Self-monitoring in the assessment of eating disorders.

Self-monitoring is a key feature of cognitive behavioral therapy (CBT) for eating disorders. It provides a detailed measure of eating problems and the circumstances under which they occur, but it does not yield precise estimates of amount of caloric intake. It indexes the progress of treatment and helps guide the focus of each therapy session. Adherence to self-monitoring is good provided that therapists implement it skillfully within a collaborative therapeutic alliance. Anorexia nervosa patients may pose a particular challenge in this respect. Self-monitoring may play an important role in the rapid effects of CBT for bulimia nervosa. Preliminary data indicate that self-monitoring of binge eating and purging may provide a valid measure of treatment outcome.