Research on the social determinants of obesity describes the importance of family dynamics and how they can influence an individual's weight and weight-related behaviors. These proximal influences include parent-child, couple, and limited research on intergenerational and sibling dynamics. However, familial research is often isolated to one relationship subsystem (i.e., parent-child or couple) and is not integrated into the larger Family Systems Theory (FST) framework. The purpose of this paper is twofold: to present recommendations for future work by expounding on FST concepts for weight management and obesity prevention, and to provide a review of the theoretical and empirical evidence for each family system and subsystem, including (a) the extended family, (b) family environment, (c) couple, (d) parent-child, and (e) sibling, and present methodological and analytical considerations. K E Y W O R D S families and health/illness, family intervention, family systems theory, program evaluation, social relations across the life course