Self esteem & Body esteem

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Survey Form

About my body

We want to know how you feel about the way you look. Please read each sentence and select ‘yes’ if the sentence describes what you think about yourself. Select ‘no’ if the sentence does not describe what you think about yourself.
Please answer all questions

I like what I look like in pictures*

Other people consider me good looking*

I’m proud of my body*

I am preoccupied with trying to change my body weight*

I think my appearance would help me get a job*

I like what I see when I look in the mirror*

There are lots of things I’d change about my looks if I could*

I am satisfied with my weight*

I wish I looked better*

I really like what I weigh*

I wish I looked like someone else*

People my own age like my looks*

My looks upset me*

I’m as nice looking as most people*

I’m pretty happy about the way I look*

I feel I weigh the right amount for my height*

I feel ashamed of how I look*

Weighing myself depresses me*

My weight makes me unhappy*

My looks help me to get dates*

I worry about the way I look*

I think I have a good body*

I look as nice as I’d like to*

What I think about myself

People can think that they are good at some things and not so good at other things. We want to know what you think about yourself.
Below are some sentences that describe what people think about themselves. Read these sentences and decide whether the sentence is a lot like you, a bit like you, not like you, or not at all like you.

On the whole, I am satisfied with myself*

At times I think I am no good at all*

I feel that I have a number of good qualities*

I am able to do things as well as most other people*

I feel I do not have much to be proud of*

I certainly feel useless at times*

I feel that I am a person of worth, at least on an equal plane with others*

I wish I could have more respect for myself*

All in all, I am inclined to feel that I am a failure*

I take a positive attitude toward myself*