Are You Having an Affair with Food?

Name

First

Email

1. I often find myself eating foods that I have sworn off. I vow to stop eating certain foods only to find myself head first into the proverbial cookie jar.*

True
False

2. I carry a lot of guilt about my eating behaviors.*

True
False

3. I eat foods knowing that my body will react badly, yet I just cannot seem to stop myself.*

True
False

4. I eat so fast that I usually don’t remember eating!*

True
False

5. I often eat while watching television, driving or playing with one of my electronic gadgets.*

True
False

6. My Spiritual practices could use some practicing. I know I feel better when I am connected, but I am not consistent.*

True
False

7. I believe that buying bigger clothes means that I am giving up on myself.*

True
False

8. I go to great lengths to hide my binges.*

True
False

9. I have tried more diet and exercise programs than I could possibly count. I know a lot about nutrition and fitness yet this knowledge hasn't helped me.*

True
False

10. I have a hard time feeling full with food.*

True
False

11. I believe I have an issue with food that is keeping me from thriving.*

True
False

12. I am ready for a different approach so I can end the affair with food..*

True
False