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Eating Disorder Free Guide
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Eating Attitudes Test (EAT-26)
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Post-Workshop Questionnaire
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Eating Attitudes Test (EAT-26)
Eating Attitudes Test (EAT-26)
Instructions:
This is a screening measure to help you determine whether you might have an eating disorder that needs professional attention. This screening measure is not designed to make a diagnoses of an eating disorder or to take the place of professional consultation. Please fill out the below form accurately, honestly and completely as possible. There are no right or wrong answers. All of your responses are confidential.
Name
*
First Name
Last Name
Email
*
Part A : Complete the following questions
Birth Date
*
Date Format: MM slash DD slash YYYY
Gender
*
Male
Female
Height (in cm)
*
Current Weight (in kg)
*
Highest Weight (excluding pregnancy)
*
Lowest Adult Weight
*
Ideal Weight
*
Part B: Check a response for each of the following statements:
Am terrified about being overweight
*
Always
Usually
Often
Sometimes
Rarely
Never
Avoid eating when I am hungry
*
Always
Usually
Often
Sometimes
Rarely
Never
Find myself preoccupied with food
*
Always
Usually
Often
Sometimes
Rarely
Never
Have gone on eating binges where I feel that I may not be able to stop
*
Always
Usually
Often
Sometimes
Rarely
Never
Cut my food into small pieces
*
Always
Usually
Often
Sometimes
Rarely
Never
Aware of the calorie content of foods that I eat
*
Always
Usually
Often
Sometimes
Rarely
Never
Particularly avoid food with a high carbohydrate content (i.e. bread, rice, potatoes, etc.)
*
Always
Usually
Often
Sometimes
Rarely
Never
Feel that others would prefer if I ate more
*
Always
Usually
Often
Sometimes
Rarely
Never
Vomit after I have eaten
*
Always
Usually
Often
Sometimes
Rarely
Never
Feel extremely guilty after eating
*
Always
Usually
Often
Sometimes
Rarely
Never
Am preoccupied with a desire to be thinner
*
Always
Usually
Often
Sometimes
Rarely
Never
Think about burning up calories when I exercise
*
Always
Usually
Often
Sometimes
Rarely
Never
Other people think that I am too thin
*
Always
Usually
Often
Sometimes
Rarely
Never
Am preoccupied with the thought of having fat in my body
*
Always
Usually
Often
Sometimes
Rarely
Never
Take longer than others to eat my meals
*
Always
Usually
Often
Sometimes
Rarely
Never
Avoid foods with sugar in them
*
Always
Usually
Often
Sometimes
Rarely
Never
Eat diet foods
*
Always
Usually
Often
Sometimes
Rarely
Never
Feel that food controls my life
*
Always
Usually
Often
Sometimes
Rarely
Never
Display self-control around food
*
Always
Usually
Often
Sometimes
Rarely
Never
Feel that others pressure me to eat
*
Always
Usually
Often
Sometimes
Rarely
Never
Give too much time and thought to food
*
Always
Usually
Often
Sometimes
Rarely
Never
Feel uncomfortable after eating sweets
*
Always
Usually
Often
Sometimes
Rarely
Never
Engage in dieting behavior
*
Always
Usually
Often
Sometimes
Rarely
Never
Like my stomach to be empty
*
Always
Usually
Often
Sometimes
Rarely
Never
Have the impulse to vomit after meals
*
Always
Usually
Often
Sometimes
Rarely
Never
Enjoy trying new rich foods
*
Always
Usually
Often
Sometimes
Rarely
Never
Part C: Behavioral Questions: In the past 6 months have you:
Gone on eating binges where you feel that you may not be able to stop
*
Never
Once a month or less
2-3 times a month
Once a week
2-6 times a week
Once a day or more
Defined as eating much more than most people would under the same circumstances and feeling that eating is out of control
Ever made yourself sick (vomited) to control your weight or shape?
*
Never
Once a month or less
2-3 times a month
Once a week
2-6 times a week
Once a day or more
Ever used laxatives, diet pills or diuretics (water pills) to control your weight or shape?
*
Never
Once a month or less
2-3 times a month
Once a week
2-6 times a week
Once a day or more
Exercised more than 60 minutes a day to lose or to control your weight?
*
Never
Once a month or less
2-3 times a month
Once a week
2-6 times a week
Once a day or more
Lost 9 kg or more in the past 6 months?
*
Yes
No
Total Point:
Email
This field is for validation purposes and should be left unchanged.
contact me
You can reach me by
phone or whatsapp on
+961 3 52 66 37
by email at:
melissarizk@hotmail.com