Questions:

1. Yes No Do you only eat when you are hungry and stop when you are satisfied?
2. Yes no Do you feel you have an unhealthy diet?
3. Yes no Does your mood, good or bad, cause you to eat?
4. Yes no Can you leave food on your plate?
5. Yes no Do certain situations or events trigger you to eat?
6. Yes no Do you feel guilty when you eat?
7. Yes no Do you constantly think about food?
8. Yes no Do you become physically uncomfortable after eating?
9. Yes no Do you feel in control around food?
10. Yes no Do you eat without thinking?
11. Yes no Do you reward yourself with food?
12. Yes no Do you ever skip meals to control your weight?