Objective The study set out to compare the three main diagnostic groups of eating disorder patients using established questionnaire measures of psychopathology. Method 156 referrals to a specialized eating disorder service completed the EDI, the Rosenberg Self-Esteem Scale and the SCL-90-R. Results With the exception of the bulimia subscale of the EDI, there were no significant differences between ‘EDNOS’ patients and the full syndromes. Discussion EDNOS patients appear to present with similar levels of psychological deficit to anorexia nervosa and bulimia nervosa patients. It is argued, therefore, that a problem-orientated approach to assessment may be a more appropriate way of assessing therapeutic need than relying solely on diagnosis. Copyright © 2005 John Wiley & Sons, Ltd and Eating Disorders Association.