Eating disorder food journal

Using a food diary worksheet or emotional eating journal allows clinicians to help clients identify disordered patterns and self-monitor emotional triggers in real time.

This article explores how clinicians can integrate self-monitoring journals into eating disorder recovery protocols and optimize client outcomes.

We’ve included a free downloadable eating disorder food journal and recovery worksheet to save to your electronic health record (EHR) and use in your practice.

What is CBT for eating disorders?

Cognitive behavioral therapy (CBT) is an evidence-based treatment for binge eating disorder and bulimia nervosa. 

While each eating disorder has distinct features, the cognitive model treats eating disorders and eating psychopathology similarly. Namely, that eating disorders are an overevaluation of shape, weight, and behaviors that control eating and body size, such as restrictive dieting and excessive exercise. 

There are two types of CBT used for disordered eating: 

• Cognitive behavioral therapy for bulimia nervosa (CBT-BN): CBT-BN is the leading treatment for bulimia, with a success rate of 50% of patients sustaining their recovery.

• Enhanced cognitive behavioral therapy (CBT-E): A further developed version of CBT-BN used to treat anorexia nervosa. There are various versions and durations of CBT-E treatment, depending on the severity of the disorder. Research suggests CBT-E was successful in treating 60% of outpatients, with low rates of relapse. 

CBT-E works by engaging the client in treatment, including self-monitoring (such as keeping a thought log and writing a food journal), receiving psychoeducation, addressing eating patterns, establishing a support network, modifying maladaptive thoughts and beliefs, addressing low self-esteem and perfectionism, and relapse prevention. 

How food journals can support eating disorder recovery

Keeping an eating disorder food journal or reflection log is a core element of self-monitoring in CBT-E, playing a crucial role in treatment. 

There are several ways to approach journaling in recovery, including structured reflection prompts, a food diary worksheet, food tracking apps, or voice memos. While traditional food tracking focuses on intake, non-diet approaches—such as an emotional eating journal—focus on identifying thoughts, feelings, and coping strategies without recording calories or portions. Whatever format is used, the information collected should help clients track their emotional states, triggers, and cognitive patterns. 

Self-monitoring through an eating disorder food journal or thought log has several benefits:

• Increases awareness and understanding of disordered eating patterns, cognitive distortions, and negative core beliefs

• Promotes behavioral change by noting triggers in the moment and encouraging the use of healthy coping skills 

• Helps to monitor treatment progress and can provide valuable data to adapt or modify treatment planning

• Reviewing journal entries in therapy helps reinforce self-compassion and positive coping habits

As with all interventions, benefits should be considered for each individual. Sometimes, keeping an eating disorder food journal can be triggering for clients and increase disordered eating behaviors, such as perfectionism or obsessive thoughts. In those cases, a thought-focused recovery journal offers a safer alternative.

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How to use the eating disorder food journal

You can download and use the food tracking worksheet and recovery journal in several ways:

• Use the worksheet to provide psychoeducation about eating disorder recovery and the key components of CBT.

• Complete the food diary worksheet in session to demonstrate how to identify and challenge unhelpful thoughts.

• Ask the client to reflect on the worksheet, complete the reflection questions between sessions, and report their findings at their next therapy appointment. 

• Use the eating disorder food journal in group therapy sessions to encourage clients to share more about how this resource could help their eating disorder recovery. 

• Combine this worksheet with other eating disorder resources, including our articles on how to identify eating disorders, psychoeducation on eating disorders, and tips for addressing eating disorders during the holiday season.

• Share the food diary worksheet with coworkers.

• Use this worksheet to provide training to interns or supervisees on eating disorders and different interventions. 

Sources

• Kelly, A. C., Vimalakanthan, K., & Miller, K. E. (2014). Self‐compassion moderates the relationship between body mass index and both eating disorder pathology and body image flexibility. Body Image.

• Murphy, R., Straebler, S., Cooper, Z., & Fairburn, C. G. (2010). Cognitive behavioral therapy for eating disorders. The Psychiatric Clinics of North America.

• Nazar, B. P., Bernardes, C., Peachey, G., et al. (2016). The risk of eating disorders comorbid with attention-deficit/hyperactivity disorder: A systematic review and meta-analysis. International Journal of Eating Disorders.

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