Overcoming
Disordered Eating

Overcoming Disordered Eating
Information Pack A
Take Charge … Initiate Change
Module 4
Self-Monitoring
Introduction
Self-monitoring
How to complete your self-monitoring sheet
My self-monitoring sheet (example)
Worksheet: My self-monitoring sheet for baseline (blank)
What is a binge?
Worksheet: My self-monitoring sheet (blank)
Module summary
About this module

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This is the fourth module of Information Pack A, which provides information about disordered eating andoffers strategies to help you start changing the behaviours associated with your disordered eating and weightcontrol habits. We suggest you read through all the modules of this Information Pack, in order, before
embarking on change.
If you do think you might suffer from an eating disorder, it is important that you talk to your General Practitioner, as
there are many physical complications that can arise from being at an unhealthily low weight or from losing weightvery quickly, or from purging. We advise you to seek professional help with working on an eating disorder.
If you use any extreme weight control behaviours – even rarely – you should also see your General Practitioner for a
full medical check-up, as your health might be compromised. Such extreme measures include:• extreme food restriction/fasting (and/or rapid weight loss)• purging (self-induced vomiting, misuse of laxatives or diuretics)• extreme exercise
The information provided in this document is for information purposes only. Please refer tothe full disclaimer and copyright statement available at http://www.cci.health.wa.gov.au
regarding the information on this website before making use of such information.
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Module 4: Self-Monitoring

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Overcoming
Disordered EatingIntroduction
In this module, we will begin to help you move into ‘Action’ mode. You will learn how to break the vicious
cycle of your disordered eating by initiating a positive eating behaviour, self-monitoring. Self-monitoring will
become an important part of improving your eating habits. This behaviour was mentioned in Module 1, butwill now be explored in greater detail.

Self-Monitoring
What is Self-Monitoring?
Self-monitoring involves recording your daily food intake, and any eating disordered behaviours, plus any
thoughts/feelings you were having at the time. You do this by completing daily self-monitoring sheets. Thismight be a scary prospect. We will therefore explain why this is important and then, hopefully, you will
understand the benefits of self-monitoring.
Why is Self-Monitoring Important?
You may be asking yourself: “Why in the world would I want to write down all the awful food I eat, andthen what I do with it, then think about how I’m feeling, and then look at it?” It may seem like ahuge task, but it is extremely useful in overcoming disordered eating. Completing daily records ofyour eating behaviours provides you with information about your problem. You can become akind of detective, searching for clues: What triggered the disordered eating? What did I eat? What
did I do then? What was I thinking and feeling at the time? What conclusions can I draw?
Recent research has shown that people who begin using self-monitoring sheets early in the change process
have the most positive outcomes. This is because the self-monitoring sheets allow people to have the mostaccurate picture of how the disordered eating keeps itself going and how it can be changed. It is importantthat you make an honest and accurate record. This may feel uncomfortable, but you will come to find this auseful tool for overcoming your disordered eating.
Self-monitoring encourages you to analyse the thoughts that influence your eating and helps you to identify
influential thought patterns. For example, thinking negatively about yourself and your self-worth may lead toovereating. By recording your thoughts you become conscious of this pattern and can begin to counteract
these thoughts. Self-monitoring also helps you to identify situations that lead to disordered eating. For
example, you may be in the habit of skipping meals all day, getting home in the afternoon feeling extremely
hungry, and then binge eating. By recording this behaviour, it becomes easier to become aware of theharmful patterns that maintain your disordered eating.
Once you become aware of what is going on, you will find it easier to change, because you will know whatneeds changing! Also, once you become aware of your behaviours and begin to see patterns, you will start
realising that these behaviours are not just arbitrary and automatic, but CAN be changed. You will find that
self-monitoring becomes an important part of correcting your disordered eating. Initially, you may find thatrecording your food intake makes you feel uncomfortable. Most people who feel this way become more
comfortable with the process over time and find self-monitoring a useful tool for improving their eating.
You may also fear that writing everything down will make you obsess MORE about food, and this may bethe case – but only in the short term. For long-term change it is very helpful.

