Objective The aim of this study was to compare the outcome of eating disorders (EDs) in Japan with that in Western countries. Method Two hundred and thirty‐three Japanese women with an ED were followed for 4 to 9 years. We identified fully recovered women (good outcome group), partially recovered women (intermediate outcome group) and women with an active ED (poor outcome group) based on physical, behavioural and psychological indices. Results Ninety‐seven subjects were categorized as having a good outcome, 58 as intermediate and 61 as poor, and 17 had died. There was a significant difference in outcome results among the types of ED at intake. Women with both anorexia nervosa and bulimia nervosa, diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised, at intake had the worst recovery rates. Conclusions These results suggest that the outcome of EDs in Japan is relatively similar to that in Western countries, irrespective of sociocultural background and health systems. Copyright © 2014 John Wiley & Sons, Ltd and Eating Disorders Association.