The prevalence of obesity has risen sharply in the United States in  the past few decades. Etiologic links between obesity and substance  use disorders have been hypothesized.
To determine whether familial risk of alcohol  dependence predicts obesity and whether any such association  became stronger between the early 1990s and early 2000s.
We conducted analyses of the repeated cross-sectional  National Longitudinal Alcohol Epidemiologic Survey (1991-1992)  and National Epidemiologic Survey on Alcohol and Related Conditions  (2001-2002).
The noninstitutionalized US adult population in  1991-1992 and 2001-2002.
Individuals drawn from population-based,  multistage, random samples (N = 39 312 and 39 625).
Obesity, defined as a body mass index  (calculated from self-reported data as weight in kilograms divided  by height in meters squared) of 30 or higher and predicted from  family history of alcoholism and/or problem drinking.
In 2001-2002, women with a family history of alcoholism  (defined as having a biological parent or sibling with a history  of alcoholism or alcohol problems) had 49% higher odds of obesity  than those without a family history (odds ratio, 1.48; 95% confidence  interval, 1.36-1.61; P < .001), a highly significant  increase (P < .001) from the odds ratio of 1.06 (95%  confidence interval, 0.97-1.16) estimated for 1991-1992. 
 For men in  2001-2002, the association was significant (odds ratio, 1.26; 95%  confidence interval, 1.14-1.38; P < .001) but not as strong  as for women. 
The association and the secular trend for women were  robust after adjustment for covariates, including sociodemographic  variables, smoking status, alcohol use, alcohol or drug dependence,  and major depression. Similar trends were observed for men but did  not meet statistical significance criteria after adjustment for  covariates.
This link has emerged in recent years and may result from an interaction between a changing food environment and predisposition to alcoholism and related disorders.
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