The aim of this chapter is to review how problems in social cognition and interpersonal functioning can act as risk and maintaining factors for eating disorder behaviors and how these can lead to a variety of reactions, including expressed emotion, from others. The theoretical background explaining the mechanisms underpinning these interpersonal problems is described in the cognitive interpersonal model. Many domains of social cognition are impaired in anorexia nervosa, including facial expressivity and a negative, attentional, and interpretational bias to social interactions. In part, these are secondary effects of starvation, but they are of relevance as they have an emotional impact on others. The cognitive interpersonal model provides a template to develop interventions which moderate problematic aspects of social emotional functioning to increase social connection. These interventions have been co-created with patients and carers. Furthermore, a task sharing approach has been applied to the delivery of the intervention by including people with lived experience. Work evaluating these novel approaches is summarized.