What is your age?
* must provide value
What is your gender?
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Female Male
What is your ethnicity? (Please select all that apply.)
* must provide value
American Indian or Alaskan Native
Asian or Pacific Islander
Black or African American
Hispanic or Latino
White/Caucasian
Prefer not to answer
Other
What is your height in feet and inches?
For example, if you are 5 feet and 4 inches, write 5'4".
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What is your current weight in pounds?
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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.
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True False
I usually eat too much at social occasions, like parties and picnics.
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True False
Sometimes things just taste so good that I keep on eating even when I am no longer hungry.
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True False
When I feel anxious, I find myself eating.
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True False
Life is too short to worry about dieting.
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True False
When I am with someone who is overeating, I usually overeat too.
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True False
Sometimes when I start eating, I just can't seem to stop.
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True False
When I feel sad, I often overeat.
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True False
I enjoy eating too much to spoil it by counting calories or watching my weight.
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True False
When I see a real delicacy, I often get so hungry that I have to eat right away.
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True False
When I feel lonely, I console myself by eating.
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True False
I eat anything I want, any time I want.
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True False
While on a diet, if I eat a food that is not allowed, I often then splurge and eat other high calorie foods.
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True False
I go on eating binges even though I am not hungry.
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True False
When I walk past a snack bar or café, I have the desire to buy something delicious.
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True False
I find it difficult to resist eating delicious foods.
* must provide value
True False