The purpose was to examine the extent to which yearly assessments of eating patterns and attitudes, self-esteem, and coping strategies over a 3-year period among adolescent girls predicted the degree of disturbed eating attitudes at the year 3-assessment. Our main hypothesis was that such attitudes year 3 would be predicted by eating attitudes, restrained, emotional, and external eating behavior, as well as by low self-esteem and coping by acting out or avoidance. The results suggest that eating patterns and attitudes were the strongest predictors of disturbed eating attitudes year 3. Self-esteem and coping had a limited predictive value for eating attitudes year 3, and the effect of self-esteem appeared to be mediated by coping. The results suggest that early eating patterns and attitudes are potentially important predictors for the development of more serious eating disturbances among adolescent girls.