1- (__) I think I am fat, even when friends, family or health professionals say I am not.

2- (__) I avoid foods which I think have fat in them almost entirely or are repulsed by them.

3- (__) I eat much more slowly and/or much less than others eat.

4- (__) I have lost my period or my interest in sex.

5- (__) I feel like I am in control when I am fasting or restricting food intake.

6- (__) I almost never eat anything without estimating how many calories I am eating

7- (__) I assume that being very thin is an important value in life. The thinner the better.

8- (__) I have tried to eat more food to sustain a healthy weight and have been unable to continue doing so.

9- (__) I think that being too thin is not as bad as being too fat.

10- (__) I have gotten light headed or weak from not eating or restricting my food.

Write down how many items apply in this section _____

11- (__) I see myself as someone who binges and purges food.

12- (__) I have increased the number of times I purge by vomiting.

13- (__) I used diuretics to try to control my weight.

14- (__) I exercise hard more than an hour a day to control weight and feel deprived or guilty when I don't.

15- (__) I am almost always on a diet.

16- (__) I used laxatives to get rid of food when I was not constipated.

17- (__) I have tried to stop purging and have been unable to stay stopped.

18- (__) I don’t tell my parents, friends or health professionals how much I binge or purge.

19- (__) I am obsessed with thinking that my body needs to be different or better.

20- (__) I admit that I have caused myself some physical harm by purging and I still do it.

Write down how many items apply in this section _____

21- (__) I eat when I am not hungry.

22- (__) I sometimes eat much faster and/or much more than others eat.

23- (__) I isolate from others so that I can eat the way want.

24- (__) I graze or snack frequently between meals.

25- (__) I sometimes think I will eat moderately and then eat much more than I expected to eat.

26- (__) I use food to numb difficult feelings.

27- (__) I have tried to stop bingeing and been unable to stay sstopped.

28- (__) I am obsessive in the way I think about food.

29- (__) I think weight causes me serious physical and social problems and

30- (__) I still overeat.

31- (__) I can overeat on almost any food.

Write down how many items apply in this section _____