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How to complete your self-monitoring sheet
As part of making changes to your eating, you will need to complete a self-monitoring sheet that details
your food intake each day. The self-monitoring sheet records the time you ate, what you ate, where you
ate, if you considered the event to be a binge, if you engaged in vomiting or laxative use, and the situationand feelings that accompanied your eating. Overleaf you will find an example of a completed self-monitoring
sheet, and it might help you to look at it in order to get an idea of what a completed self-monitoring sheet
looks like.
There are some important issues to consider when you start self-monitoring:• Be accurate and honest with yourself. You may feel tempted to omit food items or behavioursout of feelings of shame or guilt. However, not being completely truthful will only limit your progress.
Remember that this is your record, and being honest with yourself is an important step in changing
your behaviour.
• Complete your self-monitoring sheets in “real-time”. Do not wait until the end of the day to
try to remember what you ate. Recording your food intake while you eat (or immediately afterwards)
will help you get a more accurate record of your thoughts and feelings, and the content of your meal. It
will also help you analyse your thoughts and the situations that encourage you to eat.
• Do not record calories.
• Carry your self-monitoring sheets with you wherever you go, to assist you in making records.
However we realise that it can be difficult to carry your self-monitoring sheets all the time. Somepeople find it helpful to carry a mini-notebook or jot down notes in their diary then transcribe these
into their self-monitoring records later that day.
The point of self-monitoring is not to add up your food intake at the end of the day. Self-monitoring will
help you understand why you eat, and the processes and thoughts that lead to your disordered eating.
Your self-monitoring sheets are important and it is crucial that you complete them honestly and accurately.
Below are some guidelines for completing your self-monitoring sheet:• Day and Date: note the day and date (one self-monitoring sheet per day)
• Time: Record the time you began the meal or snack.
• Food & liquid intake: Record both food and liquid intake, including water, soft drinks, coffee or tea,or alcohol. Bracket foods together when you consider them to be part of the same meal/snack.
• Location: Be specific about the location of your eating. If you are at home eating on the couch, write‘couch at home’ rather than ‘home’. This extra information may give you more insight into your eatinghabits.
• Binge: If you considered the meal or snack to be part of a binge episode, record an asterisk (*) in thiscolumn of your self-monitoring sheet. (See Page 7 for examples of what constitutes a binge.)• Vomiting or laxative use: If you vomit, record a ‘V’ in this column. If laxatives are used, record an‘L’ in this column and write down how many you took. If the vomiting or use of laxatives do not occur
in conjunction with food intake, record the event leaving the food intake column empty.
• Situation/feelings/thoughts: We ask you to record the situation, thoughts or feelings associatedwith your eating. Behaviours such as weighing and shape checking should also be recorded. This will
give you the chance to consider what triggered your eating, how you felt about your eating, and how
your eating made you feel about yourself.
• Exercise: If you exercise, record the time period you exercised and the type of exercise you engage
in, as well as any thoughts or feelings associated with the exercise.
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Below is an example of a completed record:

My Self-monitoring SheetDayMondayTime

Food & liquid intake

7:30am2 pieces of toast withmargarine
1 mug of coffee

Date__22/01/07________Location]]*(Binge)

V/L

Situation/thoughts/feelings
7:00am: Weighed myself. 65kgs
Less than last night. Pleased.

Kitchentable

10:00 am

1 can of diet Pepsi

At work

12:00 pm

Mug of coffee

At work

1:30 pm

Mug of coffee

At work

Cake in the staffroom forcolleague’s birthday. Pleased I
didn’t eat any.
Only coffee for lunch, trying to
make up for breakfast

4:30pm4:40pm4:45pm4:53pm200gm packet of chips
1 doughnut
1 doughnut
1 can of diet lemonade
6 chocolate biscuits
1L of ice cream
1 can of diet lemonade
2 pieces of toast,margarine and jam

Home, infront of theTVSat in front of TV when I got
home. Felt bored, tired andhungry. Started eating.

