A patient diagnosed with bulimia nervosa has been receiving cognitive behavior therapy (CBT) at the eating disorders clinic. Which of the following patient actions indicates to the nurse that the patient is making progress toward using adaptive eating behaviors?

Choice A reason: Verbalizing the importance of nutrition shows cognitive understanding but does not necessarily reflect behavioral change. Insight alone is not sufficient to indicate progress in CBT. Choice B reason: Weight gain may occur for various reasons and does not confirm that the patient is using adaptive eating behaviors. It could result from bingeing or fluid retention rather than healthy eating patterns. Choice C reason: Taking medications as prescribed is important but is not a direct indicator of progress in CBT, which focuses on identifying and modifying maladaptive thoughts and behaviors. Choice D reason: Identifying feelings associated with the urge to binge is a core goal of CBT. It reflects increased self-awareness and the ability to recognize emotional triggers, which is essential for developing healthier coping strategies.