While working with people with eating disorders, I am reminded time and again that the most simple tool is the most effective one. Eating disorders may be known as intractable and very challenging to treat, but the food journal is a critical part of any success in recovery.
Initially, the journal provides a daily accounting of what someone’s eating disorder looks like. Although eating disorder symptoms are somewhat consistent from person to person, the exact way a person thinks about food and eats through the day can change. The eating disorder thoughts tend to be the most dominant thoughts in a person’s mind so the journal also gives insight into a day’s worth of thoughts.
Allowing a clinician to look at the journal symbolically represents an opening of the eating disorder itself into treatment. The therapist can ask specific questions to better understand the process involved and the decisions that are made by the eating disorder rules. The process of asking questions, giving answers and even making small suggestions to change the eating behaviors show that there can be a dialogue around the disorder, something usually very new to the person in treatment.
People often say to me that writing out the details of their food each day is the most personal thing they could imagine doing. The act of writing the journal and then sharing it allows for an intimacy not usually possible because the eating disorder dominates one’s life. Exposure of the central power of the illness invites change and progress.
When I think over the duration of my practice, any person with a moderate to severe eating disorder who I have seen make progress has committed to the food journal for a period of time. The tedium of writing down food combined with thoughts and feelings are worth pursuing for the true benefit that this tool provides. As long as the food journal is a part of recovery, there is nowhere the eating disorder thoughts and symptoms can hide.
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