Screening Questionnaire

Question 1 *

1. I never (or almost never) eat so much food that I feel uncomfortably stuffed afterwards.

2. I occasionally eat a large amount of food and end up feeling very stuffed.

3. I frequently eat large amounts of food, either at mealtime or at snacks.

Question 2 *

1. I feel capable of controlling my eating urges when I want to.

2. I feel like I have failed to control my eating more than the average person.

3. I feel utterly helpless when it comes to feeling in control of my eating urges.

Question 3 *

1. I don’t feel any guilt or self-hate after I overeat.

2. After I overeat, occasionally I feel guilt or self-hate.

3. Almost all the time I experience strong guilt or self-hate after I overeat.

Question 4 *

1. When I am dieting, I don’t lose total control of my eating even after an episode of over-eating.

2. Sometimes when I eat a “forbidden food” on a diet, I feel like I “blew it” and eat even more.

3. Frequently, I have the habit of saying to myself, “I’ve blown it now, why not go all the way” when I overeat on a diet. When that happens I eat even more.

4. I have a regular habit of starting strict diets for myself, but I break the diets by going on an eating binge. My life seems to be either a “feast” or “famine.”

Question 5 *

1. I usually am able to stop eating when I want to. I know when “enough is enough.”

2. Every so often, I experience a compulsion to eat which I can’t seem to control.

3. Frequently, I experience strong urges to eat which I seem unable to control, but at other times I can control my eating urges.

4. I feel incapable of controlling urges to eat. I have a fear of not being able to stop eating voluntarily.

Question 6 *

1. I don’t think much about trying to control unwanted eating urges.

2. At least some of the time, I feel my thoughts are pre-occupied with trying to control my eating urges.

3. I feel that frequently I spend a lot of time thinking about how much I ate or about trying not to eat anymore.

4. It seems to me that most of my waking hours are pre-occupied by thoughts about eating or not eating. I feel like I’m constantly struggling not to eat.