1 Not at all true for me				5 Very true for me
1.	It is difficult to motivate myself to eat appropriately.	1□	2□	3□	4□	5□
2.	It is difficult to motivate myself to exercise.	1□	2□	3□	4□	5□
3.	Often the amount of effort I need to put into controlling what I eat doesn't seem worthwhile.	1□	2□	3□	4□	5□
4.	Exercising is rewarding when I do it, but I have trouble getting myself started.	1□	2□	3□	4□	5□
5.	Losing weight is rewarding, but I have trouble keeping motivated to maintain weight loss.	1□	2□	3□	4□	5□
6.	I get bored easily with exercise.	1□	2□	3□	4□	5□
7.	When my efforts to control my eating don't result in weight loss, I have trouble staying motivated.	1□	2□	3□	4□	5□
8.	I can't find anything at all appealing or positive about exercise.	1□	2□	3□	4□	5□
9.	When I'm very hungry I have trouble controlling what I eat.	1□	2□	3□	4□	5□
10.	Often the amount of effort I need to put into exercising doesn't seem worthwhile.	1□	2□	3□	4□	5□
11.	When I start eating something that I think I shouldn't, I have trouble stopping eating.	1□	2□	3□	4□	5□
12.	I have difficulty exercising when I get busy.	1□	2□	3□	4□	5□
13.	I have difficulty exercising when I am in a bad mood.	1□	2□	3□	4□	5□
14.	When my efforts to exercise regularly don't result in weight loss, I have trouble staying motivated.	1□	2□	3□	4□	5□
15.	Sometimes I have cravings for foods that aren't good for me (e.g., chocolate, sweets), that I have difficulty controlling.	1□	2□	3□	4□	5□
16.	I don't have the right equipment to exercise.	1□	2□	3□	4□	5□
17.	Many kinds of exercise require a level of skill/ coordination that I don't have (e.g., aerobics, tennis, rollerblading).	1□	2□	3□	4□	5□
18.	I have difficulty exercising when I feel tired.	1□	2□	3□	4□	5□
19.	The thought of not being able to eat what I want, when I want it, depresses me.	1□	2□	3□	4□	5□
20.	My friends/family do not support my efforts to change my exercise patterns.	1□	2□	3□	4□	5□
21.	I have difficulty exercising when my family/ friends want me to spend time with them.	1□	2□	3□	4□	5□
22.	I have difficulty exercising when I am slightly sore from the last time I exercised.	1□	2□	3□	4□	5□
23.	My friends/family do not support my efforts to change my diet.	1□	2□	3□	4□	5□
24.	It is difficult for me to find good places to exercise.	1□	2□	3□	4□	5□
25.	My life is so busy that I have trouble finding time to eat properly.	1□	2□	3□	4□	5□
26.	I have difficulty exercising when I am away from home.	1□	2□	3□	4□	5□
27.	I often find myself in situations where eating a lot of food seems to be expected (e.g., holiday, social occasions, work functions, business trips).	1□	2□	3□	4□	5□
28.	My life is so busy that I have trouble finding time to exercise.	1□	2□	3□	4□	5□
29.	Healthy foods are often not available when it is time for me to eat (e.g., healthy choices not available at home, work, or in restaurants).	1□	2□	3□	4□	5□
30.	I have difficulty finding people to exercise with.	1□	2□	3□	4□	5□
31.	I don't know what types of exercise or how much I need to exercise in order to lose weight.	1□	2□	3□	4□	5□
32.	I have trouble estimating portion sizes.	1□	2□	3□	4□	5□
33	I have trouble estimating the calorie and fat content of food.	1□	2□	3□	4□	5□
34.	I have trouble figuring out how much exercise I have done.	1□	2□	3□	4□	5□
35.	I have difficulty figuring out how to fit exercise into my daily life.	1□	2□	3□	4□	5□
36.	I don't know what foods I should eat to lose weight.	1□	2□	3□	4□	5□
37.	I don't know how to prepare healthy foods.	1□	2□	3□	4□	5□
38.	I have difficulty exercising when I haven't exercised in a while.	1□	2□	3□	4□	5□
39.	I have difficulty exercising when I just want to relax and enjoy myself.	1□	2□	3□	4□	5□