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Question
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Almost Never
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Sometimes
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Often
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Very Often
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| 1: My child eats excessively more food than what most children their age would eat at least once a week or more |
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| 2: My child is unable to restrain themselves from eating and struggles to control what, when and how much they eat |
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| 3: My child eats until they cannot eat any more |
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| 4: My child eats their food noticeably faster than other children their age |
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| 5: My child eats large amounts of food even when they are not physically hungry |
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| 6: My child is only able to stop eating once they feel uncomfortably full, ill or nauseous |
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| 7: My child tries to hide how much they eat from people or waits to eat when they are alone |
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| 8: My child seems embarrassed, upset, ashamed or guilty with what and how much they eat |
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| 9: My child seems distressed when they overeat and worries about the effects overeating could have on their body shape or weight |
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| 10: My child seems anxious, depressed or disgusted about their body weight, shape and the amount of food that they eat |
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| 11: My child tries to control their appetite or lose weight from overeating more than once a week, such as by self-induced vomiting, fasting, exercising excessively, or consuming laxatives, diuretics or other weight-loss drugs |
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| 12: My child’s eating patterns or weight interferes with their relationships, functioning at home or school, or with their ability to feel good about themselves |
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