Overcoming
Disordered Eating

Overcoming Disordered Eating
Information Pack A
Take Charge … Initiate Change
Module 5
Regular Eating & Regular Weighing
Introduction
Regular Eating
How to Eat Regularly
My Daily Meal Plan
Weighing and WeightMy Weight Chart (Example)
My Weight Chart
Module Summary
About This Module

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This is the fifth 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 to thefull disclaimer and copyright statement available at http://www.cci.health.wa.gov.au regarding theinformation on this website before making use of such information.
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Introduction
In the last module we introduced self-monitoring. In this module we will encourage you continue yourinvolvement in ‘Action’ mode. You will learn another step in breaking the vicious cycle of your disorderedeating by initiating regular eating and regular weighing, which will become important parts of improving
your eating habits.

Regular Eating
Regular eating is an important component of healthy eating habits. It makes sense to follow a regular eating
plan, but it can be confusing, when we have so much conflicting advice about when to eat.
What is Regular Eating?
Regular eating involves eating something roughly every three hours. Regular eating usually takes the form of
three meals and 2 or 3 snacks a day. This usually involves:• Breakfast• A snack for morning tea• Lunch• A snack in the afternoon• Dinner• A snack after dinner if required (e.g., if you’ve had an early dinner)
Why is Regular Eating Important?
Establishing regular eating habits forms a fundamental part of overcoming disordered eating. Regular eatingis the foundation upon which other positive changes in eating habits are based.
The aim of regular eating is to establish a positive eating habit that can be built upon as you progress
through the modules of this information package – and throughout your life. The first step is to get used toeating regularly. Many people have got used to skipping meals, so eating every 3 – 4 hours might seem hardat first. Regular eating provides a structure and once it becomes part of your routine, it will require little
energy or conscious thought to keep it in place. When it becomes a habit, the content of your meals andsnacks can be adjusted as required. Eating regularly will also improve concentration, keep your blood sugar
levels stable and minimise feelings of tiredness, dizziness and irritability.
Regular eating establishes habits that combat delayed or infrequent eating and unstructured eating, such as
grazing. When you are eating regularly, you avoid the extreme hunger that can lead to binge eating. In
Module 3 we saw how one set of dietary rules relates to when we allow ourselves to eat. You may
currently be following a dietary rule about “when” to eat. Some people follow a rule of not eating before
dinner time. Others follow a rule of only eating once a day. However, as we discussed in Module 3,
irregular eating leads to hunger. When your body becomes hungry and your mind becomes preoccupied
with food, it is likely that you will overeat or binge. In this way, strict dietary rules lead to binge eating (and
often purging) and keep eating disorders going. To break the cycle of your disordered eating, it is important
to stop these behaviours. Regular eating will help you change your dietary rules about when to eat andreplace them with a healthy regimen. This will help you remove the influence of dietary restriction andhunger on your eating habits, and help you resolve your disordered eating. It may also help you feel morein control. Furthermore, if you leave more than 5 hours between eating (during the day), your body goesforCentrelinical
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into “Starvation Mode”, expecting a further lack of food. It lowers its metabolic rate in order to preserve
energy. Therefore, when you do eat next, the food will be metabolised differently, for the purpose ofstorage – exactly what you are trying to avoid!
Do you have any dietary rules about when to eat? If so, how do they affect your life? If your rules about
when to eat involve eating irregularly or skipping meals, do you find yourself getting hungry? Does this leadto binge eating? If so, consider how regular eating may be helpful, and write your thoughts below.

