Survey: Body Image Assessment


How secure, confident, and healthy is your body image?

Amidst persistent, culturally-accepted beliefs that we cannot be too rich or too thin, our life experiences often speak loudly to the contrary. When 67% of all American women routinely withdraw from life-engaging activities like raising their hand in class or even going to the doctor (Dove Campaign for Real Beauty), it is time to take a look at the effects body image has on our quality of life.

You have a right to feel good about the skin in which you live. Professional help has been shown to help restore positive self-esteem for individuals who struggle with body image. In order to determine how confident you are about your body, it is best to begin with a simple assessment like the one below.

Instructions: Answer each question using the rating scale of 1–5, where 1 = Never True and 5 = Always True. When you have answered all of the questions, enter your name and email address along with your score in the form below to receive your confidential Body Image Assessment Scoring Interpretation.

Assessment Developed by: Milana Leshinsky and Larina Kase, Psy.D., M.B.A.

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