February 18, 2020 Comment: 0 Quizzes Step 1 of 3 - Part 1 33% What is your age?*Please enter a value between 16 and 150.Your Gender*FemaleMaleOther1. Have you had the desire for a totally flat stomach?Not at allJust a littleSomewhatModeratelyQuite a lotAlmost every dayAll the time2. Have you felt fat?Not at allJust a littleSomewhatModeratelyQuite a lotAlmost every dayAll the time3. Has your shape or weight influenced how you think or judge yourself?Not at allJust a littleSomewhatModeratelyQuite a lotAlmost every dayAll the time4. Have you gone for long periods of time (8 waking hours or more) without eating anything at all in order to influence your shape or weight?Not at allJust a littleSomewhatModeratelyQuite a lotAlmost every dayAll the time5. How often do you feel uncomfortable seeing your body (e.g., seeing yourself in the mirror, a window reflection, etc.)?Not at allJust a littleSomewhatModeratelyQuite a lotAlmost every dayAll the time6. Have you had a definite fear of losing control over eating?Not at allJust a littleSomewhatModeratelyQuite a lotAlmost every dayAll the time7. How often do you eat in secret (not counting binge-eating episodes)?Not at allJust a littleSomewhatModeratelyQuite a lotAlmost every dayAll the time8. How dissatisfied have you been with your weight or body shape?Not at allJust a littleSomewhatModeratelyQuite a lotAlmost every dayAll the time9. Have you been deliberately trying to limit the amount of food you eat to influence your shape or weight (whether or not you have succeeded)?Not at allJust a littleSomewhatModeratelyQuite a lotAlmost every dayAll the time10. Have you had a desire to have an empty stomach with the aim of influencing your weight or shape?Not at allJust a littleSomewhatModeratelyQuite a lotAlmost every dayAll the time 11. How concerned have you been about other people seeing you eat?Not at allJust a littleSomewhatModeratelyQuite a lotAlmost every dayAll the time12. How often do you feel uncomfortable about others seeing your shape or figure (e.g., at the gym, in a locker room, while swimming, etc.)?Not at allJust a littleSomewhatModeratelyQuite a lotAlmost every dayAll the time13. Have you tried to exclude from your diet any foods that you like in order to influence your weight or shape (whether or not you’ve succeeded)?Not at allJust a littleSomewhatModeratelyQuite a lotAlmost every dayAll the time14. Have you had a definite fear that you might gain weight?Not at allJust a littleSomewhatModeratelyQuite a lotAlmost every dayAll the time15. Have you tried to follow definite rules regarding your eating (e.g., a calorie limit) in order to influence your shape or weight?Not at allJust a littleSomewhatModeratelyQuite a lotAlmost every dayAll the time16. Have you eaten and then felt guilty because of its impact on your shape or weight? Not at all Just a little Somewhat Moderately Quite a lot Almost every day All the timeNot at allJust a littleSomewhatModeratelyQuite a lotAlmost every dayAll the time17. Has thinking about your shape or weight made it very difficult to concentrate on things you are interested in (e.g., working, following a conversation, reading, etc.)?Not at allJust a littleSomewhatModeratelyQuite a lotAlmost every dayAll the time18. How much would it have upset you if you had been asked to weigh yourself once a week for the next 4 weeks?Not at allJust a littleSomewhatModeratelyQuite a lotAlmost every dayAll the time19. Have you had a strong desire to lose weight?Not at allJust a littleSomewhatModeratelyQuite a lotAlmost every dayAll the time20. Has thinking about food, eating, or calories made it very difficult to concentrate on things you are interested in (e.g., working, following a conversation, reading, etc.)?Not at allJust a littleSomewhatModeratelyQuite a lotAlmost every dayAll the time Test ResultPlease enter your personal information to receive the test results.Your Name* First Last Your Email* This iframe contains the logic required to handle Ajax powered Gravity Forms.