How to Eat Regularly
At this stage, the content of your meals and snacks is not of primary importance. What is crucial is that you
start the habit of eating regularly. To make progress, we ask you to begin regular eating once you haveobtained a few days’ records (from your self-monitoring records) of baseline eating.
When establishing your own system of regular eating, try to follow these guidelines:• Make regular eating a priority. It needs to become an important part of your day and may need, inthe short term, to take precedence over other activities.
• Plan your meals or snacks. Know when your next meal or snack will be, and where it will comefrom. Carrying a snack with you can help if you get caught away from the house/office. Think up a list of
possible snacks that you can have with you in your car or in your bag (e.g., an apple, a muesli bar).
• Eat whatever you would like for your meals or snacks. At the beginning, the content of yourmeals or snacks is not important. Establishing regular eating will make it easier for you to modify thecontent of meals and snacks later, as you work through this information package.
• You may choose what to eat, but you must try hard not to purge (i.e., vomit or use laxatives).
• Do not skip a meal or snack. Being busy at home or work, or being out, is not an excuse formissing a meal or snack. Regular eating must be a priority.
• Do not leave a gap of more than 4 hours between meals/snacks. If you have trouble
remembering to eat regularly, you may find it useful to set a personal alarm to signal meal/ snack time.
• Do not eat between meals or snacks. Eating between meals or snacks is known as grazing. Grazing
is an unhelpful eating habit which prevents you from developing structure in your eating habits. If you
have the urge to graze, try to resist it. You may find the idea of “surfing” this urge a useful concept.
When you feel the urge to eat between meals or snacks, you also may find it useful to distract yourself
with other tasks. Do your best to delay eating by 15 minutes. Remember that such urges pass withtime, and if you are conscious of such urges you can overcome them. If you consistently experiencehunger between meals and snacks you may want to reconsider how you schedule your eating –everybody is different. Maybe 3-4 hours is just too long for your body to go without food! Or maybe
you’re not eating enough to sustain you, and you need to have slightly larger meals/snacks.
• Do not give up. Initially, you may find it difficult to stick to regular eating. If this is the case don’t
worry or give up; regular eating becomes easier with practice.
You may be worried that regular eating will lead to weight gain, but people who are not underweight do
not usually gain weight with regular eating. Remember you are less likely to binge if you eat regularly – and
it is this binge eating that puts on weight, even if you purge. (We will discuss this more in Module 6.)
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Developing a Regular Eating plan
The guidelines above will help you develop a system of regular eating. However, you need to devise a plan
to make regular eating work in your own personal circumstances. Consider how you will work aroundobstacles to regular eating. For example, if you will be away from the home or office at mealtime, what will
you do? If you are afraid of eating often, how will you manage this fear? Write your thoughts below.

We suggest that you divide your day up and plan the times when you are going to have a meal or a snack.
Imagine, for example, Marie, someone who normally wakes up and has coffee and breakfast at around 7a.m., and who has her evening meal at around 6 p.m. That is 11 hours, so a half-way point (5.5 hours)
would be a good time to plan lunch – that is, 12.30 p.m. Half-way between breakfast and lunch isapproximately 10 am, so that’s when Marie should have her morning tea. Half-way between lunch and herevening meal is 3-3.30 p.m., so that’s when she should plan afternoon tea. And because she has an early
evening meal, she may consider another snack at around 8 p.m.
See what such a schedule might look like:
Example - Marie
Meal/Snack
BreakfastMid-morning snack
Lunch

Time Marie gets up

Evening snack(optional)

Meal plan

7 am

1 cup muesli, 1l/f yoghurt, 1 apple
1 coffee with Hi-Lo milk
1 banana, 1 coffee with Hi-Lo milk

10

Half-way between breakfast 12.30
and evening meal

Afternoon snack
Evening meal

Time

3.30

Time Marie usually eatssupper6
8

1 ham & cheese & avocado sandwich
1 glass fruit juice, 1 small banana
1 muesli bar
1 tea with Hi-Lo milk
Chicken stir-fry with 1 cup rice
1 piece toast with Vegemite
1 cup tea with Hi-lo milk

Don’t be too rigid - these are not hard-and-fast rules, merely guidelines. For example, if Marie knew she
was going to be in a lecture till 4, she might wait until then to have her afternoon snack. However, if herclass ran from 2-5, she may need to take a snack in her bag and make sure she took a break, eating it sometime between 3 and 3.30.
Now let’s see how you might plan your eating during the day. Fill in the schedule overleaf for tomorrow:forCentrelinical
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My Daily Meal plan
Meal/snack
BreakfastTime

Meal planMid-morning snack
Lunch
Snack with afternoontea
Evening meal

Half-way between breakfast
and evening mealTime I usually eat supper

Evening snack(optional)

