EATING SELF-REGULATION SCALE

EATING AND WEIGHT CONTROL STRATEGIES SCALE

This test takes approximately 20 minutes.
Please try to answer the questions as accurately as possible. This will ensure that the data we are collecting and the feedback you'll be getting are as accurate as possible.
Questions 1-19 are meant to give us an idea of who you are and what your experience with weight control has been.
Questions 20-69 represent our Eating and Weight Control Strategies Scale.
Please provide us with your comments and suggestions about this test, as well as your e-mail address (only if you want our feedback concerning your score), before you submit your answers.

Background Infomation

1. Are you Male or Female?

Female
Male

2. What is your age? years.

3. Nationality (country of birth):

4. Country, province/state, and city where you live:

Weight & Diet History

5. What is your weight in pounds? lbs.

6. What is your height in inches? (Write 69 if you are 5'9") in.

7. Are you currently on a diet?

Yes
No (Go to question 9)

8. If yes, specify the kind of a diet you are currently on, and then go to question 11.

9. If you are not currently on a diet, do you intend to go on one?

Yes
No

10. If yes, what kind of a diet do you intend to go on?

11. What was your weight (in pounds) one month ago? lbs.

12. What was your weight (in pounds) six months ago? lbs.

13. What was your weight (in pounds) twelve months ago? lbs.

14. What is the maximum you have ever weighed (in pounds)? lbs.

15. How many diets have you previously been on?

16. What is the largest amount of weight you have lost while on a diet? lbs.

17. At what age did your weight problem begin? years.

18. How much would you like to weigh? lbs.

19. How much weight would you like to lose in the coming month?

EATING AND WEIGHT CONTROL STRATEGIES SCALE

DURING THE PAST TWO WEEKS, how often did you do each of the following?

20. Stopped eating before I was completely full.
Never
Sometimes
Often
Most of the time

21. Selected the healthiest food choices available in the situation.
Never
Sometimes
Often
Most of the time

22. Planned my meals ahead of time.
Never
Sometimes
Often
Most of the time

23. Cooked my own meals.
Never
Sometimes
Often
Most of the time

24. Counted calories as a way of controlling my eating.
Never
Sometimes
Often
Most of the time

25. Tried to eat a good balance of types of foods.
Never
Sometimes
Often
Most of the time

26. Overate because the food was very tasty.
Never
Sometimes
Often
Most of the time

27. Skipped breakfast because I was not hungry.
Never
Sometimes
Often
Most of the time

28. Ate a "light" meal because I had eaten too much earlier in the day.
Never
Sometimes
Often
Most of the time

29. Had an idea about the number of calories I wanted to eat for the day.
Never
Sometimes
Often
Most of the time

30. Felt neither too full nor too hungry after meals.
Never
Sometimes
Often
Most of the time

31. Ate whatever I felt like, with little thought about health or diet considerations.
Never
Sometimes
Often
Most of the time

32. Intentionally overate because I had a desire to feel very full.
Never
Sometimes
Often
Most of the time

33. Overate because I was socializing.
Never
Sometimes
Often
Most of the time

34. Avoided "healthy" foods because they taste bad.
Never
Sometimes
Often
Most of the time

35. Ate home cooked meals.
Never
Sometimes
Often
Most of the time

36. Overate because I was tired.
Never
Sometimes
Often
Most of the time

37. Overate because I missed a meal.
Never
Sometimes
Often
Most of the time

38. Kept eating even though I was full.
Never
Sometimes
Often
Most of the time

39. Ate "fast food" because it was easier than cooking.
Never
Sometimes
Often
Most of the time

40. Made sure I ate at least 2 servings of fruit per day.
Never
Sometimes
Often
Most of the time

41. Overate because I was happy.
Never
Sometimes
Often
Most of the time

42. Avoided eating high fat and fried foods.
Never
Sometimes
Often
Most of the time

43. Ate a lot in the evening because I was still hungry after supper.
Never
Sometimes
Often
Most of the time

44. Ate 3 meals per day.
Never
Sometimes
Often
Most of the time

45. Ate while watching TV.
Never
Sometimes
Often
Most of the time

46. Overate because I was sad.
Never
Sometimes
Often
Most of the time

47. Overate because I was angry.
Never
Sometimes
Often
Most of the time

48. Ate faster than other people.
Never
Sometimes
Often
Most of the time

49. Chose water instead of soft drinks.
Never
Sometimes
Often
Most of the time

50. Chose small portions.
Never
Sometimes
Often
Most of the time

51. Overate because I was anxious.
Never
Sometimes
Often
Most of the time

52. Overate because I was eating with others.
Never
Sometimes
Often
Most of the time

53. Overate because I was stressed.
Never
Sometimes
Often
Most of the time

54. Ate whatever food was fastest to prepare.
Never
Sometimes
Often
Most of the time

55. Ate dessert if it was available.
Never
Sometimes
Often
Most of the time

56. Tried to keep my overall sugar intake down.
Never
Sometimes
Often
Most of the time

57. Made sure I ate at least 2 servings of vegetables or salad per day.
Never
Sometimes
Often
Most of the time

58. Overate because I was disappointed in someone.
Never
Sometimes
Often
Most of the time

59. Overate because I was in a restaurant.
Never
Sometimes
Often
Most of the time

60. Ate slowly.
Never
Sometimes
Often
Most of the time

61. Overate because there was a lot of good food to eat.
Never
Sometimes
Often
Most of the time

62. Ate sweet snacks (or drinks) between meals.
Never
Sometimes
Often
Most of the time

63. Overate because I was at a party.
Never
Sometimes
Often
Most of the time

64. Overate because I was eating alone.
Never
Sometimes
Often
Most of the time

65. Ate a lot even though I wasn't really hungry.
Never
Sometimes
Often
Most of the time

66. Ate during the night when my sleep was interrupted.
Never
Sometimes
Often
Most of the time

67. Overate because I wanted to relax.
Never
Sometimes
Often
Most of the time

68. Overate because I was disappointed in myself.
Never
Sometimes
Often
Most of the time

69. Tried to eat plenty of fruits and vegetables.
Never
Sometimes
Often
Most of the time

Comments & Feedback

Please provide us with your comments and/or suggestions regarding this survey.

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