1. Can you eat when you are hungry and quit when you are satisfied?
   yes no

2. Do you stop eating because you think you should (as opposed to because your body is satisfied)?
   yes no

3. Do you make food choices based on foods you enjoy?
   yes no

4. Do you become physically uncomfortable (such as weak, tired, dizzy, a headache) when you under-eat or diet?
   yes no

5. Do you feel that your food selections are a combination of "healthy foods" and "pleasurable foods"?
   yes no

6. Do you have to eat in a certain pattern -- always three meals a day or always at a certain time of the day?
   yes no

7. Do you trust that if you eat when you are hungry and stop when you are satisfied, you will not get fat?
   yes no

8. Do you feel guilty when you eat to the point that you are stuffed and uncomfortable?
   yes no

9. Can you balance the time you give to thoughts about food, weight and dieting with other important aspects of your life, such as relationships, work and self-development?
   yes no

10. Do you watch what other people eat and use that to determine what and how much you will eat?
    yes no

11. Can you leave some cookies on the plate because you know you can have some again tomorrow?
    yes no

12. Do you usually pick foods based on their calorie content?
    yes no

This screening test was developed by The Renfrew Center to assist individuals in determining their relationship with food. For more information about eating disorder treatment and professional resources, please visit The Renfrew Center web site at www.renfrew.org or call 1-800-RENFREW.