Food Diary
Food Diary
When & Where
Time & Location
0% Complete
Your responses are private. They are not viewed by a clinician. If you feel like you need help, contact one of our therapists. Visit Education and Resources Page for Eating Disorders to learn more about Eating Disorders and to get in touch with one of iTherapy's counselors.
What was I doing?
Who was I with?
14% Complete
Your responses are private. They are not viewed by a clinician. If you feel like you need help, contact one of our therapists. Visit Education and Resources Page for Eating Disorders to learn more about Eating Disorders and to get in touch with one of iTherapy's counselors.
What I ate & drank
28% Complete
Your responses are private. They are not viewed by a clinician. If you feel like you need help, contact one of our therapists. Visit Education and Resources Page for Eating Disorders to learn more about Eating Disorders and to get in touch with one of iTherapy's counselors.
Binge?
Y or N
42% Complete
Your responses are private. They are not viewed by a clinician. If you feel like you need help, contact one of our therapists. Visit Education and Resources Page for Eating Disorders to learn more about Eating Disorders and to get in touch with one of iTherapy's counselors.
Vomit or Laxatives?
V or L
57% Complete
Your responses are private. They are not viewed by a clinician. If you feel like you need help, contact one of our therapists. Visit Education and Resources Page for Eating Disorders to learn more about Eating Disorders and to get in touch with one of iTherapy's counselors.
Exercise?
What did I do? How long for? When?
71% Complete
Your responses are private. They are not viewed by a clinician. If you feel like you need help, contact one of our therapists. Visit Education and Resources Page for Eating Disorders to learn more about Eating Disorders and to get in touch with one of iTherapy's counselors.
Triggers
Thoughts
Feelings
What started it? Reason for binge?
What went through my mind?
Physical sensations & emotions?
85% Complete
Your responses are private. They are not viewed by a clinician. If you feel like you need help, contact one of our therapists. Visit Education and Resources Page for Eating Disorders to learn more about Eating Disorders and to get in touch with one of iTherapy's counselors.
| When & Where? | What was I doing? Who was I with? |
What I ate or drank | Binge? | Vomit or Laxatives? | Exercise? | Triggers Thoughts Feelings |
|---|---|---|---|---|---|---|
Answer Question to Complete Worksheet |
Answer Question to Complete Worksheet |
Answer Question to Complete Worksheet |
Answer Question to Complete Worksheet |
Answer Question to Complete Worksheet |
Answer Question to Complete Worksheet |
Answer Question to Complete Worksheet |
| When & Where? |
|---|
Answer Question to Complete Worksheet |
| What was I doing? Who was I with? |
Answer Question to Complete Worksheet |
| What I ate & drank |
Answer Question to Complete Worksheet |
| Binge? |
Answer Question to Complete Worksheet |
| Vomit or Laxatives? |
Answer Question to Complete Worksheet |
| Exercise? |
Answer Question to Complete Worksheet |
| Triggers Thoughts Feelings |
Answer Question to Complete Worksheet |
© Carol Vivyan 2009, permission to use for therapy purposes.
100% Complete
Your responses are private. They are not viewed by a clinician. If you feel like you need help, contact one of our therapists. Visit Education and Resources Page for Pain Management to learn more about Pain Management and to get in touch with one of iTherapy's counselors.
Thanks to www.getselfhelp.co.uk for this template.
