What's Your Relationship with Food and with Your Body?

I feel out of control with my eating _____
I dislike my body _____
I am always trying to control my weight _____
I often binge eat and then try to get rid of calories _____
I skip meals to control my weight _____
I am secretive about my eating _____
I get anxious when I don't exercise _____
Others say I have lost a lot of weight in a short period of time _____
My menstrual periods are irregular or have stopped completely _____
I am scared of weight gain _____
Sometimes I vomit after eating _____
I use diet pills, laxatives or other substances to control my weight _____
I believe I am overweight even though others tell me I am not _____
I don't deserve to eat and feel guilty if I do _____
I isolate myself from others because of the way I look or because food may be involved _____


If you have checked 3 or more, e-mail Avalon or call 1-866-814-0999 to speak directly with a clinician.

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