Questionnaire

Type 1, The Depressed Craver. Type 1, The Depressed Craver.

Your cravings are strongest toward the dim end of the day—in the afternoon or evening.-------

(Severity 1-10)

You wake up in the night and head for the fridge.

(Severity 1-10)

You eat to get to, or get back to, sleep.

(Severity 1-10)

You crave more (and perhaps gain more) in fall and winter. Your mood is worse in winter, too. You tend to be negative, depressed, or pessimistic.

(Severity 1-10)

You frequently worry or feel anxious.

(Severity 1-10)

You have frequent feelings of low self-esteem, guilt, or shame.

(Severity 1-10)

You are obsessed with certain thoughts or behaviors (e.g., your body, your weight, biting your nails, pulling your eyelashes out).

(Severity 1-10)

You are a perfectionist or a neat freak. You tend to be controlling with others. You are subject to irritability or anger.

(Severity 1-10)

You have panic attacks.

(Severity 1-10)

You have phobias: fear of heights, small spaces, crowds, snakes, etc.

(Severity 1-10)

You are hyperactive

(Severity 1-10)

You often have a nervous stomach (knots, butterflies).

(Severity 1-10)

You are a night owl or have middle of the night insomnia.

(Severity 1-10)

You suffer pain from headaches, TMJ, or fibromyalgia.

(Severity 1-10)

You are using or have used an SSRI antidepressant drug (like Zoloft, Lexapro, or Prozac) with some benefit.

(Severity 1-10)

Your symptom total: _____________ (Each check mark equals a score of one.) If your symptom score is over 7, especially if most of your severity ratings are over 3, you are a Type 1 Depressed Craver. Your symptom total: _____________ (Each check mark equals a score of one.) If your symptom score is over 7, especially if most of your severity ratings are over 3, you are a Type 1 Depressed Craver.

(score)

Type 2, The Crashed Craver. Type 2, The Crashed Craver.

Your cravings for sugar or starch are stronger when you have skipped or delayed a meal.

(Severity 1-10)

You tend to skip breakfast and/or other meals.

(Severity 1-10)

Your cravings spike later in the day if you’ve skipped any earlier meals.

(Severity 1-10)

You suspect you have (or you have been diagnosed with) hypoglycemia.

(Severity 1-10)

You are diabetic or pre-diabetic. (Your blood sugar levels rise too high, but drop too low at times, as well.) You get dizzy, shaky, or headachy if you go too long between meals.

(Severity 1-10)

You find it harder to concentrate when you go too long without healthy meals

(Severity 1-10)

You can get irritable, or blow up, if you go too long without full meals.

(Severity 1-10)

You feel more stressed the fewer regular meals you eat. Hypoglycemia, diabetes, or alcoholism run in your family. You are drawn to alcohol on a regular basis.

(Severity 1-10)

Your symptom total: _____________ (Each check mark equals a score of one.) If your symptom score is over 4, especially if your severity ratings are mostly over 3, you are a Type 2 Crashed Craver. Your symptom total: _____________ (Each check mark equals a score of one.) If your symptom score is over 4, especially if your severity ratings are mostly over 3, you are a Type 2 Crashed Craver.

(score)

Type 3, The Comfort Craver Type 3, The Comfort Craver

You crave—no, love—certain foods. They are treats that give you feelings of pleasure, enjoyment, or reward and taste “sooo goood.”

(Severity 1-10)

You think of your comfort foods as your best friends.

(Severity 1-10)

Chocolate is particularly beloved.

(Severity 1-10)

You get extra pleasure if you read, watch TV, or play with the computer pad, or phone while you eat.

(Severity 1-10)

You are very sensitive to emotional or physical pain.

(Severity 1-10)

You often feel sad, lonely, or hurt.

(Severity 1-10)

You tear up or cry easily; even at TV commercials.

(Severity 1-10)

You adore animals and need their loving company.

(Severity 1-10)

You get a high from bulimic bingeing or purging or from restricting calories

(Severity 1-10)

You have a history of chronic physical pain from back or other injuries, or have chronic emotional pain from unresolved trauma or protracted personal ordeals.

(Severity 1-10)

You are a dough lover—bread, cookies, and pasta are at the top of your list. You have trouble eating even whole wheat products moderately.

(Severity 1-10)

Cheese, ice cream, frozen yogurt, butter, and even milk are irresistible.

(Severity 1-10)

Dough and milk combined are your top treats: crackers and cheese, pizza, macaroni and cheese or the ultimate, dough and milk with chocolate—chocolate cheesecake, and cookie dough ice cream.

(Severity 1-10)

You may also crave certain other substances or activities that give you similar feelings: painkillers, pot or alcohol; serious aerobic exercise, porn, or self-harm.

(Severity 1-10)

Your symptom total: _____________(Each check mark equals a score of one.) If your symptom score is over 6, especially if most of your severity ratings are over 3, you are a Type 3 Comfort Craver. Your symptom total: _____________(Each check mark equals a score of one.) If your symptom score is over 6, especially if most of your severity ratings are over 3, you are a Type 3 Comfort Craver.

(score)

Type 4, The Stressed Craver Type 4, The Stressed Craver

You are overstressed or burnt out.

(Severity 1-10)

You reach for snack food to counteract stress.

(Severity 1-10)

You are unable to relax and loosen up easily.

(Severity 1-10)

You have stiff, tense, or painful muscles.

(Severity 1-10)

Your mind is cluttered and it’s hard to focus.

(Severity 1-10)

It’s hard to meditate, pray, or be mindful, still, or at peace.

(Severity 1-10)

You feel easily overwhelmed

(Severity 1-10)

You can feel close to panic.

(Severity 1-10)

You don’t get away on regular vacations to relax, rest, and regenerate.

(Severity 1-10)

It is hard to get to sleep (or stay asleep) at times because of the above symptoms. You are drawn to alcohol on a regular basis.

(Severity 1-10)

Your symptom total: _____________ (Each check mark equals a score of one.) If your symptom score is over 4, especially if most of your severity ratings are over 4, you are a Type 4 Stressed Craver. Your symptom total: _____________ (Each check mark equals a score of one.) If your symptom score is over 4, especially if most of your severity ratings are over 4, you are a Type 4 Stressed Craver.

(score)

Type 5, The Fatigued Craver Type 5, The Fatigued Craver

You gravitate toward the stimulant effect of caffeine, coffees, sodas (including artificially sweetened ones), iced teas, energy drinks, or anything chocolate.

(Severity 1-10)

Your energy is on the low side.

(Severity 1-10)

You frequently feel the need to be more alert and focused.

(Severity 1-10)

You are low in drive and motivation.

(Severity 1-10)

Sweets give you a “pick-me-up.”

(Severity 1-10)

You have trouble concentrating, or have attention problems.

(Severity 1-10)

You are easily bored and feel the need for some excitement.

(Severity 1-10)

You have tried, and liked. stimulant drugs like Ritalin, Adderall, diet pills, methamphetamine, cocaine.

(Severity 1-10)

Your symptom total: ____________ (Each check mark equals a score of one.) If your symptom score is over 4, especially if most of your severity ratings are mostly over 3, you are a Type 5 Fatigued Craver. Your symptom total: ____________ (Each check mark equals a score of one.) If your symptom score is over 4, especially if most of your severity ratings are mostly over 3, you are a Type 5 Fatigued Craver.

(score)

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