Please enter your identifier number:
What is your age?
What age did you experience the onset of anorexia nervosa?
What is your occupation?
Highest education
If you selected Other, please specify:
First half of postcode
What age did you move out of the family home?
What words would you best describe your family?
What is the problem/challenge that brought you to this group?
Please input the minimal normal weight you are referring to in Kg:
Please input the minimal normal weight that you are referring to in Kg:
The following statements refer to methods which you may use to control your weig
Please indicate which weight control method(s) you are referring to (you may sel
Submission date
Gender
Relationship to carer
Do you currently live with a family member
Marital status
Are you in receipt of benefits
How often has your eating/weight resulted in you feeling embarrassed or differen
How often has your eating/weight made you feel worse about yourself?
How often has your eating/weight made you not want to be with people?
How often has your eating/weight resulted in you believing that you will never g
How often has your eating/weight made you feel lonely?
How often has your eating/weight resulted in less interest or pleasure in activi
How often has your eating/weight led you to not care about yourself?
How often has your eating/weight made you feel odd, weird, or unusual?
How often has your eating/weight resulted in avoiding eating in front of others?
How often has your eating/weight caused cold hands or feet?
How often has your eating/weight caused frequent headaches?
How often has your eating/weight caused weakness?
How often has your eating/weight affected your ability to pay attention when you
How often has your eating/weight affected your ability to comprehend some verbal
How often has your eating/weight reduced your ability to concentrate?
How often has your eating/weight led to problems with treatment provider(s) rega
How often has your eating/weight led to you having difficulty paying monthly bil
How often has your eating/weight resulted in significant financial debt?
How often has your eating/weight led to the need to spend money from savings or
How often has your eating/weight resulted in the need to borrow money?
How often has your eating/weight led to a leave of absence from work?
How often has your eating/weight led to low grades?
How often has your eating/weight resulted in reduced hours at work?
How often has your eating/weight resulted in you losing a job or dropping out of
How often has your eating/weight led to failure in a class or classes?
Have you been consciously trying to limit the amount of food you eat to influenc
Have you attempted to avoid eating any foods which you like in order to influenc
Have you attempted to follow definite rules regarding your eating in order to in
Has your weight influenced how you think about (judge) yourself as a person?
Has your shape influenced how you think about (judge) yourself as a person?
How dissatisfied have you felt about your weight?
How dissatisfied have you felt about your shape?
In my family we talk to each other about things that matter to us
People often don't tell each other the truth in my family
Each of us gets listened to in our family
It feels risky to disagree in our family
We find it hard to deal with everyday problems
We trust each other
It feels miserable in our family
When people in my family get angry they ignore each other on purpose
We seem to go from one crisis to another in my family
When one of us is upset they get looked after within the family
Things always seem to go wrong for my family
People in the family are nasty to each other
People in my family interfere too much in each other's lives
In my family we blame each other when things go wrong
We are good at finding new ways to deal with things that are difficult
Severity of problems
How are you managing at a family?
Do you think this group will be helpful?
The following statements refer to gaining weight:
The following statements refer to body weight:
The following statements refer to parts of your body which may particularly conc
The following statements refer to you appearance:
The following statements refer to your health:
The following statements refer to the importance of body shape and weight:
The following statements refer to a fear of fatness:
The following statements refer to weight loss:
The following statements refer to body fat vs muscle:
The following statements refer to the rate of weight gain
The following statements refer to certain shape and weight standards which you m
The following statements refer to certain foods which you may avoid eating (such
The following statements refer to daily food consumption:
The following statements refer to time spent thinking about food and your weight
The following statements refer to certain eating behaviours (such as needing to
The following statements refer to feelings associated with eating (such as feeli
Issues with using methods to control weight
The following statements refer to certain emotional problems (such as feeling de
The following statements refer to certain characteristics (such as perfectionism
The following statements refer to relationship problems (such as relationships w
Marital status - other
Method of weight control - other
Start Date
Survey Time Point
Response ID
Completion Date