1. Do you find yourself obsessing over your body?
Yes No
2. Do you hold off on certain activities because of the way you view your body?
Yes No
3. Would losing and/or gaining weight make you feel better about yourself?
Yes No
4. When you eat, do you sometimes feel guilty?
Yes No
5. Are you comfortable in your body?
Yes No
6. Do you think negatively about your body?
Yes No
7. Do you think changing parts of your body would make your life better, and how you view yourself?
Yes No
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