AbstractThis study prospectively investigated the prognostic significance over 1 and 2 years of objectively assessed ego functioning in a group of 37 eating disordered patients. Previously, ego functioning was found to vary substantially within the group, and to be unrelated to symptomatic aspects (Norring et al., 1989). Differences in ego pathology proved to be a strong predictor of status in terms of overall mental health, work adjustment, and self‐rated emotional problems, and was superior to other variables (e.g., binge eating, duration) in this respect. More specifically, deficits in the regulation of self‐esteem were suggested to be particularly important for prognosis. Status in terms of eating disorder symptomatology was predicted strongly the first year, but not the second. Post hoc analyses suggested that during the second year those with more severe ego disturbances caught up on the advantage held by the others. It is concluded that differences in ego pathology are of importance for prognosis with respect to overall psychological and social functioning in eating disorders, and may be so for the eating disturbance its