Request edit access
JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Your Body And The World- survey for women by @ronitplank
Please complete this anonymous survey only once. If you'd like to be considered for a podcast interview, you can include your email address at the end. Thank you!
contact:
YourBodyAndTheWorld@gmail.com
Sign in to Google
to save your progress.
Learn more
1. Can you remember how old you were when you began judging your body?
Your answer
2. What (to the best of your recollection) made you begin to criticize it?
Your answer
3. How many times a day do you think about your body in a critical way?
Your answer
4. Do clothing size numbers affect your mood? How?
Your answer
5. What does being skinny/thin meant to you?
Your answer
6. How many times in your life have you wanted to lose weight?
Your answer
7. Did a parent or loved one ever suggest a diet or put you on one when you were growing up?
Your answer
8. If you've been on diets can you list 3?
Your answer
9. What is your first thought when you see a woman who looks heavier than you?
Your answer
10. What is your first thought when you see a woman who looks thinner than you?
Your answer
11. Growing up, where did your family fall socio-economically?
Your answer
12. If you have ever wanted to lose weight, what did you want that weighing less would get you?
Your answer
13. If you have ever lost a "goal" amount of weight did it help you stop thinking of your body in a critical way or give you peace of mind?
Your answer
14. Do you feel your eating has ever become disordered in pursuit of changing your body? If yes, please share a few details.
Your answer
15. Do you feel you see your body accurately? How so or how not?
Your answer
16. What does being slim/thin mean to you?
Your answer
17. What if anything does thinking about your body size and shape distract you from?
Your answer
18. When you feel confident about your body what do you like about it?
Your answer
19. If you could offer girls and women younger than you one piece of advice about their bodies what would it be?
Your answer
20. What is your age group?
I'm a teenager
I'm in my 20s
I'm in my 30s
I'm in my 40s
I'm in my 50s
I'm in my 60s
I'm in my 70s
I'm in my 80s
Clear selection
21. (Optional) My race/ethnicity is:
Your answer
23. Please indicate if you would like to be considered for an interview on the podcast for this project or if you have a particular anecdote about body image/weight you would like to share:
Yes, I have a story to share/would like to be considered for a podcast interview.
No thanks.
Clear selection
24. If people often describe you as fit, thin, or slim and you are available for an interview (anonymous as an option) please add your email here:
Your answer
24. Thank you so much for participating! If you want updates on this project, survey results, news about the accompanying podcast, and/or answered "Yes, I have a story to share/would like to be considered for a podcast interview", please add your email below:
Your answer
25. If you would like to share a body image experience to be read on The Body Myth podcast please add it here. Also indicate if you would like Ronit to include your name or keep this anonymous. No more than 250 words please.
Your answer
Submit
Page 1 of 1
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. -
Terms of Service
-
Privacy Policy
Does this form look suspicious?
Report
Forms
Help and feedback
Contact form owner
Help Forms improve
Report
