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  1. When I have eaten in company I have tended to time my eating as a form of strategy
  2. so that others are not really aware of just how little I am eating.
  3. When I have eaten something reasonably substantial I have tended to fe
  4. el disappointed or even angry with myself as well as slightly relieved.
  5. I have become irritable and impatient at mealtimes if someone has tried to persuade me to eat something.
  6. 1 have often avoided meal times by claiming that I have already eaten when it is not true.
  7. Some food has made me wish I could eat it as other people do but I have nonetheless found that I could not bring myself to do so.

The original PROMIS questionnaire had thirty questions on each addictive outlet, mostly focusing upon the first eight of these twelve addictive characteristics. It was found in practice to be time-consuming and cumbersome and was therefore cut down to one third of its length by selecting those answers that most commonly featured in patients with these specific addictive outlets. The questionnaires were validated against all the other addiction questionnaires commonly used throughout the world in various forms of addictive or compulsive behaviour and they were also validated against normal controls selected from my general medical practice and from psychology students. Over four thousand patients have now completed the Shorter PROMIS Questionnaires and it is available on our website ( ) together with an automated scoring system to provide an insight into the significance of the answers. In general a total of twenty points on any individual outlet gives cause for concern.

For patients with eating disorders it is necessary to differentiate the two extremes of behaviour: bingeing and starving. There are therefore two questionnaires: one for each of these behaviours. Some patients will provide answers that are currently in one extreme or the other but it is common to find patients - as one would expect from clinical experience - who have both tendencies and who perhaps alternate from one to the other at different times in their lives. It is this specific awareness that illustrates that changing a patient's body weight is not necessarily an indication that his or her eating disorder has been treated successfully. A particular patient may move from starving to bingeing and go straight through what would be considered to be a normal body weight and finish up significantly the far side. Or perhaps a patient will discover that self-induced vomiting or purging can maintain body weight while he or she continues to have periodic or regular binges.

Patients who have eating disorders commonly cross-addict into work, exercise, shopping and spending. The specific characteristics that refer to these behaviours when they are addictive or compulsive are as follows:

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