RH54_Summer_2018

Real Health Body Image Survey
Dissatisfaction with one’s body image is a common problem in the United States, and it can trigger a host of mental health problems, including depression, anxiety, anger and self-hate. It can also interfere with the development of healthy relationships with others. Please take the survey below and let us know how you feel about your body.

As a thank-you, one winner selected at random from among the completed surveys will receive a yoga DVD (suggested retail price $11.98). Visit realhealthmag.com/surveys/rules for the official contest rules.
1) Are you satisfied with your current weight?

YesNo
2) Do you compare the way you look to the way others look?

YesNo
3) Do you become frustrated/depressed if you're unable to find clothes that fit?

YesNo
4) Do you feel pressure to look a certain way?

YesNo
5) Do you feel insecure about your appearance?

YesNo
6) Have concerns about how you look ever stopped you from attending social events?

YesNo
7) Do you think other people find you attractive?

YesNo
8) Do you believe there's such a thing as the perfect body?

YesNo
9) Do you find yourself frequently judging other people by their appearance?

YesNo
10) What year were you born?
11) What is your gender?

MaleFemaleTransgenderOther
12) What is your household income?

Under $15,000$15,000–$34,999$35,000–$49,999$50,000–$74,999$75,000–$99,999$100,000 and over
13) What is the highest level of education attained?

Some high schoolHigh school graduateSome collegeBachelor’s degree or higher
14) What is your ethnicity? (Check all that apply.)

American Indian or Alaska NativeArab or Middle EasternAsianBlack or African AmericanHispanic or LatinoNative Hawaiian or other Pacific IslanderWhiteOther
15) Where do you get Real Health?

I’m a subscriberMy doctor’s officeMy churchA community or college organizationIt was mailed to meOther
Full Name

First NameLast Name
Organization (if you represent one):
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
E-mail
Phone Number

Area CodePhone Number
Enter the message as it's shown*
Should be Empty:

Real Health Body Image Survey