Please delete if this isn't acceptable. Thank you so much in advance. :)
Survey for the eating disordered:
Age you developed an eating disorder:
Are you on any anti-depressants?
Have you been in any sort of treatment program?
If you had to choose your favorite body part, which would it be?
Have you ever been physically abused? (Hit/punched, molested, raped, groped, victim of exhibition, etc.)
If so. . .
At what age?
What type of abuse was it?
Did you tell anyone about it afterwards?
If you told someone, how long afterwards was it?
Financially, were you raised in a. . .?
Low income home / middle class home / upper class home:
Number of siblings:
Are your parents. . .?
Divorced / married / separated:
If married. . .
Which parent would you say you're closest to?
Does this parent know about your eating disorder?
If no, how does it make you feel that they don't notice something that your entire life is consumed with?
If they're divorced. . .
Did you view one of your parents as, 'weaker,' or more emotional after the divorce?
And if so, what measures (if any) did you take to ensure that you weren't a, 'burden,' (financially/emotionally/physically) to this parent?
Did you feel that you were somehow responsible for the divorce?