Eating Disorder Awareness How much more or less do you feel you worry about your weight and body shape than other people your age? I WORRY A LOT LESS THAN OTHER PEOPLE I WORRY A LITTLE LESS THAN OTHER PEOPLE I WORRY ABOUT THE SAME AS OTHER PEOPLE I WORRY A LITTLE MORE THAN OTHER PEOPLE I WORRY A LOT MORE THAN OTHER PEOPLE How afraid are you of gaining 3 pounds? NOT AFRAID OF GAINING SLIGHTLY AFRAID OF GAINING MODERATELY AFRAID OF GAINING VERY AFRAID OF GAINING TERRIFIED OF GAINING When was the last time you went on a diet? I HAVE NEVER BEEN ON A DIET I WAS ON A DIET ABOUT ONE YEAR AGO I WAS ON A DIET ABOUT 6 MONTHS AGO I WAS ON A DIET ABOUT 3 MONTHS AGO I WAS ON A DIET ABOUT 1 MONTH AGO I WAS ON A DIET LESS THAN 1 MONTH AGO I’M ON A DIET NOW Compared to other things in your life, how important is your weight to you? MY WEIGHT IS NOT IMPORTANT COMPARED TO OTHER THINGS IN MY LIFE MY WEIGHT IS A LITTLE MORE IMPORTANT THAN SOME OTHER THINGS IN MY LIFE MY WEIGHT IS MORE IMPORTANT THAN MOST, BUT NOT ALL, THINGS IN MY LIFE MY WEIGHT IS THE MOST IMPORTANT THING IN MY LIFE Do you ever feel fat? NEVER RARELY SOMETIMES OFTEN ALWAYS Do you consume a small amount of food (i.e., less than 1200 calories/day) on a regular basis to influence your shape or weight? Yes No Do you struggle with a lack of interest in eating or food? Yes No Do you avoid certain or many foods because of such features as texture, consistency, temperature, or smell, or have other people suggested this may be the case for you? Yes No Do you avoid certain or many foods because of fear of experiencing negative consequences like choking or vomiting, or have other people suggested this may be the case for you? Yes No Have you experienced significant weight loss (or are at a low weight for your age and height) but are not overly concerned with the size or shape of your body? Yes No Are you currently in treatment for an eating disorder? Yes No NOT CURRENTLY, BUT I HAVE BEEN IN THE PAST First namePhoneEmail ResultsVote
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