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Eating Assessment Test (EAT) - 26 - v2

Page One

Please fill out this form as honestly and completely as possible. There are no right or wrong answers. Only your clinician will see the results and will discuss them with you., Thank you!
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Gender *This question is required.
Whole numbers only (no decimals or fractions) This question requires a valid number format.
Whole numbers only (no decimals or fractions) This question requires a valid number format.
Whole numbers only (no decimals or fractions) This question requires a valid number format.
Whole numbers only (no decimals or fractions) This question requires a valid number format.
Whole numbers only (no decimals or fractions) This question requires a valid number format.
Whole numbers only (no decimals or fractions) This question requires a valid number format.
1. I am terrified about being overweight. *This question is required.
2. I avoid eating when I am hungry. *This question is required.
3. I find myself preoccupied with food. *This question is required.
4. I have gone on eating binges where I feel that I may not be able to stop. *This question is required.
5. I cut my food into small pieces. *This question is required.
6. I am aware of the calorie content of foods that I eat. *This question is required.
7. I particularly avoid food with a high carbohydrate content (ie, bread, rice, potatoes, etcetera). *This question is required.
8. I feel that others would prefer if I ate more. *This question is required.
9. I vomit after I have eaten. *This question is required.
10. I feel extremely guilty after eating. *This question is required.
11. I am preoccupied with a desire to be thinner. *This question is required.
12. I think about burning up calories when I exercise. *This question is required.
13. Other people think that I am too thin. *This question is required.
14. I am preoccupied with the thought of having fat on my body. *This question is required.
15. I take longer than others to eat my meals. *This question is required.
16. I avoid foods with sugar in them. *This question is required.
17. I eat diet foods. *This question is required.
18. I feel that food controls my life. *This question is required.
19. I display self-control around food. *This question is required.
20. I feel that others pressure me to eat. *This question is required.
21. I give too much time and thought to food. *This question is required.
22. I feel uncomfortable after eating sweets. *This question is required.
23. I engage in dieting behavior. *This question is required.
24. I like my stomach to be empty. *This question is required.
25. I have the Impulse to vomit after meals. *This question is required.
26. I enjoy trying new rich foods. *This question is required.
27. In the past six months have you gone on eating binges where you feel that you may not be able to stop?
28. In the past six months have you ever made yourself sick (vomited) to control your weight or shape?
29. In the past six months have you ever used laxatives, diet pills or diuretics (water pills) to control your weight or shape?
30. In the past six months have you exercised more than 60 minutes a day to lose or to control your weight?
31. Have you lost more than twenty pounds in the last six months?
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