Start Date
End Date
Progress
Duration (in seconds)
Recorded Date
User Language
Over the last 2 weeks, how often have you been bothered by any of the following problems?Please click to indicate your answer - Little interest or pleasure in doing things
Over the last 2 weeks, how often have you been bothered by any of the following problems?Please click to indicate your answer - Feeling down, depressed, or hopeless
Over the last 2 weeks, how often have you been bothered by any of the following problems?Please click to indicate your answer - Trouble falling or staying asleep, or sleeping too much
Over the last 2 weeks, how often have you been bothered by any of the following problems?Please click to indicate your answer - Feeling tired or having little energy
Over the last 2 weeks, how often have you been bothered by any of the following problems?Please click to indicate your answer - Poor appetite or overeating
Over the last 2 weeks, how often have you been bothered by any of the following problems?Please click to indicate your answer - Feeling bad about yourself — or that you are a failure or have let yourself or your family down
Over the last 2 weeks, how often have you been bothered by any of the following problems?Please click to indicate your answer - Trouble concentrating on things, such as reading the newspaper or watching television
Over the last 2 weeks, how often have you been bothered by any of the following problems?Please click to indicate your answer - Moving or speaking so slowly that other people could have noticed? Or the opposite — being so fidgety or restless that you have been moving around a lot more than usual
Over the last 2 weeks, how often have you been bothered by any of the following problems?Please click to indicate your answer - Thoughts that you would be better off dead or of hurting yourself in some way
Over the last 2 weeks, how often have you been bothered by the following problems? Please click to indicate your answer - Feeling nervous, anxious, or on edge
Over the last 2 weeks, how often have you been bothered by the following problems? Please click to indicate your answer - Not being able to stop or control worrying
Over the last 2 weeks, how often have you been bothered by the following problems? Please click to indicate your answer - Worrying too much about different things
Over the last 2 weeks, how often have you been bothered by the following problems? Please click to indicate your answer - Trouble relaxing
Over the last 2 weeks, how often have you been bothered by the following problems? Please click to indicate your answer - Being so restless that it's hard to sit still
Over the last 2 weeks, how often have you been bothered by the following problems? Please click to indicate your answer - Becoming easily annoyed or irritable
Over the last 2 weeks, how often have you been bothered by the following problems? Please click to indicate your answer - Feeling afraid as if something awful might happen
When things go wrong in our lives or don’t work out as we hoped, and we feel we could have done better, we sometimes have negative and self-critical thoughts and feelings. These may take the form of feeling worthless, useless or inferior etc. However, people can also try to be supportive of themselves. Below are a series of thoughts and feelings that people sometimes have. Read each statement carefully and click the one that best describes how much each statement is true for you. - I am easily disappointed with myself.
When things go wrong in our lives or don’t work out as we hoped, and we feel we could have done better, we sometimes have negative and self-critical thoughts and feelings. These may take the form of feeling worthless, useless or inferior etc. However, people can also try to be supportive of themselves. Below are a series of thoughts and feelings that people sometimes have. Read each statement carefully and click the one that best describes how much each statement is true for you. - There is a part of me that puts me down.
When things go wrong in our lives or don’t work out as we hoped, and we feel we could have done better, we sometimes have negative and self-critical thoughts and feelings. These may take the form of feeling worthless, useless or inferior etc. However, people can also try to be supportive of themselves. Below are a series of thoughts and feelings that people sometimes have. Read each statement carefully and click the one that best describes how much each statement is true for you. - I am able to remind myself of positive things about myself.
When things go wrong in our lives or don’t work out as we hoped, and we feel we could have done better, we sometimes have negative and self-critical thoughts and feelings. These may take the form of feeling worthless, useless or inferior etc. However, people can also try to be supportive of themselves. Below are a series of thoughts and feelings that people sometimes have. Read each statement carefully and click the one that best describes how much each statement is true for you. - I find it difficult to control my anger and frustration at myself.
When things go wrong in our lives or don’t work out as we hoped, and we feel we could have done better, we sometimes have negative and self-critical thoughts and feelings. These may take the form of feeling worthless, useless or inferior etc. However, people can also try to be supportive of themselves. Below are a series of thoughts and feelings that people sometimes have. Read each statement carefully and click the one that best describes how much each statement is true for you. - I find it easy to forgive myself.
