OBJECTIVE The present study tested a dual-process family model in understanding the relationships among dysfunctional family relationships, family preoccupation with weight and appearance, and body- and self-esteem problems in the development of eating and psychiatric symptoms. METHOD Subjects, 918 adolescent girls from eight high schools, completed measures assessing familial factors, body- and self-esteem problems, and eating and general psychiatric symptoms. RESULTS Structural equation analyses suggested that family environment contributed to the development of eating and psychiatric symptoms through two interrelated pathways. On one hand, family preoccupation with weight and appearance had direct effects on body dissatisfaction and eating symptoms. Body dissatisfaction had direct effects on self-esteem deficit and eating symptoms, and indirect effects mediated by self-esteem deficit on eating and psychiatric symptoms. On the other hand, general family dysfunction had direct effect on negative self-esteem, and indirect effects through negative self-esteem on eating and psychiatric symptoms. DISCUSSION Findings are discussed in relation to the possible mechanisms by which dysfunctional family relationships and family preoccupation with weight may predispose girls to eating pathology.