1. I tend to overeat only certain types of food.

• Yes
• No

2. Once I have a bite of certain foods my eating may go out of control.

• Yes
• No

3. I sometimes worry that I won't get enough to eat or I might never stop eating.

• Yes
• No

4. Sometimes the only way to make cravings go away is to eat whatever I'm thinking about.

• Yes
• No

5. I have gone to unusual lengths to get the food I'm craving.

• Yes
• No

6. I overeat when I'm feeling anger, depression, fatigue, or looking forward to comfort or reward.

• Yes
• No

7. Many days I head straight for the refrigerator when I get home from the day's activities.

• Yes
• No

8. I've noticed I eat when I'm bored.

• Yes
• No

9. For no reason I sometimes find that I am extremely hungry.

• Yes
• No

10. I am uncomfortable expressing or sharing my feelings.

• Yes
• No

11. I would like to be a more confident person.

• Yes
• No

12. After I lose weight and receive positive attention I start regaining the weight.

• Yes
• No

13. I want to lose weight to please people who are important in my life.

• Yes
• No

14. I'm reaching the point where I'm afraid that I will never lose the excess weight.

• Yes
• No

15. I feel bad about my weight which makes me feel like a failure.

• Yes
• No