PurposeThis study aimed to examine the most important problems and needs caregivers of adult inpatients with eating disorders (EDs) are confronted with in their everyday lives. A further aim was to investigate the associations between problems, needs, involvement, and depression in carers.MethodsFifty-five caregivers of inpatients with EDs (26 anorexia nervosa, 29 bulimia nervosa) completed the Carers' Needs Assessment, Beck Depression Inventory, and the Involvement Evaluation Questionnaire. The relationships between variables were tested via multiple linear regressions and mediation analyses.ResultsThe most frequent problem reported by caregivers was a lack of information about the course and treatment of the illness and consequent disappointment, whereas their most frequently reported needs were different forms of information and counselling. Problems, unmet needs, and worrying were especially high in parents compared to other caregivers. Involvement mediated significantly between problems (b= 0.26,BCaCI [0.03, 0.49]) as well as unmet needs (b= 0.32,BCaCI [0.03, 0.59]) of caregivers and their depressive symptoms.ConclusionOur findings underline the importance of including the problems and needs of caregivers of adult eating disorder patients in the planning of family and community interventions, to support their mental health.Level of evidenceLevel III: Evidence obtained from cohort or case–control analytic studies.Supplementary InformationThe online version contains supplementary material available at 10.1007/s40519-023-01572-1.