BACKGROUND: Perspectives of young people with eating disorders and their parents on helpful aspects of care should be incorporated into evidence-based practice and service design, but data are limited. AIMS: To explore patient and parent perspectives on positive and negative aspects of care for young people with eating disorders. METHOD: Six online focus groups with 19 young people aged 16–25 years with existing or past eating disorders and 11 parents. RESULTS: Thematic analysis identified three key themes: the need to (a) shift from a weight-focused to a more holistic, individualised and consistent care approach, with a better balance in targeting psychological and physical problems from an early stage; (b) improve professionals' knowledge and attitude towards patients and their families at all levels of care from primary to ‘truly specialist’; (c) enhance peer and family support. CONCLUSIONS: Young people and parents identified an array of limitations in approaches to care for young people with eating disorders and raised the need for change, particularly a move away from a primarily weight-focused treatment and a stronger emphasis on psychological needs and individualised care. DECLARATION OF INTEREST: None.