Please answer the questions below as accurately as you can:
1. Do you worry about your weight, shape or appearance more than other people? Yes/No
2. Do you avoid eating certain foods because of your weight, shape or appearance? Yes/No
3. Do you often restrict your food or embark upon diets? Yes/No
4. Do you believe your weight, shape and appearance are an important aspect of your identity? Yes/No
5. Are you fearful of gaining weight ? Yes/No
6. Do you often feel out of control around food and eating? Yes/No
7. Do you regularly eat what you or others think is a large quantity of food in one sitting? Yes/No
8. Do you regularly eat until feeling uncomfortable full? Yes/No
9. Do you engage in secretive eating behaviours or hide your food? Yes/No
10. Do you often feel fat? Yes/No
11. Do you feel guilty or depressed after eating ? Yes/No
12. Do you ever make yourself vomit after eating? Yes/No
13. Do you use insulin in way not prescribed to manage your weight? Yes/No
14. Do you take any medications or supplements to compensate for eating or to give yourself permission to eat? Yes/No
15. Do you use exercise to compensate for eating or to give yourself permission to eat? Yes/No
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