Assess Your Triggers: Uncover Why Healthy Eating is a Struggle!
No one but you will see this. Take your time to answer in your most private honest self.
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First Name
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Over the last 2 weeks, name how often have you been bothered by and of the following problems?
Rows
Not at all-0
Rarely
Sometimes
Often
All the time
1. I Eat Fast
2. I Eat When I Am Stressed
3. I Eat While Standing
4. I Eat In the Car
5. I Eat In Front of the TV
6. I Eat With a Phone or Other Device Near Me
7. I Eat at Night
8. I Eat Sweets When I am Stressed
9. I Eat More When I Drink Alcohol
10. I Eat More When I Am Out
11. I Hide My Eating
12. I Sometimes Forget What I Just Ate
13. I Eat Carbs When I Am Stressed
14. If I Have Something I Shouldn't I Tend To Go Off the Rails For the Rest of the Day
15. When I Am Out, I Tend to Eat Differently
16. I Eat Out Of a Bag
17. I Eat More Sweets When I Am Alone
18. I Binge
19. I Judge Food as Good or Bad
20. I Feel Guilty When I Eat Something on My Bad List
21. I Think of Food All the Time
22. I Worry About my Weight All the Time
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