For Parents and loved ones

Questionnaire
   


BACA Questionnaire

Answer Yes or No to the following questions:

Do you or someone you know:
Yes No : Constantly think about food, weight, or body image?
Yes No : Fear gaining weight immensely?
Yes No : Become anxious prior or after eating?
Yes No : Feel guilty after eating?
Yes No : Go through long periods of time without eating, or eating very little?
 
Yes No : Feel ashamed of eating in front of others?
Yes No : Feel badly about weight or physical appearance?
Yes No : Get on the scale several times a day to weigh self?
Yes No : Cut food in tiny peices or hide food?
Yes No : Exercise excessively?
Yes No : Vomit after meals?
Yes No : Use laxatives or diuretics in the hope of preventing weight gain?
 
Yes No : Eat large amounts of food rapidly without being able to stop?
Yes No : Eat when lonely, sad or depressed?
Yes No : Believe food controls your life?
Yes No : Have dizzy spells unrelated to another medical condition?

Have you or someone you know:

Yes No : Lost or gained a considerable amount of weight in a brief period of time?
 
Yes No : Stopped having menstrual periods for at least 3 months?
Yes No : Been confronted with a "weight problem" by friends or family?
 
If you or someone you know answered Yes to any of the previous questions, further evaluation is essential. Eating disorders are progressive conditions. The faster a person gets help, the faster they will free themselves of weight related issues.



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