People fill the body satisfaction questionnaires to reflect their opinion about their own bodies. Their replies help to understand their problems better and facilitate finding a solution for that.
Sample Body Satisfaction Questionnaire
Name of Participant: ____________________________________________
Address of Participant: __________________________________________
Contact number: _____________________ email address: _____________________
Date of birth: ________________________ today’s date: _____________________
Please answer the following questions.
1. Which one of these describes you the best?
a. Too thin
c. Normal weight
d. Slightly fat
e. Very fat
2. Does your family members or friends call you very thin?
a. Yes, always
b. Sometimes, they all have different opinions
c. No, not at all.
3. Are you often teased by people because you are fat?
a. Most of the times
b. Very rarely
4. How happy are you with your present weight?
a. I am quite happy
b. I am not quite sure
c. I am unhappy about my weight
5. What do you think you are?
a. Under weight
b. Optimum weight
c. Over weight
6. Have you ever done any of the following?
a. Tried to lose weight
b. Trying to lose weight now
c. Trying to gain weight
d. Tried to gain weight in the past
7. To lose weight, which of the following methods would you adopt?
a. Reduce the amount of food you consumed earlier
b. Exercise more
c. Skip some meals
d. Take medications to reduce weight
8. Which of the following methods are you likely to adopt to gain weight?
a. Eat more food
b. Exercise more
c. Consume medicinal supplements
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