Weight and Weighing
Weight
It is important to bear in mind that the goal of this information package is not for you to lose weight, and thatthe goal of weight loss is incompatible with correcting disturbed eating. Remember what we said in Module 1
about holding off on any plans to lose weight, while you focus on improving from your disordered eating?
This is a timely reminder of that.
Nevertheless, we know that you will still be concerned about your weight. You may be worried that eating
regularly might mean eating more than you’ve been used to, which could lead to weight gain. We would
like to remind you that most people in the healthy weight range who adopt regular eating end up within 1
kg. of where they started, and some even lose weight. This is because even if you consume more calories
than usual from healthy food choices, you’re less likely to binge eat and therefore you’ll be ingesting fewer
calories. This means you’re not actually eating more, you may be eating less, with fewer calories overall!
Remember, more healthy food ∏ smaller and/or fewer binges.
So why not go for following a healthy meal plan and regular eating? Give it a try!
Weighing Yourself
Most people with disordered eating are concerned about their weight and weigh themselves frequently,
often several times a day. Do you weigh yourself often? This is very unhelpful, as it can give you misleading
information. Frequent weighing will limit your progress because it leads to preoccupation with weight
and with the number on the scale.
Everyone’s weight fluctuates throughout the day, by up to 2-3 kg. Weight depends upon many factors,
including: when you have eaten and drunk, your body hydration, the stage in your menstrual cycle (if you
are female), and bowel/bladder functions – even the temperature and humidity outside! So there is no suchthing as your “true weight”, only a measure of your weight at one particular moment. If you weigh yourself
too often, these normal fluctuations may lead you to misinterpret your weight – and then restrict your
food.
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Remember that you can’t interpret any one single reading on the scale. Clinicians generally look for weight
trends, which we get from looking over the previous four readings. Don’t get hung up on a number. We
encourage you to think of a weight range in which your body and eating patterns would be healthy. (Thisweight range should include a variation of up to 3 kg, such as “between 66 and 69 kg.”) If you look at theexample overleaf, you will see that the woman’s weight at Week 7 is 3 kg above her starting weight, but it
doesn’t stay that high.
We suggest that you weigh yourself once a week, at the same time, on the same scales,
wearing similar clothing (or none) each time. Why do we suggest that you weighyourself? Knowing your weight each week is central to your progress because:• Your eating habits will be changing, and it is important that you have an accurate
understanding of how these changing eating habits affect (or don’t affect) yourweight. It’s a reality check.
• It will allow you to track your progress towards your target weight range.
• Avoidance of your weight will not help your treatment.
Measuring your weight weekly, examining your weight changes, and identifying weight patterns over anumber of weeks will help you to focus on long-term and accurate trends. It is important that you do notweigh yourself more than once a week. You may find it easier to stick to this rule if you give your scales tosomeone for safe-keeping.
Does what we have just told you about weight fluctuations make sense? What seems like a healthy weight
range for you? Does frequent weighing make you miserable? If this is the case, consider how just weighing
once a week may benefit you. Take a moment to think about weighing yourself, and how you will manage
with only weighing once a week. Write your thoughts below.

Overleaf you will find a weight chart. We suggest that you start by calculating your BMI and your healthy
weight range, using the formula in Module 1. Look at the example below to help you understand how tocomplete your weight chart.
1. The left hand column is for weight. Write your current weight about half-way down, where the asterisk(*) is.
2. Starting from your current weight, fill in the weight column, working up by 1 kg per line, and thendown.
3. Calculate your BMI and enter it in the first box next to your weight
4. Calculate the top and the bottom of your healthy weight range, and enter the figures “25” and “20”next to the weight that corresponds to those top and bottom figures.
5. Each week, mark your current weight. Don’t get hung up on a number. Look for trends over the past 4
weeks.

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My Weight Chart(Example)
Here is the example from Module 1: a woman who is 1.70m tall and weighs 67kg, and whose healthy weight
range is 58 – 72 kg. Her current BMI is 23.18. We have also added in her weight over the following 20
weeks.
Wt
(kg)

BMI

72
71
70
69
68
* 67

25
x
x
x

x

X
23.18

x

x

x

x

x

x

x

x

x

66
65
64
63
62
61
60
59
58
Week

20
1

2

3

4

5

6

7

8

9

10

11

12

13

14

x
x

x

x

15

16

17

x

18

Overleaf you will find a blank Weight Chart. Enter your current weight and BMI data:

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My Weight Chart
Wt
(kg)

BMI

*

Week

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

Date

for
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Module Summary
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Regular eating will require you to eat something approximately every 3 hours.
Regular eating will help give structure to your eating habits.
Regular eating is designed to break your dietary rules about when to eat. Eating irregularly leads tohunger and preoccupation with food, which subsequently encourages binge eating.
Weekly weighing is recommended, in order to track trends in weight. It is important to weigh yourself
only once a week.
Frequent weighing is unhelpful as it leads to preoccupation with weight and gives information that is
easily misleading. Weight fluctuates throughout the day and is influenced by many factors.
Weight may, understandably, be a concern to you, but you need to remember that having a goal ofweight loss is incompatible with recovering from an eating disorder, and you need to suspend any
thoughts of losing weight while working through these modules. Most people in the healthy weight
range who follow this kind of programme do not gain weight, and some lose weight once they stop
binge eating.
A weight chart can help keep track of your weight and give you feedback on trends over time.

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 6 (Binge Eating, Purging & Driven Exercise) we will begin to
tackle some of the core symptoms of your disordered eating.
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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: Centre
for Clinical Interventions

ISBN: 0-975799525

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Created: March 2007. Revised November 2010.

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