This is the first ever study to use an online CBT program to successfully reduce carer distress and improve carers' ability to support the person with AN.

Fifty-five percent of the caregivers have high EE. High-EE relatives noted a higher caregiving burden than low-EE relatives particularly on the 'dimension of loss'. The level of EE was reduced following a skills training program.

The results of this pilot study indicate that the intervention is acceptable to carers and may have a positive impact on carers' mental health and experience of care-giving. Further investigation of the intervention is warranted.

Only two-thirds of participants started treatment. Although there were significant group x time interactions for bingeing and vomiting, favouring the CD-ROM group at 3 months and the waiting-list group at 7 months, post hoc group comparisons at 3 and 7 months found no significant differences for bingeing or vomiting. CD-ROM-based delivery of this intervention, without support from a clinician, may not be the best way of exploiting its benefits.