Why do some therapists recommend using a food diary for eating disorders?
When it comes to eating disorders treatment, there are several therapies available. One of the most common therapies offered is CBT-E (or Enhanced Cognitive Behavioural Therapy).
One cornerstone of the CBT-E approach is to keep a food diary. Monitoring your intake through writing down what you eat, what time you eat, and also, how you feel and think about what you have eaten, is considered essential to the success of this treatment.
But is this always a good idea? In my experience, using a food diary for eating disorders can be incredibly useful, but for some people, the idea of keeping records of their intake, let alone showing this to someone else, activates a huge amount of shame. This is totally understandable, given how long our clients have been trying to hide their difficulties away in secrecy and the negative messages they have already internalised about their own eating. Understanding that this happens is important information for your therapist. It may shift the focus of therapy for a while. This is normal.
So, is keeping a food diary right for you? We are all individuals, with different needs. It may help you, it may not. So, in this post, I want to share with you what I feel to be some of the advantages and disadvantages of doing so. I hope that having this information will help you and your therapist to come to the right decision for you.
Without further ado, here are some of the pros and cons of keeping a food diary for eating disorders:
The advantages of using a food diary:
1. Increased self-awareness: keeping a food diary can help you to become more aware of your own eating patterns. This includes the types of foods you eat, the amounts you are consuming, and the times of day you are eating. This information can be an incredibly useful way to learn how regular eating can regulate your blood sugar and mood, and reduce the physical triggers of bingeing.
2. Identification of triggers: a food diary can allow you to identify the triggers that may be contributing to your disordered eating behaviours. Your therapist may ask you to keep track of not only what you have eaten, but how you feel and what you think each time you eat. Doing this can quickly help you see what your personal triggers are.
3. Accountability: a food diary can serve as a form of accountability. When you’ve been eating in a disordered way for a long time, thought patterns, like ‘all or nothing thinking’ or ‘minimising’, can make it easy to lose perspective on what you’ve actually eaten. Life is busy, and when you don’t write things down, it’s easy to forget how you have cared/not cared for yourself that day. Food diaries can help you to stay on track with your meal plan, be honest with yourself, and support yourself with learning more functional ways of dealing with distress and the disordered eating behaviours you have identified.
4. Collaboration with your therapist: a food diary can be a useful tool for your therapist, allowing them to support you more fully. Having your food intake and eating patterns documented will provide a detailed record that can be used to guide and tailor your personal treatment.
The disadvantages of using a food diary:
1. Increasing obsessive behaviour: for some people with eating disorders, keeping a food diary can become an obsessive behaviour that actually contributes to feelings of anxiety and stress, making the eating disorder behaviours worse.
2. Triggering disordered eating: focusing too much on food and eating can be triggering for some people with eating disorders. If this is you, it could lead to an increased preoccupation with food and a heightened risk of engaging in disordered eating behaviours.
3. Inaccurate reporting: some people may not accurately report their food intake. This could be either conscious or unconscious, but it will lead to an inaccurate record of their eating patterns, and potentially to you not getting the correct level or type of treatment. Sometimes guilt and shame can drive inaccurate reporting, and it’s important your therapist understands and responds to this.
4. Negative emotions: keeping a food diary can lead to negative emotions such as guilt or shame, particularly if you haven’t met your ‘dietary goals’. These negative emotions can help to strengthen the eating disorder, creating a negative spiral.
It’s really important to remember that keeping a food diary is just one of the many tools that we use to help with recovery from an eating disorder. It could work really well for you, or it could make things feel worse.
If your therapist has suggested it, and you have any concerns, speak to them about these and use our advantages and disadvantages to discuss whether it’s a good idea.
If you’re not yet under the care of a therapist, but you suspect that it’s time to get some support with disordered eating, please don’t hesitate to book a free initial consultation with one of our senior psychologists. We offer this 20-minute consultation completely free of charge so that you can get to know us and find out a bit more about how we could help you.
Visit this page to book your appointment.
At the initial consultation, we’ll tell you more about how we work and help you figure out if it’s time to get support with your mental health.
Take care
Dr Courtney
p.s. If you’d like more information about CBT-E, visit this page. It’s the official news website for everything to do with CBT-E – you can also download a useful food diary template.
