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  1. Surveys
  2. 2014
  3. February
  4. B
  5. Body Image
0%
Questions marked with an * are required Exit Survey
 
 
What is your age?
 
10-20
 
21-30
 
31-40
 
41-50
 
51+
 
 
 
* What is your gender?
 
Male
 
Female
 
 
 
* Are you happy with your body image?
 
Yes, I am very confident
 
Somewhat, there are a few things I would change if I could
 
Not at all, I have no confidence
 
 
 
* How important is your appearance to you?
 
Very important
 
Moderately important
 
Slightly important
 
Not important
 
 
 
* What do you think has played the biggest part in developing your body image?
 
My own perception of my body
 
Peer Pressure
 
Pressures from family
 
The media (magazines, tv, etc)
 
Other
 
 
 
 
* Which features of your body are you most dissatisfied with?
 
Face
 
Arms
 
Chest
 
Height
 
Weight
 
Legs
 
Shoulders
 
Stomach/abs
 
Thighs
 
Other
 

 
 
 
* On a scale of 1 to 5, how important do you think physical appearance is for men in this society? (5 being most important, 1 being least important)
 
1
 
2
 
3
 
4
 
5
 
 
 
* On a scale of 1 to 5, how important do you think physical appearance is for women in this society? (5 being most important, 1 being least important)
 
1
 
2
 
3
 
4
 
5
 
 
 
* Do you compare your body to others? If so, who do you compare it to most?
 
I don't compare my body to others
 
Peers
 
Celebrities
 
Athletes
 
Models
 
Other
 
 
 
 
* Which of these would you say effects your body image most?
 
Being insecure around people
 
Gaining motivation to exercise/be healthy
 
Embarrassment
 
Unhappiness
 
Lowered self-esteem
 
Unwanted by opposite sex
 
Other