Self-monitoring by recording eating behaviors and associated thoughts and feelings in daily food journals is basic to nutrition counseling and to Cognitive Behavior Therapy (CBT) in the treatment of eating disorders. In nutrition counseling, self-monitoring is beneficial for both nutrition counselor and patient. For nutrition counselors, food journals provide detailed descriptions of eating patterns and the circumstances of eating problems and is a concrete way to assess progress. For patients, self-monitoring increases awareness of eating problems and precipitating events. Food journals are a way for patients to communicate about their experiences between sessions and to help identify and differentiate between eating situations that are difficult or manageable. Some patients may have exaggerated the extent of their eating-disordered behaviors, and self-monitoring provides a more realistic picture that is reassuring.
I often say that “Food journals solve mysteries and suggest solutions.” For example, when a patient’s weight is not responding as expected, food journals can help determine the cause. Food journals provide information about the patient’s food patterns and about which foods are acceptable to the patient. They also provide undeniable evidence that restrictive eating increases the likelihood of binge eating.