AllCare Behavioral Health Services, Inc.

March 10, 2010
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Eating Disorders Self Assessment

Instructions: Please answer the following questions regarding eating disorder. Then, click on the submit button below the questionnaire to see your AllCare eating depression score.

1) I feel embarrassed about my body shape when I wear a bathing suit in public.

Never Sometimes Frequently

2) I go on crash diets to lose weight in order to fit into a smaller size than what I usually wear.

Never Sometimes Frequently

3) I am judgmental of other people's weight.

Never Sometimes Frequently

4) I make myself vomit after a meal.

Never Sometimes Frequently

5) I eat on my own before dining with others so it seems as if I have a small appetite.

Never Sometimes Frequently

6) I feel guilty about the kinds of foods I eat.

Never Sometimes Frequently

7) I make excuses or lie about my eating habits.<

Never Sometimes Frequently

8) I get upset when I look at myself in a full length mirror.

Never Sometimes Frequently

9) I am afraid of being fat.

Never Sometimes Frequently

10) I compare my body to super-models and movie stars' bodies and I feel unattractive.

Never Sometimes Frequently

11) I eat large amounts of foods in a short period of time.

Never Sometimes Frequently

12) I associate some activities with eating, for example watching T.V. and snacking.

Never Sometimes Frequently

13) I begin new restrictive diets.

Never Sometimes Frequently

14) I reward myself with food.

Never Sometimes Frequently

15) I feel unable to control how much I eat.

Never Sometimes Frequently

16) How much I weigh on a certain day determines how I feel about myself.

Never Sometimes Frequently

17) I cancel attending events that I've been anticipating because I am ashamed of my weight.

Never Sometimes Frequently

18) I limit what I eat to just few kinds of foods in an effort to lose weight.

Never Sometimes Frequently

19) I turn to my favorite comfort foods when I am feeling disappointed, anxious, or stressed.

Never Sometimes Frequently

20) My friends tell me I look great, but when I look in the mirror my body size is all wrong.

Never Sometimes Frequently

21) I keep secret stashes of food.

Never Sometimes Frequently

22) I eat small amounts of food in front of others, and over-eat as soon as I'm left alone.

Never Sometimes Frequently

23) I use diuretics or laxatives in an effort to control my weight.

Never Sometimes Frequently

24) I lie when asked for whom I am buying certain foods.

Never Sometimes Frequently