- Choose only ONE response per question.
- Don't spend too long on any one question.
- Your first reaction is typically the most accurate.
- There are no right or wrong answers.
- Answer all questions. Do not leave any blank!
Part A
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Part B |
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1. I feel my weight is out of my control. |
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2. I reward myself with food. |
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3. There are more advantages to being overweight than not being overweight. |
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4. The thought of having to diet the rest of my life makes me angry. |
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5. If I make up my mind to lose weight, I know I can do it. |
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6. Losing weight is really not that important to me. |
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7. One must follow a diet to the letter in order to be successful. |
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8. There comes a point in dieting when I become so uncomfortable that I return to my old eating habits. |
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9. Stress is the cause of my weight problem. |
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10. I refuse to diet forever. |
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11. I believe it is possible at some unconscious level I might benefit not losing weight. |
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12. I like being overweight. |
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13. Dieting means never being able to eat the things you like. |
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14. If things in my life were going better, I would not be overweight. |
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15. It is my intention to change my eating habits forever. |
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16. I must resolve to never eat "goodies" again in order to be successful losing weight. |
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17. If I eat something that is not on my diet I consider myself off the diet. |
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18. I think there are sometimes good reasons for remaining overweight. |
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19. Dieting\weight loss is just too painful. |
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20. I will probably control my weight by dieting periodically rather than trying to change the way I eat forever. |
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21. I believe I can lose weight and keep it off. |
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22. When something bad happens to me, I find I often eat to feel better. |
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23. Others people's ability to deal with the discomfort of losing weight is better than mine. |
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24. I plan to change the way I eat permanently. |
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25. I am not sure I really want to lose this excess weight. |
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26. The problem with losing weight is dieting is just too uncomfortable for me. |
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27. I find I eat when I am upset. |
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28. I don't really believe I will ever reach my weight goal. |
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29. The thought of dieting the rest of my life is unacceptable to me. |
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30. My diets have failed in the past because once I go off them, I don't go back on them.
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31. I am under a lot of stress. |
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32. Those closest to me are supportive when I have been trying to lose weight. |
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33. The desire in me to overeat is stronger than the desire to diet. |
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34. In order to be successful at weight control, I must change my eating habits for the rest of my life. |
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35. Once I cheat on a diet, the diet is really over for me. |
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36. I don't have the willpower it takes to lose weight and keep it off. |
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37. There is one part of me that wants to lose weight and another part of me that refuses. |
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38. I find I do well on a diet until I run into that one temptation that I don't refuse. |
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39. I overeat as a result of stress in my life. |
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40. There are advantages to being overweight. |
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Optional: We would appreciate it if you would take a moment to answer the following questions: |
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Where did you first hear about The NBH weight Loss Center? |
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How did you find the The NBH weight Loss Center web site? (If you found this web site by using a search engine or another web site, please specify which one) |
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