Objective: To examine whether dietary patterns are associated with obesity phenotypes. Design: Cross-sectional study. Subjects: We recruited 664 participants aged between 18 and 55 years. Dietary data were collected from a food frequency questionnaire. A factor analysis was performed to derive dietary patterns. Body mass index (BMI), weight and waist girth were recorded using standard procedures. Fat mass and fat-free mass were assessed by electrical bioimpedance. Obesity was defined as having a BMIX30 kg m À2 and a positive FHO (FHO þ ) as having at least one obese first-degree relative. Results: Two dietary patterns were identified; Western and Prudent. The Western pattern was mainly characterized by a higher consumption of refined grains, French fries, red meats, condiments, processed meats and regular soft drinks whereas the Prudent pattern was mainly characterized by a higher consumption of non-hydrogenated fat, vegetables, eggs and fish and seafood. Subjects in the top tertile of the Western pattern had higher BMI, weight, waist girth, waist-to-hip ratio and fat mass than those in the lower tertile. In contrast, subjects in the top tertile of the Prudent pattern had lower BMI, weight, waist girth, fat mass, HDL-cholesterol levels, and lower triglyceride levels than those in the lowest tertile. Individuals in the upper tertile of the Western pattern were more likely to be obese (obesity was defined as having a BMIX30 kg m À2 ) (OR ¼ 1.82, 95% CI 1.16-2.87) whereas those in the upper tertile of the Prudent pattern were less likely to be obese (OR ¼ 0.62, 95% CI 0.40-0.96). These latter significant associations were only observed among those with FHO þ . No such association was observed among FHOÀ individuals. Conclusion: Individuals having a high score of Western pattern were more likely to be obese and those having a high score of the Prudent pattern were less likely to be obese, and this is particularly among individuals with an FHO þ .