When things go wrong in our lives or don’t work out as we hoped, and we feel we could have done better, we sometimes have negative and self-critical thoughts and feelings. These may take the form of feeling worthless, useless or inferior etc. However, people can also try to be supportive of themselves. Below are a series of thoughts and feelings that people sometimes have. Read each statement carefully and click the one that best describes how much each statement is true for you. - There is a part of me that feels I am not good enough.
When things go wrong in our lives or don’t work out as we hoped, and we feel we could have done better, we sometimes have negative and self-critical thoughts and feelings. These may take the form of feeling worthless, useless or inferior etc. However, people can also try to be supportive of themselves. Below are a series of thoughts and feelings that people sometimes have. Read each statement carefully and click the one that best describes how much each statement is true for you. - I still like being me.
When things go wrong in our lives or don’t work out as we hoped, and we feel we could have done better, we sometimes have negative and self-critical thoughts and feelings. These may take the form of feeling worthless, useless or inferior etc. However, people can also try to be supportive of themselves. Below are a series of thoughts and feelings that people sometimes have. Read each statement carefully and click the one that best describes how much each statement is true for you. - I have become so angry with myself that I want to hurt or injure myself.
When things go wrong in our lives or don’t work out as we hoped, and we feel we could have done better, we sometimes have negative and self-critical thoughts and feelings. These may take the form of feeling worthless, useless or inferior etc. However, people can also try to be supportive of themselves. Below are a series of thoughts and feelings that people sometimes have. Read each statement carefully and click the one that best describes how much each statement is true for you. - I have a sense of disgust with myself.
When things go wrong in our lives or don’t work out as we hoped, and we feel we could have done better, we sometimes have negative and self-critical thoughts and feelings. These may take the form of feeling worthless, useless or inferior etc. However, people can also try to be supportive of themselves. Below are a series of thoughts and feelings that people sometimes have. Read each statement carefully and click the one that best describes how much each statement is true for you. - I can still feel lovable and acceptable.
When things go wrong in our lives or don’t work out as we hoped, and we feel we could have done better, we sometimes have negative and self-critical thoughts and feelings. These may take the form of feeling worthless, useless or inferior etc. However, people can also try to be supportive of themselves. Below are a series of thoughts and feelings that people sometimes have. Read each statement carefully and click the one that best describes how much each statement is true for you. - I stop caring about myself.
When things go wrong in our lives or don’t work out as we hoped, and we feel we could have done better, we sometimes have negative and self-critical thoughts and feelings. These may take the form of feeling worthless, useless or inferior etc. However, people can also try to be supportive of themselves. Below are a series of thoughts and feelings that people sometimes have. Read each statement carefully and click the one that best describes how much each statement is true for you. - I find it easy to like myself.
When things go wrong in our lives or don’t work out as we hoped, and we feel we could have done better, we sometimes have negative and self-critical thoughts and feelings. These may take the form of feeling worthless, useless or inferior etc. However, people can also try to be supportive of themselves. Below are a series of thoughts and feelings that people sometimes have. Read each statement carefully and click the one that best describes how much each statement is true for you. - I remember and dwell on my failings.
When things go wrong in our lives or don’t work out as we hoped, and we feel we could have done better, we sometimes have negative and self-critical thoughts and feelings. These may take the form of feeling worthless, useless or inferior etc. However, people can also try to be supportive of themselves. Below are a series of thoughts and feelings that people sometimes have. Read each statement carefully and click the one that best describes how much each statement is true for you. - I call myself names.
Below is a list of situations that people may encounter because of their weight. Please click to indicate whether, and how often on average each of these situations has happened to you. Please rate for the time in your life when this was most significant. - Being singled out as a child by a teacher, school nurse, etc., because of your weight.
