Within 1 month, real rTMS lessened excessive self-regulatory behaviors around food. At 4 months, both sham and real groups showed a small treatment effect size from baseline measures of BMI and ED symptomatology, with medium and medium to large improvements in quality of life and mood, respectively. Greater improvements were seen in the real treatment group. By 18 months, measures continued to improve with the difference in improvements between real and sham groups growing: BMI showed medium between-group differences; ED symptomatology, clinical impairment, and depressive symptoms showed small between-group differences, all favoring real treatment. Overall, moderate improvements were made in ED symptoms while significant improvements were made in clinical impairment. Real rTMS treatment was more favorable with 46% of the participants originally assigned to real treatment being weight recovered (>18.5 kg/m2), compared to 9% of participants originally assigned to the sham treatment. By the end of rTMS treatment, patients reported improved ED symptoms, mood, psychosocial functioning, and quality of life. They found they had developed more flexibility around eating, the ability to consider goals and motivations outside of their disorder, increased social engagement, and a more positive and hopeful outlook on the future.