I need help

Questionnaire

Click to answer and double-click if you changed your mind.

1. I think that people who are thinner than me are happier and have a better life?
2. I am becoming more and more preoccupied with my physical appearance and with my weight?
3. I often compare myself to others and their bodies?
4. I often weigh myself?
5. I am extremely afraid of getting fat?
6. I have difficulty maintaining an appropriate weight for my age, sex, and height?
7. I have seen my weight change drastically in last few months?
8. I keep track of the amount of calories and fat in the food that I eat?
9. There are certain types of food (like dairy products, meat, and candy) that I don’t eat anymore in order to lose weight?
10. It happens that I eat very large quantities of food in a very short period of time?
11. I feel guilty after eating?
12. It happens that I eat in secrecy or lie when asked about what I have eaten?
13. I am very afraid that I am not able to control my weight or that I will lose control when I eat?
14. I exercise excessively and if I would not be able to do it one day, I would be very frustrated?
15. I exercise even if I am hurt or sick?
16. I don’t have my period anymore? Or, my period is very irregular and it has happened that I have gone months without having it?
17. I have sudden mood swings. I especially feel emotional, irritable, depressive or anxious?
18. I don’t want to eat with my family?
19. I isolate myself more and more and I spend less and less time with my friends and family?
20. My friends and family often tell me that I should stop restricting my food intake to lose weight?
21. I am often cold, tired, or feel dizzy?
22. I have noticed that I am losing my hair?

If you have more than one orange mark, this might imply that you are preoccupied with your body and food intake. We encourage you to look at our services and to talk to someone that you trust.

Inspired from : ANEB Quebec, 2000

Adapted by: Champagne et Hasan, 2002