Binge Monitoring Form
Use this form to help you understand and identify the triggers for your binge eating.  Discuss this with your doctor, nurse or counsellor.  You may be able to plan different ways of coping with the trigger event.
Date: 	  Day of week: 	  Time: 	
What were you doing immediately before the binge?	

	
How did you feel immediately before binge-eating?	

	
What did you eat during the binge?	

	
What did you think or feel during the binge?	

	
Why did you end the binge?	

	
How did you feel by the end of the binge?	

	
Did you vomit, take laxatives or diuretics, or exercise before, during, or after the binge? (If yes, 
please give details.)	

If yes to the previous question, how did you feel afterwards (ie after vomiting, going to the
 toilet, etc.)?	

What do you feel caused you to binge on this occasion?	

Other relevant comments you wish to record:	

Delaying a binge
When you feel like binge eating, it may be helpful to ask yourself the following questions.
Am I HUNGRY at the moment?
If you are hungry it is important that you have something to eat. However, select only a small portion of appetising food and return the excess food to the cupboard or fridge. Take small bites and chew each mouthful slowly and carefully. Do not put more food into your mouth until you have finished your current mouthful. While you are eating, think about whether the food has managed to stop you from feeling hungry. If you are still hungry, select another small portion of food (returning the excess food to the fridge or cupboard), and chew each mouthful slowly and carefully. Once again, think about whether you are still hungry. Continue eating small portions of food (returning the food to the cupboard or fridge each time) until you no longer feel hungry. If you stop feeling hungry but want to keep eating, ask yourself the following questions.
If I am not hungry, what am I trying to achieve by eating?
Write your thoughts into your food diary.
Will binge-eating make me feel better?
Write your thoughts into your food diary.
Why will binge-eating make me feel better?
Write your thoughts into your food diary.
Is there any other way to feel better apart from binge-eating?
Options you may consider are:
·	Calling a friend for a social chat or to talk about how you are feeling
·	Going for a walk
·	Doing something else enjoyable
·	15 minutes of progressive muscle relaxation
·	Structured problem solving (if your urge to binge eat has resulted from something unpleasant that may have just happened)
·	Talking and communicating about your feelings in a clear and assertive manner (if your urge to binge eat has resulted from a disagreement with someone)
N.B.: Delay tactics can also be used to reduce the likelihood of vomiting or purging after a snack, meal, or binge. After eating, gradually try to increase the delay before vomiting or taking laxatives by engaging in distracting activities. Try to get used to the feeling of having food in your stomach. Given time, the food will be digested and your stomach will no longer feel full or bloated.

Frequency of Binge-Eating, Vomiting, and Purging
Use this form to keep track of your progress over the weeks.  Discuss the results with your doctor, nurse or counsellor.
Number of binges, vomits and purges

  15																

																
																
  10																

																
																
  5																

																
																
  0																

	0	1	2	3	4	5	6	7	8	9	10	11	12	13	14	15	

	Weeks

Use a red pen to record the number of binge eating sessions each week.
Use a blue pen to record the number of times you vomit each week.
Use a black pen to record the number of times you purge (take laxatives) each week.

How to handle or prevent relapse  
1.	Take time out to think about what is happening and to make a plan of action.
2.	Start keeping a food and behaviour diary again.
3.	Make sure you eat three meals a day plus snacks. Do not let more than three hours pass without eating something.
4.	Talk to a close friend or relative about your concerns. They will probably be pleased that you confided in them.
5.	Avoid weighing yourself more than once a week. If necessary, stop weighing yourself altogether.
6.	If you are feeling anxious, depressed, or stressed, try using the problem solving technique to work out a positive solution to your problem.
7.	Make sure your goals are realistic. If you are aiming for something that is too difficult, set yourself an easier goal. Relapse is very common, and does NOT mean that you are a failure. Progress takes time and effort. DON’T GIVE UP!!
8.	Make an appointment to see your usual clinician or doctor. He or she will assist you to get back on track.
For those who have trouble with overeating:
9.	Plan (in advance) how you are going to spend your time. If necessary, try to avoid being alone. Have a list of interesting activities you can become involved in during ‘difficult’ moments. 
10.	Identify ‘high-risk’ activities or times of day when you think you may be most likely to overeat. Try to avoid these activities or situations.
11.	Try to avoid entering the kitchen between meals, and avoid going to the supermarket. If necessary, ask someone else to do your shopping for you. 
12.	Avoid carrying money if you think you may be tempted to buy food. If you must carry money, carry as little as possible.