Weight Loss Behaviours Survey 

Q1.  How often do you participate in the following behaviours in an attempt to lose weight?
Never Rarely Sometimes Frequently Always
Exercise
Not eat between meals
Keep busy to avoid eating
Go on a magazine diet
Go on your own diet
Select low joule foods
Drink water before meals
Skip meals
Do excessive exercise
Become vegetarian
Avoid situations where there will be food
Take advantage of illness to avoid eating
Use natural laxatives (e.g: bran)
Use chemical laxatives
Fast or starve yourself
Try to vomit
Vomit
Smoke cigarettes
Slimming/diet pills
Not swallowing food
Other methods?  Specify...

Demographics 

Q2. Gender

Male
Female

Q3. 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

Q4. Weight    kg or lbs

Q5. Height cm or ft in

Q6. Country of residence 

Q7. 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

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Q1.  How often do you participate in the following behaviours in an attempt to lose weight?

Exercise
Not eat between meals
Keep busy to avoid eating
Go on a magazine diet
Go on your own diet
Select low joule foods
Drink water before meals
Skip meals
Do excessive exercise
Become vegetarian
Avoid situations where there will be food
Take advantage of illness to avoid eating
Use natural laxatives (eg: bran)
Use chemical laxatives
Fast or starve yourself
Try to vomit
Vomit
Smoke cigarettes
Slimming/diet pills
Not swallowing food