Eating Disorder Screening

Check the appropriate response for each of the following statements.

Please use the mouse to move from one question to the next. Do not use the 'Enter' key or the form will be submitted prematurely.

Am terrified about being overweight.
Always
Usually
Often
Sometimes
Never

Avoid eating when I'm hungry.
Always
Usually
Often
Sometimes
Never

Find myself preoccupied with food.
Always
Usually
Often
Sometimes
Never

Have gone on eating binges where I feel that I may not be able to stop.
Always
Usually
Often
Sometimes
Never

Cut my food into small pieces.
Always
Usually
Often
Sometimes
Never

Aware of the calorie content of the foods that I eat.
Always
Usually
Often
Sometimes
Never

Particularly avoid food with a high carbohydrate content (e.g., bread, rice, potatoes, etc.)
Always
Usually
Often
Sometimes
Never

Feel that others would prefer if I ate more.
Always
Usually
Often
Sometimes
Never

Vomit after I eat.
Always
Usually
Often
Sometimes
Never

Feel extremely guilty after eating.
Always
Usually
Often
Sometimes
Never

Am preoccupied with a desire to be thinner.
Always
Usually
Often
Sometimes
Never

Think about burning up calories when I exercise.
Always
Usually
Often
Sometimes
Never

Other people think I'm too thin.
Always
Usually
Often
Sometimes
Never

Am preoccupied with the thought of having fat on my body.
Always
Usually
Often
Sometimes
Never

Take longer than others to eat my meals.
Always
Usually
Often
Sometimes
Never

Avoid foods with sugar in them.
Always
Usually
Often
Sometimes
Never

Eat diet foods.
Always
Usually
Often
Sometimes
Never

Feel that food controls my life.
Always
Usually
Often
Sometimes
Never

Display self control around food.
Always
Usually
Often
Sometimes
Never

Feel that others pressure me to eat.
Always
Usually
Often
Sometimes
Never

Give too much time and thought to food.
Always
Usually
Often
Sometimes
Never

Feel uncomfortable after eating sweets.
Always
Usually
Often
Sometimes
Never

Engage in dieting behavior.
Always
Usually
Often
Sometimes
Never

Like my stomach to be empty.
Always
Usually
Often
Sometimes
Never

Have the impulse to vomit after meals.
Always
Usually
Often
Sometimes
Never

Enjoy trying rich new foods.
Always
Usually
Often
Sometimes
Never

The test results will be returned to you as a web page immediately after you submit the test.

The results WILL NOT be saved, e-mailed, or in any way be available to, or read by, anyone.

Click the "Finish" button to proceed to the results page.

Finish

Note: This is only a screening instrument and should not be used as the sole determinant of a problem. It is recommended that a complete evaluation, using other instruments, be used and interpreted by a qualified professional.

Rimrock Foundation | 1231 North 29th Street | Billings, MT 59101
(800) 227-3953 | (406) 248-3175