Do some of your feelings make you want to eat? Indicate the extent to which the following feelings make you want to eat by checking one box for each of the feelings listed below. If there is another feeling not listed below that makes you want to eat, please make a note of the feeling and the extent of your desire to eat.
from Arnow, B., Kenardy, J. & Agras, W. The Emotional Eating Scale. International Journal of Eating Disorders. 1995. Vol. 18, No. 1, pages 79-90.