Take the following survey to see how you rate on your relationship with food.

  Yes   No       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 week, 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-developments?

  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?

Scoring
     Add up all the "No" responses to the odd-numbered questions. Give one point for each "No" and put that number in the box to the left.
     Add up all the "Yes" responses to the even-numbered questions. Give one point for each "Yes" and put that number in the box to the left.

     Total of both of the above numbers.

Interpretation*
This survey is designed to help you reflect on your relationship with food. "Normal" eating is flexible. It varies in response to emotion, daily activities, hunger and proximity to food.

Scores between 0 and 3. These scores generally indicate a healthy attitude toward food and eating.

Scores between 4 and 8. These scores suggest that cultural pressures about appearance and ideas about how much and what kinds of foods to eat may be negatively affecting self-acceptance and overall happiness. Exploring these issues may be helpful.

Scores between 9 and 12. These scores suggest serious issues with food, ranging from food obsession to an eating disorder. These issues could be interfering with daily life and may negatively affect overall health. Professional assistance is recommended to deal with thoughts, feelings, and behaviors related to food and body image. Medical evaluation and intervention may also be needed to address health concerns.

*Note: The "Healthy Relationship with Food" Inventory can only give results based on the limited number of questions asked in the inventory. It cannot account for the truthfulness of the answers, only for the self-reporting of each participant. The interpretations given are for informational and educational purposes only, and do not constitute or substitute for any psychological and medical evaluations performed buy a qualified professional, nor for any psychological or medical treatment. if psychological or medical evaluation and treatment are indicated, immediately consult a qualified professional.

For more information about eating disorder, treatment, and professional resources, please call The Renfrew Center at 1-800-RENFREW or visit their website at www.renfrew.org.

Source: The Renfrew Center, 2001