Session 2

Session 2 of cognitive behaviour therapy (CBT) for binge-eating disorder (BED) is mainly dedicated to reviewing and reinforcing real-time monitoring, and introducing regular eating. From Session 2 onwards, the former primarily focuses on the content of monitoring, which helps both the patient and therapist increase their understanding of the maintenance processes acting in the patient’s eating disorder, and amend or update their personalized formulation. Regular eating is concerned with the patient’s eating patterns, i.e., when they eat rather than what or how much, and has two components: (i) eating at regular intervals throughout the day, i.e., three planned meals and two snacks, and (ii) not eating between planned meals and snacks. The procedure, if well done, rapidly reduces the frequency of binge-eating episodes and, thanks to it, at the end of Step One, most patients report only “residual” binge-eating episodes to be addressed during Step Two. To facilitate the implementation of regular eating, the patient should be advised to plan three meals and two snacks, and self-monitor eating in real time, and taught how to use the “things to say and do” procedure to cope with the urge to deviate from the eating plan, reduce food stimuli, and get back on track after a slip-up.