Targeting Childhood to Prevent Adult Obesity

What is your age?

What is your gender?

What is your ethnicity? (Please select all that apply.)

What is your height in feet and inches?
For example, if you are 5 feet and 4 inches, write 5'4".

What is your current weight in pounds?

When I smell a sizzling steak or see a juicy piece of meat, I find it very difficult to keep from eating, even if I have just finished a meal.

I usually eat too much at social occasions, like parties and picnics.

Sometimes things just taste so good that I keep on eating even when I am no longer hungry.

When I feel anxious, I find myself eating.

Life is too short to worry about dieting.

When I am with someone who is overeating, I usually overeat too.

Sometimes when I start eating, I just can't seem to stop.

When I feel sad, I often overeat.

I enjoy eating too much to spoil it by counting calories or watching my weight.

When I see a real delicacy, I often get so hungry that I have to eat right away.

When I feel lonely, I console myself by eating.

I eat anything I want, any time I want.

While on a diet, if I eat a food that is not allowed, I often then splurge and eat other high calorie foods.

I go on eating binges even though I am not hungry.

When I walk past a snack bar or café, I have the desire to buy something delicious.

I find it difficult to resist eating delicious foods.