I used diet pills, laxatives, metabolism-boosting pills, or other weight loss aid

I am very aware of my intake of fats, carbohydrates, or calories

My body weight has drastically changed (decreased or increased) recently

My mood improves when I feel in control of my weight and/or eating

I feel guilty when I eat

There are certain foods I avoid

I hide food or lie to others about how much I actually eat

I sometimes feel unable to stop eating once I start

There are some things I hate about my shape or size of my body

I use food as a comfort or an escape from my problems

I often skip meals on purpose

My eating and/or exercise impacts my day to day activities

I feel guilty when I do not exercise

I have a great deal of difficulty identifying what I am feeling

I spend a great deal of time planning meals/thinking about food

I avoid social situations because I am ashamed of my eating/weight

I worry about gaining weight

I sometimes vomit to control my weight

Once I reach my goal weight, I believe I'll feel good about myself

I find it difficult to cope with my emotions

I feel out of control around food

The way I feel about my body stops me from going out in public

I often feel anxious around food

I follow rules about how/when/what to eat