Current empirical evidence suggests that true recovery from eating disorders is not possible without a corresponding improvement in body image and self-esteem. Ten studies in current literature evaluate this relationship between self-esteem and clinical eating disorders during inpatient treatment or during follow-up studies but do not provide both pre- (baseline) and post-treatment self-esteem scores. As a result, many questions about the nature of the relationship between eating disorders and self-esteem remain unanswered. The purpose of this study was to empirically investigate whether a comprehensive measure of self-esteem, given to women at the beginning of inpatient treatment for eating disorders, reliably predicted treatment outcome. Specific and global levels of self-esteem were determined by the Multidimensional Self-Esteem Inventory (MSEI). Pearson Product Moment Correlations run on SPSS 10 were used to determine significant results. Participants in this study included 246 women experiencing anorexia nervosa, bulimia nervosa, or eating disorder not otherwise specified who received inpatient treatment at the Center for Change (CFC), in Orem, Utah, during the years 1996 to 2003. For the purposes of this study, outcome was measured upon termination of treatment at the Center for Change. CFC discharge was based on clinical judgment of progression through the treatment program, medical stability, reduction of purging behaviors, body weight, as well as attainment of additional treatment goals designed by the therapist. The results of the current study replicate earlier research that reports that positive treatment outcome is nearly always associated with high self-esteem at discharge. These findings extend earlier research by suggesting that high levels of self-esteem at admission are associated with positive treatment outcome. This investigation, which is the first to examine self-esteem change scores between admission and discharge, found that women who experience the greatest decrease in eating disorder symptomatology are those who presented at admission with low self-esteem. Further, a significant association was found between improvements in self-esteem and decreases in eating disorder symptomatology. These findings suggest that the women who report high self-esteem at admission, or women who have low self-esteem but make dramatic improvements by discharge, are likely to experience significant reductions in disordered eating behaviors.