Weight Efficacy Life-Style Questionnaire                                                  Client ID#_________________

                                                                                                                        Date: ______/______/______

                                                                                                                        Assessment Point:  _____________

Listed below are a number of situations that lead some people to use eat. We would like to know how Confident you are that you would not eat in each situation.

circle the number that best describes your feelings of confidence to not EAT FoOD in each situation according to the following scale:

0          1          2          3          4          5          6          7          8          9

                                        not confident                                                                           VeRY Confident

1.  I can resist eating when I am ANxious (nervous)

0          1          2          3          4          5          6          7          8          9

2.  i can control my eating on the weekends.

0          1          2          3          4          5          6          7          8          9

3.  I can resist eating even when i have to say “no” to others.

0          1          2          3          4          5          6          7          8          9

4.  i can resist eating when i feel physically run down.

0          1          2          3          4          5          6          7          8          9

5.  I can resis eating when i am watching tv.

0          1          2          3          4          5          6          7          8          9

6.  i can resist eating when i am depressed (or down).

0          1          2          3          4          5          6          7          8          9

7.  i can resist eating when there are many different kinds of food available.

0          1          2          3          4          5          6          7          8          9

8.  I can resist eating even when i feel it’s impolite to refuse a second helping.

0          1          2          3          4          5          6          7          8          9

9.  i can resist eating even when i have a headache.

0          1          2          3          4          5          6          7          8          9

10.  i can resist eating when i am reading.

0          1          2          3          4          5          6          7          8          9

11.  i can resist eating when i am angry (or irritable).

0          1          2          3          4          5          6          7          8          9

12.  i can resist eating weven when i am at a party.

0          1          2          3          4          5          6          7          8          9

13.  i can resist eating even when others are pressuring me to eat.

0          1          2          3          4          5          6          7          8          9

14.  i can resist eating when i am in pain.

0          1          2          3          4          5          6          7          8          9

15.  i can resist eating just before going to bed.

0          1          2          3          4          5          6          7          8          9

16.  i can resist eating when i have experienced failure.

0          1          2          3          4          5          6          7          8          9

17.  i can resist eating even when high-calorie foods are available.

0          1          2          3          4          5          6          7          8          9

18.  i can resist eating even when i think others will be upset if i don’t eat.

0          1          2          3          4          5          6          7          8          9

19.  i can resist eating when i feel uncomfortable.

0          1          2          3          4          5          6          7          8          9

20.  i can resist eating when i am happy.

0          1          2          3          4          5          6          7          8          9

Description

Self-efficacy (Bandura, 1977) conceptualizes a person's perceived ability to perform on a task as a mediator of performance on future tasks. A change in the level of self-efficacy can predict a lasting change in behavior if there are adequate incentives and skills. The Weight Efficacy Life-Style Questionnaire is a 20-item self-report measure that assesses an individual's confidence to abstain from eating in a variety of different situations.  It is possible to obtain both an overall measure as well as situational self-efficacy based on subscale scores.

Target Population:
          Adults
Administrative Issues:
        Number of items:
                        20 items
        Mode of administration:
                        Pencil and paper self-administered
        Time required to administer:
                        5-10 minutes
        Staff expertise required for administration:
                        None
        Training required for administration:
                        No training required for administration
Norms available:

Psychometrics:
          Reliability: Cronbach alpha coefficients for internal consistency ranged from .70 to .90.

          Validity:  Demonstrated an independent cross-validation.

                        Demonstrated appropriate convergent validity with the Eating Self-Efficacy Scale.
Copyright Information:
          Instrument is not copyrighted and available at no cost

Scoring

Weight Efficacy Life-Style Questionnaire – 20 item version
 

To obtain a mean overall Weight Efficacy score, sum scores from all items and divide by 20.

To obtain mean scores for individual subscales, sum item scores for each subscale and divide by the number of items (4 for each subscale).

References

Clark, M. M., Abrams, D. B, Niaura, R. S., Eaton, C. A., & Rossi, J. S.  (1991).  Self-efficacy in weight management.  Journal of Consulting and Clinical Psychology,59(5), 739-744.