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Anorexia runs in families. This, together with the high level of concordance between identical twins, has led many authorities in the field to argue that genetic factors pay a substantial part in its aetiology. The decoding of the human genome has made possible research on the genetics of anorexia. This has failed to confirm the expected relationship. A number of leaders in the field of family therapy advocate the idea that family relationships do not cause anorexia. However, the failure of genetic explanations draws attention back to the possible role of family factors. These include family attitudes to eating and weight, attachment difficulties, problems with the expression and resolution of conflict and parental psychological control. This article briefly summarizes the current state of the genetic findings and highlights some areas of research on the family, eating disorders and anorexia that are of relevance to the practice of family therapy. Practitioner points Family therapists need not allow theories about the genetic origins of anorexia to distract them from their customary curiosity about family processes. Family therapists' understanding of the way that family relationships impact on adolescent development remains highly relevant. Recognition of some of the difficulties that are faced by girls who develop anorexia may help therapists to support patients in expressing their own needs, feelings, and views.

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