This free survey is powered by
  1. Surveys
  2. 2014
  3. December
  4. B
  5. Body Image
0%
Exit Survey
 
 
Hello:

      I am currently enrolled at Concordia College in the Adult Education Program and am in the process of finishing my education. In order for me to get my degree, I must complete a Senior Research Thesis paper that will require your help. I will be most grateful if you would participate in my survey. In this survey, you will be asked a series of general questions followed by more specific questions regarding your thoughts on body image and the effects the Entertainment Industry has on your self-esteem. It will take approximately 15-20 minutes to complete the questionnaire.

      Your participation in this study is completely voluntary. There are no foreseeable risks associated with this project. You can withdraw from the survey at any point should you feel uncomfortable answering any of the questions. However, it is very important for me to learn your opinions.

      Your survey responses will be strictly confidential and data from this research will only be used for the benefit of my study. Your information will also be coded and will remain confidential. Thank you very much for your time and support. Please start with the survey now by checking the I Agree button below.
 
 
 
 
* What is your age?
 
18-19
 
20-29
 
30-39
 
40-49
 
50-59
 
60-69
 
70+
 
 
 
* Gender
 
Male
 
Female
 
 
 
* What is your race?
 
White
 
Black or African American
 
Latino/Latina
 
Hispanic
 
Asian
 
Other
 
 
 
 
* What is your highest level of education?
 
High School Diploma
 
Some College
 
Bachelor’s Degree
 
Masters
 
Other
 
 
 
 
* Are you:
 
Married
 
Single
 
Divorced
 
Widowed
 
Other
 
 
 
 
* Employment
 
Employed
 
Unemployed
 
 
 
* How do you rate your body?  
 
In shape/Physically fit
 
Need to lose 1-5lbs
 
Need to lose 6-15lbs
 
Need to lose 16-24lbs
 
Need to lose 25+lbs
 
Don’t need to lose any weight
 
Other
 
 
 
 
What shape would you say your body most resembles?
 
Apple (carry weight most in your stomach)
 
Banana
 
Pear (carry weight more in your hips and thighs)
 
Hourglass
 
 
 
Please finish the following Statement: I am…
 
Under weight
 
Slightly under weight
 
At the right weight for my height and age
 
Slightly over weight
 
Over weight
 
 
 
Do you know your Body Mass Index? If so, please state.
 
No
 
Yes - BMI
 
 
 
 
How would you describe your self-esteem regarding your body? 
 
Low
 
Low to average
 
Average
 
Average to high
 
High
 
 
 
* How many times in the past year have you dieted? 
 
None
 
1-3 times
 
4-6
 
7-10
 
 
 
* Other people’s opinions of my body matter to me:
 
Yes
 
No
 
Sometimes
 
 
 
My self-esteem regarding my body is influenced by entertainment industry standards? 
 
Strongly disagree
 
Disagree
 
Neutral
 
Agree
 
Strongly Agree
 
 
 
My self-esteem regarding my body is influenced by my peers? 
 
Strongly disagree
 
Disagree
 
Neutral
 
Agree
 
Strongly Agree
 
 
 
Which statement mostly applies to you? 
 
I really don’t care about how I look
 
I put some time and effort into my appearance
 
I put a lot of time and effort into my appearance
 
 
 
If you could change any part of your body, what would it be?
   
 
 
 
Do you believe entertainment industry standards of body image are realistic?
 
Yes
 
No
 
Sometimes
 
 
 
* Which body mostly resembles yours currently?
Male - 1
Male - 2
Male - 3
Male - 4
Male - 5
Male - 6
Male - 7
Male - 8
Male - 9
Female - 1
Female - 2
Female - 3
Female - 4
Female - 5
Female - 6
Female - 7
Female - 8
Female - 9
 
 
 
* Which body type would you like to have?
Male - 1
Male - 2
Male - 3
Male - 4
Male - 5
Male - 6
Male - 7
Male - 8
Male - 9
Female - 1
Female - 2
Female - 3
Female - 4
Female - 5
Female - 6
Female - 7
Female - 8
Female - 9
 
 
 
* Which body type in both men and women’s categories do you feel is physically fit?
(Click all that apply)
Male - 1
Male - 2
Male - 3
Male - 4
Male - 5
Male - 6
Male - 7
Male - 8
Male - 9
Female - 1
Female - 2
Female - 3
Female - 4
Female - 5
Female - 6
Female - 7
Female - 8
Female - 9
 
 
 
* Which body type in both men and women’s categories do you feel is NOT physically fit?
(Click all that apply)
Male - 1
Male - 2
Male - 3
Male - 4
Male - 5
Male - 6
Male - 7
Male - 8
Male - 9
Female - 1
Female - 2
Female - 3
Female - 4
Female - 5
Female - 6
Female - 7
Female - 8
Female - 9
 
 
 
* Which body type in both men and women’s categories do you feel is socially acceptable?
(Click all that apply)
Male - 1
Male - 2
Male - 3
Male - 4
Male - 5
Male - 6
Male - 7
Male - 8
Male - 9
Female - 1
Female - 2
Female - 3
Female - 4
Female - 5
Female - 6
Female - 7
Female - 8
Female - 9
 
 
 
* Which body type in both men and women’s categories do you feel is NOT socially acceptable?
(Click all that apply)
Male - 1
Male - 2
Male - 3
Male - 4
Male - 5
Male - 6
Male - 7
Male - 8
Male - 9
Female - 1
Female - 2
Female - 3
Female - 4
Female - 5
Female - 6
Female - 7
Female - 8
Female - 9
 
 
 
Do you read or look at men/women’s fashion or celebrity magazines? If so, which ones?
 
Yes
 
No
 
Name the magazine(s)
 
 
 
If yes, how often do you read/look at them?
 
Once a week
 
Several times a week
 
Once a month
 
Several times a month
 
Hardly ever
 
 
 
Do you feel pressure to physically look like those in the entertainment industry, i.e. models and/or celebrities?
 
Yes
 
No
 
Sometimes
 
 
 
Have you ever compared your body to a model and/or celebrity?
 
Yes
 
No
 
 
 
Do you feel you are influenced by models and/or celebrity’s physiques?
 
Yes
 
No
 
 
 
* Do you feel your ethnicity plays a part on your view of body image?
 
Yes
 
No
 
 
 
* Which celebrity body would you most like to resemble?
(Click all that apply)
Male - 1
Male - 2
Male - 3
Male - 4
Male - 5
Female - 1
Female - 2
Female - 3
Female - 4
Female - 5
 
 
 
* Which celebrity body appears healthy?
(Click all that apply)
Male - 1
Male - 2
Male - 3
Male - 4
Male - 5
Female - 1
Female - 2
Female - 3
Female - 4
Female - 5
 
 
 
* Which celebrity body appears unhealthy?
(Click all that apply)
Male - 1
Male - 2
Male - 3
Male - 4
Male - 5
Female - 1
Female - 2
Female - 3
Female - 4
Female - 5
 
 
 
How do you feel about your body after comparing yourself to entertainment industry standards?
 
Very Dissatisfied
 
Somewhat Dissatisfied
 
Neutral
 
Satisfied
 
Very Satisfied
 
 
 
How would you describe your self-esteem regarding your body after comparing it to the body of the celebrities that you would like to most resemble?
 
Low
 
Low to average
 
Average
 
Average to high
 
High
 
The same
 
 
 
* Would you feel less worthy of a partner who is in better physical shape than you?
 
Yes
 
No
 
 
 
* Would you feel or think less of a partner who is in worse shape than you?
 
Yes
 
No