Below is a list of situations that people may encounter because of their weight. Please click to indicate whether, and how often on average each of these situations has happened to you. Please rate for the time in your life when this was most significant. - Being stared at in public
Below is a list of situations that people may encounter because of their weight. Please click to indicate whether, and how often on average each of these situations has happened to you. Please rate for the time in your life when this was most significant. - Children loudly making comments about your weight to others
Below is a list of situations that people may encounter because of their weight. Please click to indicate whether, and how often on average each of these situations has happened to you. Please rate for the time in your life when this was most significant. - Having a doctor recommend a diet, even if you did not come in to discuss weight loss
Below is a list of situations that people may encounter because of their weight. Please click to indicate whether, and how often on average each of these situations has happened to you. Please rate for the time in your life when this was most significant. - Having a romantic partner exploit you, because she or he assumed you were ‘desperate’ and would put up with it
Below is a list of situations that people may encounter because of their weight. Please click to indicate whether, and how often on average each of these situations has happened to you. Please rate for the time in your life when this was most significant. - Overhearing other people making rude remarks about you in public
Below is a list of situations that people may encounter because of their weight. Please click to indicate whether, and how often on average each of these situations has happened to you. Please rate for the time in your life when this was most significant. - Not being hired because of your weight, shape or size
Below is a list of situations that people may encounter because of their weight. Please click to indicate whether, and how often on average each of these situations has happened to you. Please rate for the time in your life when this was most significant. - Having family members feel embarrassed by you or ashamed of you
Below is a list of situations that people may encounter because of their weight. Please click to indicate whether, and how often on average each of these situations has happened to you. Please rate for the time in your life when this was most significant. - Having people assume you overeat or binge eat because you are overweight
Below is a list of situations that people may encounter because of their weight. Please click to indicate whether, and how often on average each of these situations has happened to you. Please rate for the time in your life when this was most significant. - Being glared at or harassed by bus passengers for taking up ‘too much’ room
The next set contains questions designed to evaluate how much you fear the judgements of others, as well as what kinds of things your mind has been saying to you about your weight or body shape. Please read each statement carefully and click to choose between 1 (completely agree with the statement) and 5 (completely disagree with the statement). - Agree I’ll always go back to being overweight.
The next set contains questions designed to evaluate how much you fear the judgements of others, as well as what kinds of things your mind has been saying to you about your weight or body shape. Please read each statement carefully and click to choose between 1 (completely agree with the statement) and 5 (completely disagree with the statement). - I caused my weight problems.
The next set contains questions designed to evaluate how much you fear the judgements of others, as well as what kinds of things your mind has been saying to you about your weight or body shape. Please read each statement carefully and click to choose between 1 (completely agree with the statement) and 5 (completely disagree with the statement). - I feel guilty because of my weight problems.
The next set contains questions designed to evaluate how much you fear the judgements of others, as well as what kinds of things your mind has been saying to you about your weight or body shape. Please read each statement carefully and click to choose between 1 (completely agree with the statement) and 5 (completely disagree with the statement). - I became overweight because I am a weak person.
The next set contains questions designed to evaluate how much you fear the judgements of others, as well as what kinds of things your mind has been saying to you about your weight or body shape. Please read each statement carefully and click to choose between 1 (completely agree with the statement) and 5 (completely disagree with the statement). - I would never have any problems with weight if was stronger
The next set contains questions designed to evaluate how much you fear the judgements of others, as well as what kinds of things your mind has been saying to you about your weight or body shape. Please read each statement carefully and click to choose between 1 (completely agree with the statement) and 5 (completely disagree with the statement). - I don’t have enough self-control to maintain a healthy weight.
The next set contains questions designed to evaluate how much you fear the judgements of others, as well as what kinds of things your mind has been saying to you about your weight or body shape. Please read each statement carefully and click to choose between 1 (completely agree with the statement) and 5 (completely disagree with the statement). - I feel insecure about others’ opinions of me.
The next set contains questions designed to evaluate how much you fear the judgements of others, as well as what kinds of things your mind has been saying to you about your weight or body shape. Please read each statement carefully and click to choose between 1 (completely agree with the statement) and 5 (completely disagree with the statement). - People discriminate against me because I’ve had weight problems.
The next set contains questions designed to evaluate how much you fear the judgements of others, as well as what kinds of things your mind has been saying to you about your weight or body shape. Please read each statement carefully and click to choose between 1 (completely agree with the statement) and 5 (completely disagree with the statement). - It’s difficult for people who haven’t had weight problems to relate to me.
