Mark the symptoms that apply to you

The following guide should take just a few minutes to complete.
Mark any symptoms you‘ve been experiencing for at least 3 months. Share your results with your doctor to help him or her understand your personal experience.

Please note this discussion guide is not a diagnostic tool. Only a doctor or other healthcare professional can diagnose B.E.D.

Within the past 3 months

01

During the last three months, did you have any episodes of excessive overeating (ie, eating significantly more than what most people would eat under similar circumstances)?

NOTE: IF YOU ANSWERED "NO" TO QUESTION 1, YOU MAY STOP. THE REMAINING QUESTIONS DO NOT APPLY TO YOU.

02

Do you feel distressed about your episodes of excessive overeating?

03

During your episodes of excessive overeating, how often did you feel like you had no control over your eating (ie, not being able to stop eating, feeling compelled to eat, or going back and forth for more food)?

04

During your episodes of excessive overeating, how often did you continue eating even though you were not hungry?

05

During your episodes of excessive overeating, how often were you embarrassed by how much you ate?

06

During your episodes of excessive overeating, how often did you feel disgusted with yourself or guilty afterward?

07

During the last 3 months, how often did you make yourself vomit as a means to control your weight or shape?

You’re done!

Your results will be in your customized Doctor Discussion Guide. Now, you can download and print your Doctor Discussion Guide to take with you to your next appointment.