Eating Behaviours Survey 

Regular Food Habits 

Q1.  Do you ... (please tick a response for each item)

Never Rarely Sometimes Frequently Always
Skip breakfast
Skip morning snack
Skip lunch
Skip afternoon snack
Skip dinner
Skip supper

Body satisfaction, mood and social influences

Q2.  Please answer each of the following questions ...

Yes No Sometimes
I eat more when I am bored or sad
When I am happy, I eat more
I feel hungry very often
I think I am too thin
I think I am too fat
People tell me I should lose weight
People tell me I should gain weight
I like my body the way it is

Other Food Habits

Q3.  How often do you ... (Please tick a response for each item)

Never Rarely Sometimes Frequently Always
Read food labels
Worry about food or drinks
Diet to lose weight
Diet to gain weight
Take vitamin pills

Demographics 

Q4. Gender

Male
Female

Q5. Age group

4-7 years
8-11 years
12-15 years
16-18 years
19-24 years
25-44 years
45-64 years
65 years and over

Q6. Weight    kg or lbs

Q7. Height cm or ft in

Q8. Country of residence 

Q9. Postcode (Australia only)

Have you completed this survey before? Yes No

References 

O'Dea, J., Food habits, body image and self esteem of adolescent girls from disadvantaged and non-disadvantaged backgrounds, Aust J Nutr Diet., 1994; 51: 74-78

O'Dea, J., Abraham., S., Heard, R., Food habits, body image and weight control practices of young male and female adolescents, Aust J Nutr Diet., 1996; 53:32-38

The following graphs display your score against the average response

Q1.  Do you ... 

Skip Breakfast
Skip Morning Snack
Skip Lunch
Skip Afternoon Snack
Skip Dinner
Skip Supper

Q2.  Answer each of the following questions ..

I eat more when I am bored or sad
When I am happy, I eat more
I feel hungry very often
I think I am too thin
I think I am too fat
People tell me I should lose weight
People tell me I should gain weight
I like my body the way it is

Q3.  How often do you ...

Read food labels
Worry about food or drinks
Diet to lose weight
Diet to gain weight
Take vitamin pills