2 minutes
The survey is open to anyone who lives with an eating disorder, or who has recovered from an eating disorder.
Full Name
Age
Gender
Phone Number
Email Address
Do you believe that you are overweight, even if you are not?
Do you feel the need to diet or control your eating in some way?
Do you feel guilty or ashamed after eating?
Do you feel like you need to exercise excessively to make up for what you have eaten?
Do you restrict certain foods or food groups from your diet?
Do you binge eat, or eat large amounts of food in a short period of time?
Do you purge after eating, either through vomiting, use of laxatives or diuretics, or excessive exercise?
Do you feel like your eating habits are impacting your quality of life?