1. Do you ever feel fat, even though people say that you are thin?
2. Has your shape or weight influenced how you think or judge yourself?
3. Have you gone for long periods of time (8 waking hours or more) without eating anything at all in order to influence your shape or weight?
4. Do you feel uncomfortable seeing your body (e.g., seeing yourself in the mirror, a window reflection, etc.)?
5. Have you deliberately tried to limit the amount of food you eat to influence your shape or weight (whether or not you have succeeded)?
6. Have you tried to control your weight by vomiting or taking laxatives?
7. Do you ever lie to others about what you eat?
8. Do you feel guilty when you eat?
9. Do you ever have eating binges?
10. Do you have unusual eating rituals or habits (e.g. using special utensils, making patterns on the plate, hiding food or spitting it out before swallowing?
11. Do you get anxious or depressed when you gain weight?
12. Do your eating habits interfere with friendships or romantic relationships?
13. If you are female, are your menstrual periods irregular or absent, or if you are male has your sex drive decreased?