Adapted from Cooper (2009) and Fairburn (2013) To overcome BN or BED, one must give up the idea of dieting. ELIMINATING DIETING GUIDELINES - GENERAL Do not attempt to deal with dieting until a regular eating plan has been established and it has had a significant impact on normalising eating habits (this could take anywhere between a couple of weeks to a few months). Ask for assistance to determine how much food is required as this may be difficult to identify if fasting or restricting has been a habit for a long time. Remember, this should be a rough guide rather than an exact formula. It is important to gradually reintroduce foods that have been avoided, so that ultimately a rational choice can be made about whether to eat it or not. If these foods continue to be avoided, then when they are consumed, they will more likely lead to a binge. ELIMINATING DIETING GUIDELINES - SPECIFIC Draw up a list of foods that have been avoided either because they were “too fattening” or they often triggered binges. Having a look around the supermarket can help to fill up this list. Organise the list into a specific hierarchy, with the items which present the least difficulty (i.e. the least threatening), down to those that are most difficult. Divide the hierarchy into three groups of difficulty: minor, moderate, and extreme. Beginning with foods which present the least difficulty, incorporate one of these items into the meal plan every second or third day. Plan this for a time that is particularly safe, for example, when you are eating with a friend and it would be impossible to then purchase additional food. Stick with foods from the ‘minor difficulty’ group until all the foods are able to be eaten without difficulty & the foods are no longer identified as being avoided. Then move to the ‘moderate difficulty’ group & repeat this process. Roughly decide on how often these foods should be eaten and in what quantity – remember not to avoid. REVIEWING THE PLAN Remember to proceed with caution, and not move onto foods that are too challenging before feeling ready. Step 5: Eliminating Dieting Systematically widening the range of foods you eat before moving to Step 6... - Make any changes necessary to eat an adequate amount of food - Identify feared foods and start to systematically reintroduce these to meal plan - Practiced managing a range of difficult situations for eating - Able to eat in a controlled way, in reasonable quantities, enjoyed foods Helping people to overcome Bulimia Nervosa and Binge-Eating Disorder using Cognitive Behavioural Techniques