Body Image Survey Questionnaire Test - the question form

Questions: 20 · 4 minutes
1. I feel uncomfortable about my appearance at social gatherings where I do not know many people.
1 – Never
2 – Sometimes
3 – Often
4 – Always
2. When I look at myself in the mirror.
1 – Never
2 – Sometimes
3 – Often
4 – Always
3. When I am around attractive people.
1 – Never
2 – Sometimes
3 – Often
4 – Always
4. When someone looks at the parts of my appearance that I do not like.
1 – Never
2 – Sometimes
3 – Often
4 – Always
5. When trying on new clothes.
1 - Never
2 - Sometimes
3 - Often
4 - Always
6. When I do physical exercise.
1 - Never
2 - Sometimes
3 - Often
4 - Always
7. After I have eaten my entire lunch.
1 – Never
2 – Sometimes
3 – Often
4 – Always
8. When I wear revealing clothing.
1 – Never
2 – Sometimes
3 – Often
4 – Always
9. When I step on the scales.
Never
Sometimes
Often
Always
10. When I think that someone has rejected me.
1 – Never
2 – Sometimes
3 – Often
4 – Always
11. When I am in a sexual situation.
Never
Sometimes
Often
Always
12. When I am in a bad mood.
1 – Never
2 – Sometimes
3 – Often
4 – Always
13. When I think about how I looked when I was younger.
1 – Never
2 – Sometimes
3 – Often
4 – Always
14. When I see myself in photos or videos.
1 – Never
2 – Sometimes
3 – Often
4 – Always
15. When I think that I have gained weight.
1 – Never
2 – Sometimes
3 – Often
4 – Always
16. When I think about how I would like to look.
1 – Never
2 – Sometimes
3 – Often
4 – Always
17. When I remember hurtful things that have been said about my appearance.
1 – Never
2 – Sometimes
3 – Often
4 – Always
18. When I am around people who talk about being overweight and dieting.
1 – Never
2 – Sometimes
3 – Often
4 – Always
19. When I look through fashion magazines.
1 - Never
2 - Sometimes
3 - Often
4 - Always
20. When I think about going on vacation.
1 – Never
2 – Sometimes
3 – Often
4 – Always
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