4 = extremely or always
3 = very much or often
2 = moderately or sometimes
1 = rarely or slightly
0 = not at all or never

1. Does your body size or shape disturb you?

2. Are you afraid of getting fat, regardless of your weight?

3. Do you think about food when not at meals?

4. Do you eat even when you are not hungry?

5. Do you ever avoid going out because you feel too fat?

6. Do you fear situations where food may be present?

7. Do you skip meals to lose weight?

8. Do you weigh yourself more than once a day?

9. How often do you go on diets?

10. If you go on a diet, do you choose extreme or fad diets which are difficult to follow?

11. Is your eating out of control? For example: If you eat one item from the box, you feel compelled to eat all the items in the box. You wake up in the middle of the night to eat.You eat too much to the point of feeling sick.

12. Do you ever feel that your dieting is out of control? For example:
You find it difficult to permit yourself not to be on a diet and you don't allow yourself to eat anything that is not a diet food.

13. Is your exercising ever out of control? For example:If you don't exercise when you "are supposed to," then you put yourself down.You exercise to lose weight more than one hour a day. You exercise as punishment for "being bad" with food.

14. Do you ever "put yourself down," feel depressed or guilty after you eat?

15. Do your feelings about yourself depend on what you have or have not eaten? For example:If you eat "good foods," diet foods, you feel worthwhile.
If you eat the "wrong foods," then you feel unworthy.

16. Do you have obsessive thoughts after you eat such as:"I shouldn't have eaten that!" or "How many calories did I just eat? I'll skip dinner."

17. Do you have obsessive thoughts about your body, such as:
"If only I lost 10 pounds, my life would be wonderful?"
"I hate her for being thinner than I am!"

18. Do you ever eat massive amounts of food at one time (binge)?

19. Do you hide food or eat food in secret places so you won't be discovered?

20. Have you attempted to control your weight by harmful and drastic measures such as: vomiting, spitting out food, diet pills, use of laxatives, diuretics (water pills), enemas, vigorous exercise, fasting or other drastic means?

TOTAL SCORE*

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* If you scored approximately 20 (twenty) points and above, it's possible that you may have an Eating Obsession which could significantly affect your emotional well-being or potentially lead to a more severe Eating Disorder.

You may wish to talk to a friend, family member or other helping person about this problem.

© 1991 PHYLISS SHANKEN, M.A.

INTROSPECT of BuxMont
2321 North Broad Street
Colmar, Pennsylvania 18915
(215) 997-3600

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