What Is Your Relationship With Food? 1. I find that when I start eating certain foods, I end up eating much more than planned* Yes No 2. I tend to eat even when I am not hungry* Yes No 3. I don’t find myself overeating often ( I eat normal portion sizes for meals/snacks)* Yes No 4. I feel like I am constantly thinking about food* Yes No 5. I eat a balanced diet (5 veggies, 2 fruit, protein and carbs with every meal)* Yes No 6. I really want to cut down or stop some of my eating behaviours and just can’t stop* Yes No 7. I rarely eat junk food* Yes No 8. I find myself attempting diet plans but find that I just can’t stick to them* Yes No 9. I eat large quantities of food, very quickly until I feel sick (binge)* Yes No 10. I tend to have periods of eating a lot (overeating/bingeing) followed by periods of not eating a lot or restricting my food intake* Yes No 11. I feel as though my weight and body negatively affects my thoughts and feelings* Yes No 12. I tend to have cravings in the afternoon and evening* Yes No 13. I eat differently in private than I do in front of others* Yes No 14. I eat in secret* Yes No 15. I only eat when I am hungry* Yes No 16. I find that I will go out of my way to obtain certain foods e.g. drive somewhere* Yes No 17. I eat certain foods to dampen or prevent certain feeling or physical sensations e.g.* Yes No 18. I eat regularly spaced meals, during the day starting from breakfast (at least 3 meals per day or 3 meals and 2 snacks)* Yes No 19. Food and/or my weight controls my social life (I avoid situations and invitations)* Yes No 20. At times I feel guilt, shame, self-loathing, depression etc. about what I have eaten* Yes No 21. I count calories (or similar) and this influences my exercise routines, what I eat during the day and how I feel* Yes No 22. I have had physical withdrawal symptoms such as agitation and anxiety when I cut down on certain foods. (Do NOT include caffeinated drinks: coffee, tea, cola, energy drinks, etc.)* Yes No 23. I could write the ‘Diet Books’ but yet I feel so confused about what to do - what to eat, when to eat etc.!* Yes No 24. I really struggle to identify physical hunger from emotional hunger* Yes No 25. My food and eating behaviour causes me significant distress* Yes No CAPTCHAEmailThis field is for validation purposes and should be left unchanged.