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About Us
Important Things To Know
Our Clinical Team
Our Support Team
Mission Vision Values
Our Environment
Careers
Assessments
Adults
Children
Teens
Psychotherapy
Adults
Teens
Children
Workshops
New Clients
Our Promise to You
Quick 1st Appointment
Our Clinical Approach
What to Expect
Virtual Services
Fees + Coverage
FAQs
Resources
Videos
Articles
Infographics
Questionnaire
Contact
Disordered Eating/Eating Disorders Questionnaire
Answer each question, then click submit to see your results.
Adult Disordered Eating Mini-Questionnaire
Not wanting to eat in fear of gaining weight
*
Not at all / Never
A little bit / Slightly
Somewhat / Moderate
Quite a bit / Often
Extremely
Gained weight recently
*
Not at all / Never
A little bit / Slightly
Somewhat / Moderate
Quite a bit / Often
Extremely
Lost weight recently
*
Not at all / Never
A little bit / Slightly
Somewhat / Moderate
Quite a bit / Often
Extremely
Crave/eat carbohydrates when I feel sad
*
Not at all / Never
A little bit / Slightly
Somewhat / Moderate
Quite a bit / Often
Extremely
Skip meals
*
Not at all / Never
A little bit / Slightly
Somewhat / Moderate
Quite a bit / Often
Extremely
Warned by others about my weight
*
Not at all / Never
A little bit / Slightly
Somewhat / Moderate
Quite a bit / Often
Extremely
Binge eating (i.e., eating large amounts of food in a 2-hour sitting)
*
Not at all / Never
A little bit / Slightly
Somewhat / Moderate
Quite a bit / Often
Extremely
Throw up or use diuretics/laxatives after eating
*
Not at all / Never
A little bit / Slightly
Somewhat / Moderate
Quite a bit / Often
Extremely
Fasting consistently for prolonged periods of time
*
Not at all / Never
A little bit / Slightly
Somewhat / Moderate
Quite a bit / Often
Extremely
Obsess about my appearance
*
Not at all / Never
A little bit / Slightly
Somewhat / Moderate
Quite a bit / Often
Extremely
Dislike the way I look
*
Not at all / Never
A little bit / Slightly
Somewhat / Moderate
Quite a bit / Often
Extremely
Eating when I am sad/angry/stressed
*
Not at all / Never
A little bit / Slightly
Somewhat / Moderate
Quite a bit / Often
Extremely
Feeling out of control when I eat
*
Not at all / Never
A little bit / Slightly
Somewhat / Moderate
Quite a bit / Often
Extremely
Feeling guilty/ashamed after eating
*
Not at all / Never
A little bit / Slightly
Somewhat / Moderate
Quite a bit / Often
Extremely
Hide/store food in strange places
*
Not at all / Never
A little bit / Slightly
Somewhat / Moderate
Quite a bit / Often
Extremely
Feelings of distress before, during, or after eating
*
Not at all / Never
A little bit / Slightly
Somewhat / Moderate
Quite a bit / Often
Extremely
Eating large amounts of food when you don’t feel hungry
*
Not at all / Never
A little bit / Slightly
Somewhat / Moderate
Quite a bit / Often
Extremely
Eating alone due to of feelings of embarrassment about by how you are eating
*
Not at all / Never
A little bit / Slightly
Somewhat / Moderate
Quite a bit / Often
Extremely
Low self-worth
*
Not at all / Never
A little bit / Slightly
Somewhat / Moderate
Quite a bit / Often
Extremely
Strict food rituals (e.g., number of times to chew; not allowing different to touch, etc.)
*
Not at all / Never
A little bit / Slightly
Somewhat / Moderate
Quite a bit / Often
Extremely
Frequently looking in the mirror for perceived flaws in appearance
*
Not at all / Never
A little bit / Slightly
Somewhat / Moderate
Quite a bit / Often
Extremely
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