Appendix

Example of a Food Journal
Date _____________

Example of a Weekly Contract

Name ________________
Date _________________

A.  Eating/Nutrition Goals (meal plan commitments, food challenges, plans to eat with others )

1.  I will try a new breakfast this week.

2.  I will keep my food journal up to date.

B.  Weight and Weighing Goals

1.  I will not weigh myself.

2.  I will work on maintaining my weight.

C.  Exercise Goals

1.  I will go to yoga class instead of running three times a week.

2.  I will take a rest day where I do no exercise.

D.  Behavior Goals

1.  I will write in my journal if I feel like bingeing or purging.

2.  I will write a healthy self versus eating disorder self dialogue at least three times this week.

F.  Relationship/Family Goals

1.  I will ask a friend to have diner with me one night this week.

2.  I will call someone if I feel like bingeing or purging.