For Healthcare Professionals
Please answer the questions below honestly.
Does your patient worry about their weight and body shape more than other people?
Does your patient avoid certain foods for reasons other than allergies or religious reasons?
Is your patient often on a diet?
Does your patient feel that their weight is an important aspect of their identity?
Is your patient fearful of gaining weight?
Does your patient often feel out of control when they eat?
Does your patient regularly eat what others may consider to be a large quantity of food at one time?
Does your patient regularly eat until feeling uncomfortably full?
Does your patient hide what they eat from others, or eat in secret?
Does your patient often feel fat?
Does your patient feel guilty or depressed after eating?
Does your patient ever make themselves vomit (throw up) after eating?
Does your patient use their insulin in ways not prescribed to manage their weight?
Does your patient take any medication or supplements to compensate for eating or to give themself permission to eat?
Does your patient exercise for the sole purpose of weight control?
Have people expressed concern about your patient’s relationship with food or their body?