The next set contains questions designed to evaluate how much you fear the judgements of others, as well as what kinds of things your mind has been saying to you about your weight or body shape. Please read each statement carefully and click to choose between 1 (completely agree with the statement) and 5 (completely disagree with the statement). - Others will think I lack self-control because of my weight problems.
The next set contains questions designed to evaluate how much you fear the judgements of others, as well as what kinds of things your mind has been saying to you about your weight or body shape. Please read each statement carefully and click to choose between 1 (completely agree with the statement) and 5 (completely disagree with the statement). - Others are/have been ashamed to be around because of my weight.
The next set contains questions designed to evaluate how much you fear the judgements of others, as well as what kinds of things your mind has been saying to you about your weight or body shape. Please read each statement carefully and click to choose between 1 (completely agree with the statement) and 5 (completely disagree with the statement). - People think I am to blame because of my weight problems
The following questions contain a series of statements about how people might think, feel, or behave. Please read each statement carefully and decide how much it pertains to you personally right now. Please click to indicate your answer. - Before going out in public, I always notice how I look.
The following questions contain a series of statements about how people might think, feel, or behave. Please read each statement carefully and decide how much it pertains to you personally right now. Please click to indicate your answer. - I am careful to buy clothes that will make me look my best.
The following questions contain a series of statements about how people might think, feel, or behave. Please read each statement carefully and decide how much it pertains to you personally right now. Please click to indicate your answer. - My body is sexually appealing.
The following questions contain a series of statements about how people might think, feel, or behave. Please read each statement carefully and decide how much it pertains to you personally right now. Please click to indicate your answer. - I constantly worry about being or becoming fat.
The following questions contain a series of statements about how people might think, feel, or behave. Please read each statement carefully and decide how much it pertains to you personally right now. Please click to indicate your answer. - I like my looks just the way they are.
The following questions contain a series of statements about how people might think, feel, or behave. Please read each statement carefully and decide how much it pertains to you personally right now. Please click to indicate your answer. - I check my appearance in a mirror whenever I can.
The following questions contain a series of statements about how people might think, feel, or behave. Please read each statement carefully and decide how much it pertains to you personally right now. Please click to indicate your answer. - Before going out, I usually spend a lot of time getting ready.
The following questions contain a series of statements about how people might think, feel, or behave. Please read each statement carefully and decide how much it pertains to you personally right now. Please click to indicate your answer. - I am very conscious of even small changes in my weight.
The following questions contain a series of statements about how people might think, feel, or behave. Please read each statement carefully and decide how much it pertains to you personally right now. Please click to indicate your answer. - Most people would consider me good-looking
The following questions contain a series of statements about how people might think, feel, or behave. Please read each statement carefully and decide how much it pertains to you personally right now. Please click to indicate your answer. - It is important that I always look good.
The following questions contain a series of statements about how people might think, feel, or behave. Please read each statement carefully and decide how much it pertains to you personally right now. Please click to indicate your answer. - I use very few grooming products.
The following questions contain a series of statements about how people might think, feel, or behave. Please read each statement carefully and decide how much it pertains to you personally right now. Please click to indicate your answer. - I like the way I look without my clothes on.
The following questions contain a series of statements about how people might think, feel, or behave. Please read each statement carefully and decide how much it pertains to you personally right now. Please click to indicate your answer. - I am self-conscious if my grooming isn't right
The following questions contain a series of statements about how people might think, feel, or behave. Please read each statement carefully and decide how much it pertains to you personally right now. Please click to indicate your answer. - I usually wear whatever is handy without caring how it looks.
The following questions contain a series of statements about how people might think, feel, or behave. Please read each statement carefully and decide how much it pertains to you personally right now. Please click to indicate your answer. - I like the way my clothes fit me.
The following questions contain a series of statements about how people might think, feel, or behave. Please read each statement carefully and decide how much it pertains to you personally right now. Please click to indicate your answer. - I don't care what people think about my appearance.
The following questions contain a series of statements about how people might think, feel, or behave. Please read each statement carefully and decide how much it pertains to you personally right now. Please click to indicate your answer. - I take special care with my hair grooming.
The following questions contain a series of statements about how people might think, feel, or behave. Please read each statement carefully and decide how much it pertains to you personally right now. Please click to indicate your answer. - I dislike my physique.
