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  1. Surveys
  2. 2016
  3. April
  4. B
  5. Body Image
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Exit Survey
 
 
Are you a male or female?
 
Male
 
Female
 
 
 
How important to you is your appearance?
 
Very important
 
Moderately important
 
Slightly important
 
Not important
 
 
 
Would you say the pressures of body image (looking a certain way) affect you?
 
Yes
 
No - SKIP TO Q7
 
 
 
What do you think is the biggest cause of your body image concerns?
 
My own perception of my body
 
Peer pressure
 
Pressure from family
 
The ideals of the media (magazines, tv, etc.)
 
Other
 
 
 
Which of these do you relate to most as an effect of body image?
 
Being insecure around people
 
Embarrassment
 
Gaining motivation to exercise, eat healthier, etc.
 
General unhappiness
 
Lowered self worth
 
Undesirable to the opposite sex
 
Other (please specify)
 
 
 
Do you often compare your body to those of others?
 
Yes
 
No
 
 
 
Against whom do you most often compare your body?
 
Actors/actresses
 
Athletes
 
Friends
 
Models
 
Other
 
 
 
Have you ever gone on a diet to change the way you look?
 
Yes, to lose weight
 
Yes, no gain weight
 
Yes, to gain muscle
 
No
 
 
 
Which feature(s) of your body are you most dissatisfied with? SELECT A MAXIMUM OF TWO.
 
Arms
 
Breasts - too large
 
Breasts - too small
 
Chest
 
Height - too tall
 
Height - too short
 
Hips
 
General weight - want to lose weight
 
General weight - want to gain weight
 
Legs
 
Musculature (want to gain muscle)
 
Shoulders
 
Stomach/abs
 
Thighs
 
 
 
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)