4:59pm5:15pm5:35pm

]
]
]
]]]]

*
*
*

**]
*

7:30pmMug of tea

8:40pm1 piece of toast, vegemite ]1 large glass wine]
5 pieces of toast,
margarine & vegemite]
1 cold apple pie]
1 packet of chocolate chipcookies]

8:44pm8:54pm
9:00pmV

5:45pm: Weighed myself.
66.7kgs. Disgusted with myself.
Vomited.
Depressed about binge.
Resolved not to eat for the restof the night.
Mum called and said she
wanted to go clothes shopping
together on the weekend. Felt
anxious. Started to eat. Too
depressed to stop.

****
VFelt awful, couldn’t look in themirror. Vomited.

Exercise (time and type): None. I’m just lazy idiot

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Overcoming
Disordered EatingPreparing Yourself to Start Your Self-monitoring sheets
Now that you understand the benefits of self-monitoring and how to complete self-monitoring sheets, it isimportant to start recording! But before you begin recording your eating behaviours, let’s take a look at
how you’re going to manage to complete those records.
Take a moment to consider how you will fit self-monitoring into your own lifestyle. For example, if you will
be eating with friends or family, what will you do? Devise a plan that makes self-monitoring work for you.
Please write your thoughts below.

You will need to make a food intake record for each day. Initially, your self-monitoring will be used to makea record of your current eating pattern. During this period you should continue eating as you have been up
until now. This will help you understand your current eating habits, and provide you with a baseline record.
This is a record of what you’re currently eating, and then you will be able to identify changes in your eating
patterns as you work through the modules in this information package.
Your Baseline RecordsA baseline record means that we would like you to record your current food intake without making any
changes to how much you eat or binge. Start by completing the blank self-monitoring sheet overleaf on
Page 6. Start now, whatever time of day it is. Write down everything you eat for the rest of today, andnote any disordered eating behaviours, plus any thoughts/feelings you might have at the time. (Go back toPage 3 for instructions and Page 4 for an example of a completed self-monitoring sheet.)
A blank self-monitoring sheet is included at the end of this module (Page 8) to help you make your own
self-monitoring records. Print out or copy 4 more blank self-monitoring sheets. Starting from NOW,
complete a self-monitoring sheet every day. Make a record of what you eat, when and where you eat it, if
you consider it a binge, if you used vomiting or laxatives, and what was going on at the time, as well as yourthoughts and feelings.
At the end of 4 days, make some time to look over your self-monitoring sheets. Even if you go ahead now
and finish reading this module – and perhaps more modules – make sure you complete your daily selfmonitoring sheets and also that you look over them after a few days.
Reviewing Your Baseline Records
Once you have 4 or 5 days worth of self-monitoring forms, set aside about half an hour to review them.
What do you see? Can you identify any trends or patterns to your eating and related behaviours? Do youtend to binge on certain types of foods? Do you binge at a certain time of day? After the same events?
Accompanied by the same emotions? Write down some observations.

By the end of 4-5 days you will be ready to move on to regular eating and more self-monitoring.
Overleaf you will find a blank self-monitoring sheet to start completing NOW.
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Disordered Eating

My Self-monitoring sheet
Day___________________
TimeFood & liquid intake

Date_________________
Location*(Binge)

V/L

Situation/thoughts/feelings

Exercise (time and type):

