Is My Relationship With Food Problematic? Self-Check by Sana Psychological.

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Have your eating habits become extremely controlled and/or feel like they are out of control?* This field is required.

YESNO

2

Have you been told by others that they are concerned about your eating habits?* This field is required.

YESNO

3

Do you feel like your relationship with food has become more impulsive or compulsive?* This field is required.

YESNO

4

Do you notice that you spend time throughout most days thinking about, planning, and/or preparing food beyond what feels acceptable?* This field is required.

YESNO

5

Do you find yourself feeling quite worried about weight and appearance?* This field is required.

YESNO

6

Do you engage in behaviours like overeating, purging (e.g., vomiting), daily weighing, and/or using exercise or medications to help compensate for food eaten?* This field is required.

YESNO

7

Do you feel like your relationship with food, weight, and/or body is unmanageable and taking over your life?* This field is required.

YESNO

8

Do you feel like your self-worth is dependent on your weight and/or body shape?* This field is required.

YESNO

9

Have you been trying to adjust your eating behaviours and find that you can’t?* This field is required.

YESNO

10

Do you hide eating, feelings about self/body, exercise, research, or other aspects of your relationship with food and/or body?* This field is required.

YESNO

11

Do you experience guilt, shame, fear, and/or financial stress after eating?* This field is required.

YESNO

12

Have you noticed that you are doing less of the things that you enjoy recently and are more focused on food, diets, eating, weight, and/or body?* This field is required.

YESNO

13

Does your relationship with food feel like a way to cope with and/or escape your emotions, stress and pain?* This field is required.

YESNO

14

What is your email? We'll send you more info.* This field is required.This is not a substitute for professional assessment or diagnosis. You may receive recommendations & free resources from Sana Psyc; you are free to unsubscribe at any time.

example@example.com

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Calculation

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Sorry :( This form is only availble in Canada

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