Please answer each question Do you have a regular eating pattern?
Do you feel a failure if you break your diet once?
Do you count the calories of everything you eat, even when not on a diet?
Do you ever fast for a whole day?
If yes, how often is this?
Do you do any of the following to help you lose weight? (a) Take diet pills; (b) Take diuretics (water tablets); (c) Take laxatives; (d) Make yourself vomit
Does your pattern of eating severely disrupt your life?
Would you say that food dominates your life?
Do you ever eat and eat until you are stopped by physical discomfort?
Are there times when all you think about is food?
Do you eat sensibly in front of others and make up in private?
Can you always stop eating when you want to?
Do you experience overpowering urges to eat and eat and eat?
When you are feeling anxious do you tend to eat a lot?
Does the thought of becoming fat terrify you?
Do you ever eat large amounts of food rapidly (not a meal)?
Are you ashamed of your eating habits?
Do you worry that you have no control over how much you eat?
Do you turn to food for comfort?
Are you able to leave food on the plate at the end of a meal?
Do you deceive other people about how much you eat?
Does how hungry you feel determine how much you eat?
Do you ever binge on large amounts of food?
If yes, do such binges leave you feeling miserable?
If you do binge, is this only when you are alone?
If you do binge, how often is this?
Would you go to great lengths to satisfy an urge to binge?
If you overeat, do you ever feel very guilty?
Do you ever eat in secret?
Are your eating habits what you would consider to be normal?
Would you consider yourself to be a compulsive eater?
Does your weight fluctuate by more than 5 pounds in a week?
If you are human, leave this field blank.
