Your eating and body image

PAGE ONE QUESTIONS FOR REPORT

These questions are about your eating and body image over the last few weeks

DO I HAVE A PROBLEM?

These questions are about your eating and body image over the last few weeks
DIETING AND EATING RESTRICTION BEHAVIOURS
I have been trying to limit the amount of food I eat to influence my weight, shape, or size	Never Rarely Sometimes Most or all of the time
I have hardly eaten anything at all for periods of time (e.g., fasted or skipped meals), to influence my weight, shape or size	Never Rarely Sometimes Most or all of the time
I have tried to exclude (e.g., not eat) foods that I like in order to influence my weight, shape, or size	Never Rarely Sometimes Most or all of the time
I have followed strict food rules or dieting plans that dictate what, when, and/or how much to eat to influence my weight, shape, or size	Never Rarely Sometimes Most or all of the time
EATING BEHAVIOURS
I have eaten really large amounts of food in one go (what others would think is unusually large)	Never Rarely Sometimes Most or all of the time
I feel totally unable to control my urges to eat. I have a fear of not being able to stop eating voluntarily	Not at all true for me Somewhat true for me Mostly true for me Very true for me
I have eaten really large amounts of food in one go (unusually large) and felt that I could not stop eating or control what or how much I was eating	Never Rarely Sometimes Most or all of the time
THOUGHTS ABOUT EATING
I feel like food, eating, and/or trying to control my eating rules my life	Not at all true for me Somewhat true for me Mostly true for me Very true for me
Controlling what, and how much I eat is very important for how I think and feel about myself as a person	Not at all true for me Somewhat true for me Mostly true for me Very true for me
I have strong feelings of guilt during or after eating	Never Rarely Sometimes Most or all of the time
BODY IMAGE
I am dissatisfied with my weight, shape, or size	Not at all true for me Somewhat true for me Mostly true for me Very true for me
I wish I were thinner/smaller	Not at all true for me Somewhat true for me Mostly true for me Very true for me
I wish I were more muscular	Not at all true for me Somewhat true for me Mostly true for me Very true for me
THOUGHTS ABOUT BODY IMAGE
My weight, body shape, or size is very important for how I think and feel about myself as a person	Not at all true for me Somewhat true for me Mostly true for me Very true for me
I am afraid of gaining weight or becoming fat	Not at all true for me Somewhat true for me Mostly true for me Very true for me
I am afraid of losing weight or becoming thin	Not at all true for me Somewhat true for me Mostly true for me Very true for me
Thinking about the weight, shape, or muscularity of my body stops me from concentrating	Never Rarely Sometimes Most or all of the time
To be in control of my life, I need to control my weight, shape, or size	Not at all true for me Somewhat true for me Mostly true for me Very true for me
BEHAVIOURS TO CONTROL WEIGHT, SHAPE, AND BODY SIZE
I have tried to control my weight, shape, or size by making myself sick (vomit)	Never Rarely Sometimes Most or all of the time
I have tried to control my weight, shape, or size by using laxatives and/or diuretics	Never Rarely Sometimes Most or all of the time
I have tried to control or change my weight, shape, or size by using pills or supplements (i.e., protein powders, meal replacements)	Never Rarely Sometimes Most or all of the time
I exercise specifically to improve my body shape or size and/or to try to control my weight	Not at all true for me Somewhat true for me Mostly true for me Very true for me
I feel extremely guilty if I miss an exercise session	Not at all true for me Somewhat true for me Mostly true for me Very true for me
I continued to exercise despite illness or injury, or if exercise interfered with important activities	Not at all true for me Somewhat true for me Mostly true for me Very true for me
I have tried to control or change my shape, or size by using anabolic steroids	Never Once but more than ten years aga Sometimes Most or all of the time

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