We should like to know how you have been feeling about your appearance over the PAST FOUR WEEKS. Please read each question and circle the appropriate number to the right. Please answer all the questions.

		Never
		|	Rarely
		|	|	Sometimes
		|	|	|	Often
		|	|	|	|	Very often
		|	|	|	|	|	Always
		|	|	|	|	|	|
1.	Have you been afraid that you might become fat (or fatter)?..................	1	2	3	4	5	6
2.	Has feeling full (e.g. after eating a large meal) made you feel fat?.........	1	2	3	4	5	6
3.	Has thinking about your shape interfered with your ability to concentrate (e.g. while watching television, reading, listening to conversations)?........................................................................................	1	2	3	4	5	6
4.	Have you imagined cutting off fleshy areas of your body?....................	1	2	3	4	5	6
5.	Have you felt excessively large and rounded?........................................	1	2	3	4	5	6
6.	Have you thought that you are in the shape you are because you lack self-control?.............................................................................................	1	2	3	4	5	6
7.	Has seeing your reflection (e.g. in a mirror or shop window) made you feel bad about your shape?......................................................................	1	2	3	4	5	6
8.	Have you been particularly self-conscious about your shape when in the company of other people?.................................................................	1	2	3	4	5	6