This study examined changes in self-esteem, before treatment ol bulimia nervosa and 18 months later. In addition, the relationship between these changes and attribution of responsibility for the improvement or continuation of bulimic symptoms was also explored. One hundred and ten women with bulimia nervosa entered a treatment trial and completed measures of self-esteem and bulimic symptoms. Fifty-one of these women also completed the same measures 18 months later, at which point they also rated the degree to which they felt responsible for any change in levels of bulimic symptoms. Women who had recovered from bulimia nervosa reported an increase in their serf-esteem. Specifically, women who recovered increased their self-like and social esteem and decreased their self-dislike. Their was no effect of type of treatment or attribution of responsibility for recovery/non-recovery on changes in self-esteem. Copyright (C) 2000 John Wiley & Sons, Ltd and Eating Disorders Association.