and initial interpretations were brought forward into the organizing and explanatory framework of the socioecological model for further exploration and elucidation. The problem of overweight/obesity among the perimenopausal women in GCC countries was found to have many dimensions. These dimensions interacted at multiple levels (individual, interpersonal, organizational and community) and encompassed factors salient in both the HBM and Kleinman's model of disease and risk behaviors. The findings of this study suggest that weight-management programs targeting perimenopausal GCC women should be planned based on the multilevel factors that are expressed by them.