COUNSELING CENTER
Self-Help Information
"The supreme happiness of life is the conviction that one is loved; loved for oneself, or better yet, loved despite oneself."
- Victor Hugo
Do You Have and Eating Disorder?
The following questionnaire will give you an indication of whether or not you are living a lifestyle that indicates anorexic and/or bulimic tendencies. Answer the following questions honestly. Write the number of your answer in the space at the left.
____1. I have eating habits that are different from those of my family and friends.
1) Often 2) Sometimes 3) Rarely 4) Never
____2. I find myself panicking if I cannot exercise as I had planned for fear of gaining weight.
1) Often 2) Sometimes 3) Rarely 4) Never
____3. My friends tell me I am thin but I don't believe them because I feel fat.
1) Often 2) Sometimes 3) Rarely 4) Never
____4. (Females) My menstrual period has ceased or become irregular due to no known
medical reasons.
1) True 2) False
____5. I have become obsessed with food to the point that I cannot go through a day without worrying about what I will or will not eat.
1) Often 2) Sometimes 3) Rarely 4) Never
____6. I have lost more than 15 percent of the normal weight for my height (e.g., 30 lbs. from 120 lbs.)
1) True 2)False
____7. I would panic if I got on the scale tomorrow and found out I had gained two pounds.
1) Often 2) Sometimes 3) Rarely 4) Never
____8. I find that I prefer to eat alone or when I am sure no one will see me, thus I am making excuses so I can eat less and less with friends.
1) Often 2) Sometimes 3) Rarely 4) Never
____9. I find myself going on uncontrollable eating binges during which I consume large amounts of food to the point that I feel sick and make myself vomit.
1) 3 or more times a day 2) 1-2 times per day 3) 1-2 times per week 4)Rarely 5) Never
____10. I use laxatives as a means of weight control.
1) Almost always 2) Sometimes 3) Rarely 4) Never
____11. I find myself playing games with food (e.g. cutting it up into tiny pieces, hiding food so
people will think I ate it, chewing it and spitting it out without swallowing) and telling myself certain foods are bad.
1) Often 2) Sometimes 3) Rarely 4) Never
____12. People around me have become very interest in what I eat and I find myself getting angry at them for pushing food on me.
1) Often 2) Sometimes 3) Rarely 4) Never
____13. I have felt more depressed and irritable recently than I used to and/or have been spending increasing amounts of time alone.
1) True 2) False
____14. I keep a lot of my fears about food and eating to myself because I am afraid no one would understand.
1) Often 2) Sometimes 3) Rarely 4) Never
____15. I enjoy making gourmet, high-calorie meals or treats for others as long as I don't have to eat any myself.
1) Often 2) Sometimes 3) Rarely 4) Never
____16. The most powerful fear in my life is the fear of gaining weight or becoming fat.
1) Often 2) Sometimes 3) Rarely 4) Never
____17. I find myself totally absorbed when reading books about dieting, exercising, and calorie counting to the point that I spend hours studying them.
1) Often 2) Sometimes 3) Rarely 4) Never
____18. I tend to be a perfectionist and am not satisfied with myself unless I do things perfectly.
1) Almost always 2) Sometimes 3) Rarely 4) Never
____19. I go through long periods of time without eating anything (fasting) as a means of weight control.
1) Often 2) Sometimes 3) Rarely 4) Never
____20. It is important to me to try to be thinner than all of my friends.
1) Almost always 2) Sometimes 3) Rarely 4) Never
|
Courtesy of Center For Change, Orem, Utah
