Question 1

I have eating habits that are different from those of my family and friends.

1- Often
2- Sometimes
3- Rarely
4- Never

Question 2

I find myself panicking if I cannot exercise as I had planned, for fear of gaining weight.

1- Almost always
2- Sometimes
3- Rarely
4- Never

Question 3

My friends tell me I am thin but I don’t believe them because I feel fat.

1- Often
2- Sometimes
3- Rarely
4- Never

Question 4

[Females only] My menstrual period has ceased or become irregular due to no known medical reasons.

1- True
2- False

Question 5

I have become obsessed with food to the point that I cannot go through a day without worrying about what I will or will not eat.

1- Often
2- Sometimes
3- Rarely
4- Never

Question 6

I have lost more than 15 percent of the normal weight for my height.

1- True
2- False

Question 7

I would panic if I got on the scale tomorrow and found out I had gained two pounds.

1- Almost always
2- Sometimes
3- Rarely
4- Never

Question 8

I find that I prefer to eat alone or when I am sure no one will see me, which means I make excuses so I can eat less and less with friends.

1- Often
2- Sometimes
3- Rarely
4- Never

Question 9

I find myself going on uncomfortable eating binges where I consume large amounts of food to the point that I feel sick and make myself vomit.

1- 3 or more times per day
2- 1-2 times per day
3- 1-2 times per week
4- Rarely
5- Never

Question 10

I use laxatives as a means of weight control.

1- On a regular basis
2- Sometimes
3- Rarely
4- Never

Question 11

I find myself playing games with food (e.g. cutting it up into pieces, hiding food so people will think I have eaten it, chewing it and spitting it out without swallowing), telling myself certain foods are bad.

1- Often
2- Sometimes
3- Rarely
4- Never

Question 12

People around me have become very interested in what I eat and I find myself getting angry at them for pushing food on me.

1- Often
2- Sometimes
3- Rarely
4- Never

Question 13

Recently I have felt more depressed and irritable than I used to and/or have been spending increasing amounts of time alone.

1- True
2- False

Question 14

I keep a lot of my fears about food and eating to myself because I am afraid no one would understand.

1- Often
2- Sometimes
3- Rarely
4- Never

Question 15

I enjoy making gourmet, high-calorie meals or treats for others as long as I don’t have to eat any myself.

1- Often
2- Sometimes
3- Rarely
4- Never

Question 16

The most powerful fear in my life is the fear of gaining weight or becoming fat.

1- Often
2- Sometimes
3- Rarely
4- Never

Question 17

I find myself totally absorbed when reading books about dieting, exercising and calorie counting to the point that I spend hours studying them.

1- Often
2- Sometimes
3- Rarely
4- Never

Question 18

I tend to be a perfectionist and am not satisfied with myself unless I do things perfectly.

1- Often
2- Sometimes
3- Rarely
4- Never

Question 19

I go through long periods of time without eating anything (fasting) as a means of weight control.

1- Often
2- Sometimes
3- Rarely
4- Never

Question 20

It is important to me to try to be thinner than all of my friends.

1- Almost always
2- Sometimes
3- Rarely
4- Never