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Definition of a Binge
Sometime it can be hard to determine if you have binged. Remember, to count as a binge,
1) The amount of food has to be:• larger than others would eat in similar circumstances• eaten within a 2-hour period
2) You have to feel out of control while eating, as if you couldn’t stop even if you wanted to, or you
couldn’t resist starting.
Here are some examples of LARGE:
cake – 4 regular slices
cereal – 6 cups
chips (packet – potato or corn) – 250 g/8 oz
chips (French fries) – 3 large servings
chocolate – 3 bars if dense, 4 if regular, 8 fun-size
corn on the cob - 4 pieces
croissants or Danish pastries or doughnuts – 4eggs – 5 (6 if scrambled or omelette)
toast – 6 slices

fruit – 5 pieces
hamburgers with bun - 3
hot dogs with bun – 4
ice cream – 6 scoopsnuts – 2.5 cups
pasta (cooked) – 6 cups
peanut butter – 6 tablespoons
pizza (large size) – 6 slices
popcorn – 3 microwave bags
steak – 500g/16 oz

Overleaf you will find another blank self-monitoring sheet that you can copy or print out.
Good luck with your food monitoring!

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My Self-monitoring sheet
Day___________________
TimeFood & liquid intake

Date_________________
Location*(Binge)

V/L

Situation/thoughts/feelings

Exercise (time and type):

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Module Summary••••

Self-monitoring is an eating behaviour that you will need to start immediately.
Self-monitoring involves recording your food intake each day. You will need to record the time ofeating, what you ate, the location of eating, the presence of binge eating, vomiting or laxatives use, any
exercise and the situation/thoughts/feelings surrounding your eating.
Self-monitoring sheets should be recorded in “real time”.
Self-monitoring will help you to analyse your eating habits and behaviours. It will also allow you toidentify thought patterns or events that lead to disordered eating.

What I Have Learned in this Module
Think about what you have learned in this module and any useful bits of information, tips or strategies thatyou want to remember. Write them down below so you can refer to them later.

Think about how you might use the information you have just learned. Write down some ways in which
you could make use of this information.

Coming Up…
In Module 5 (Regular Eating & Regular Weighing) youwill continue to work in ‘Action’ mode, learning how toaddress your disordered eating by initiating regulareating and regular weighing.

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About This Module
CONTRIBUTORS
Dr. Anthea Fursland (Ph.D.1)
Principal Clinical Psychologist
Centre for Clinical Interventions

Paula Nathan (M.Psych.3)
Director, Centre for Clinical Interventions
Adjunct Senior Lecturer, School of Psychiatry andClinical Neuroscience, University of Western Australia

Dr. Sue Byrne (Ph.D.1, D.Phil.2)
Senior Clinical Psychologist
University of Western Australia andCentre for Clinical Interventions

Amy Lampard (B.A. Hons4)
MPsych (Clinical)/ PhD Candidate
University of Western Australia

1 Doctor of Philosophy (Clinical Psychology)

2 Doctor of Philosophy (Clinical Psychology)

3 Master of Psychology (Clinical Psychology)

4 Bachelor of Arts (Psychology) with Honours

We would also like to thank Karina Allen for her contributions to the presentation of these Information Packs.
BACKGROUND AND REFERENCES
The concepts and strategies in this module have been developed from evidence-based psychologicaltreatment of eating disorders, primarily Cognitive Behaviour Therapy (CBT). This can be found in thefollowing:•••

Fairburn, C. G. (1995) Overcoming Binge Eating. New York: The Guilford Press
Fairburn, C. G., Cooper, Z., & Shafran, R. (2003) Cognitive behaviour therapy for eating disorders:a “transdiagnostic” theory and treatment. Behaviour Research and Therapy 41, pp 509-528
Fairburn, C. G. (2008) Cognitive Behavior Therapy and Eating Disorders. New York: The Guilford
Press“OVERCOMING DISORDERED EATING”
This module forms part of:
Fursland, A., Byrne, S. & Nathan, P. (2007) Overcoming Disordered Eating. Perth, Western Australia: Centrefor Clinical Interventions
ISBN: 0-975799525

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Created: March 2007. Revised November 2010.

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