The following questions contain a series of statements about how people might think, feel, or behave. Please read each statement carefully and decide how much it pertains to you personally right now. Please click to indicate your answer. - I am physically unattractive.
The following questions contain a series of statements about how people might think, feel, or behave. Please read each statement carefully and decide how much it pertains to you personally right now. Please click to indicate your answer. - I never think about my appearance.
The following questions contain a series of statements about how people might think, feel, or behave. Please read each statement carefully and decide how much it pertains to you personally right now. Please click to indicate your answer. - I am always trying to improve my physical appearance.
The following questions contain a series of statements about how people might think, feel, or behave. Please read each statement carefully and decide how much it pertains to you personally right now. Please click to indicate your answer. - I am on a weight-loss diet.
I have tried to lose weight by fasting or going on crash diets.
I think I am:
From looking at me, most other people would think I am:
ACESThe following questions ask about difficult experiences you may have had growing up. Please click to indicate your answer. Prior to your 18th birthday: - Did a parent or other adult in the household often or very often… Swear at you, insult you, put
ACESThe following questions ask about difficult experiences you may have had growing up. Please click to indicate your answer. Prior to your 18th birthday: - Did a parent or other adult in the household often or very often… Push, grab, slap, or throw so
ACESThe following questions ask about difficult experiences you may have had growing up. Please click to indicate your answer. Prior to your 18th birthday: - Did an adult or person at least 5 years older than you ever Touch or fondle you or have you tou
ACESThe following questions ask about difficult experiences you may have had growing up. Please click to indicate your answer. Prior to your 18th birthday: - Did you often or very often feel that No one in your family loved you or thought you were impor
ACESThe following questions ask about difficult experiences you may have had growing up. Please click to indicate your answer. Prior to your 18th birthday: - Did you often or very often feel that you didn’t have enough to eat, had to wear dirty clothes,
ACESThe following questions ask about difficult experiences you may have had growing up. Please click to indicate your answer. Prior to your 18th birthday: - Was a biological parent ever lost to you through divorced, abandonment, or other reason?
ACESThe following questions ask about difficult experiences you may have had growing up. Please click to indicate your answer. Prior to your 18th birthday: - Was your mother or stepmother: Often or very often pushed, grabbed, slapped, or had something t
ACESThe following questions ask about difficult experiences you may have had growing up. Please click to indicate your answer. Prior to your 18th birthday: - Did you live with anyone who was a problem drinker or alcoholic or who used street drugs?
ACESThe following questions ask about difficult experiences you may have had growing up. Please click to indicate your answer. Prior to your 18th birthday: - Was a household member depressed or mentally ill? or Did a household member attempt suicide?
ACESThe following questions ask about difficult experiences you may have had growing up. Please click to indicate your answer. Prior to your 18th birthday: - Did a household member go to prison?
Demographics What age group do you belong to?
How would you describe your gender? - Selected Choice
How would you describe your gender? - Prefer to self describe in another way- Please specify - Text
What is your ethnicity?
What is your current employment status?
Other questions From which NHS hospital were you referred? - Selected Choice
Total number of bariatric surgeries undergone?
What type of bariatric surgery did you have (If more than one please tick the one that matches the most recent surgery)? - Selected Choice
What type of bariatric surgery did you have (If more than one please tick the one that matches the most recent surgery)? - Unsure. I give consent for the researcher to find this information in my NHS bariatric record. Please type yes or no in the box below. - Text
Years after surgery
Current weight:
PHQ-9post
Self compassion
GAD7post
Body satisfaction
Self class weight
Weight preocupation
Q18_2Rev
Q18_3Rev
Q18_4Rev
Q18_5Rev
Q18_6Rev
Q18_7Rev
Q18_8Rev
Q18_9Rev
Q18_10Rev
Q18_11Rev
Q18_12Rev
Appearance Evaluation
Appearance Orientation
External stigma
Q24_1New
Q24_2New
Q24_3New
Q24_4New
Q24_5New
Q24_6New
Q24_7New
Q24_8New
Q24_9New
Q24_10New
Adverse life experiences
Percentage
Months post surgery excess weight loss calculated
GAD-7pre
PHQ-9pre