Objective This paper presents the results of a randomized controlled trial measuring the efficacy of a video‐based skills training to decrease burden and psychological distress in caregivers of inpatients treated for an eating disorder in specialized hospital units. Method Two hundred eighty‐five caregivers were randomized to either the video intervention (N = 147) or the control group (N = 138). Caregivers' primary outcomes were assessed via Eating Disorder Symptom Impact Scale, Accommodation and Enabling Scale and General Health Questionnaire‐12 at baseline and three‐months follow‐up. Results Acceptability of the intervention was high. Receiving additional external professional help like psychotherapy or clinical counselling was identified as a moderator contributing to the efficacy of the intervention. Caregivers' burden (Eating Disorder Symptom Impact Scale) and psychological distress (General Health Questionnaire‐12) were reduced by the intervention but not caregivers' accommodating behaviours (Accommodation and Enabling Scale). Conclusion The video training is a promising approach and effective supplement for caregivers of patients with an eating disorder. Additional professional help to caregivers increases the effectiveness of the intervention. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.