CONTEXT: African-American women are disproportionately affected by obesity and its related diseases. How psychological and psychosocial factors that affect this population differ across weight categories remains poorly understood. PURPOSE: To determine whether poor mental health and family functioning are associated with obesity in African-American women. METHODS: African-American women patients aged 21-65 years were interviewed at three primary care centers. Four well-established assessment tools were used to measure general mental and physical health status, family functioning, depressive symptoms and anxiety levels. Demographics, health behaviors and family and personal histories of overweight were assessed. RESULTS: Among 113 patients, after controlling for age and parity, obese women had significantly higher anxiety levels, poorer perception of their physical health, more often were overweight as a child, had overweight parents or siblings and experienced more psychosocial problems in their family growing up, compared to overweight and normal weight women. CONCLUSIONS: The observed findings of poor mental health, perception of physical health and family function in obese African-American women support a need for clinical attention and further study.