This free survey is powered by
0%
Questions marked with a * are required Exit Survey
 
 
* How important is your appearance?
 
Very important
 
Moderately important
 
Slightly important
 
Not important
 
 
 
* Would you say the pressures of body image affects you?
 
Yes
 
No - skip to Q7
 
 
 
* what do you think is the biggest cause of your body image concerns?
 
The ideals of the media (magazines, TV, etc.)
 
Pressure from family
 
Peer pressure
 
My own perception of body image
 
Other
 
 
 
* Which of these do you relate to most as an effect of body image?
 
Undesirable to the opposite sex
 
Lowered self worth
 
General unhappiness
 
Gaining motivation to exercise, eat healthier, etc.
 
Embarrassment
 
Being insecure around people
 
Other (please specify)
 
 
 
* Do you often compare your body to those of others?
 
Yes
 
No - skip to Q8
 
 
 
* Against whom do you often compare your body?
 
Actors
 
Athletes
 
Friends
 
models
 
Other (please specify)
 
 
 
* Have you ever gone on a diet to change the way you look?
 
Yes, to lose weight
 
Yes, to gain weight
 
Yes, to gain muscle
 
No
 
Other (please specify)
 
 
 
* Which feature(s) of your body are you most dissatisfied with? 
 
Arms
 
Chest
 
Height - too small
 
Height - too tall
 
General weight - want to lose weight
 
General weight - want to gain weight
 
Legs
 
Musculature (want to gain muscle)
 
Shoulders
 
Stomach/abs
 
Thighs
 
Other

 
 
 
Who/what do you think the idea of "the perfect body" is more influenced by?
 
Peers of the opposite gender
 
Peers of the same gender
 
The media (magazines, TV, etc)
 
Other