Maintenance Preparation Module

The final part of Step Two in cognitive behaviour therapy (CBT) for binge-eating disorder (BED) consists of three appointments, each separated by a 2-week interval. While the session structure remains constant, the focus gradually shifts towards future-oriented goals, of which there are three. The first is assessing progress made and the residual features to address. This involves reviewing any perceived positive changes in physical and psychosocial well-being associated with binge management (and weight in those who have undertaken weight loss), and jointly assessing which eating disorder features remain to be tackled during the maintenance. The second goal of maintenance preparation is to identify programme procedures to phase out (e.g., using the monitoring records and in-session collaborative weighing), and those that should be continued (e.g., regular eating, weekly weighing at home, proactive problem-solving, binge-eating analyses, daily step counts). The third goal is to introduce specific procedures to prevent relapse and ensure weight maintenance. This is achieved by collaboratively constructing a long-term maintenance plan, which should contain personalized advice on which residual feature of BED and weight maintenance (if indicated) to address and, at the same time, how to minimize the risk of relapse (e.g., reminders on how to deal with triggers and setbacks).