Youth Risk Behavior Survey Template Page 13
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1682.
During your life, from when have you
86.
During the past 30 days, did you
received the most information about
vomit or take laxatives to lose
sexual activity? (Select only one
weight or to keep from gaining
response.)
weight?
A.
Your parents
A.
Yes
B.
A brother or sister
B.
No
C.
Another family member
D.
Your friends
E.
A health teacher, school
The next 5 questions ask about food you
nurse, counselor, or some
ate or drank during the past 7 days.
other adult at school
Think about all the meals and snacks you
F.
The media, including
had from the time you got up until you
television, movies, the
went to bed. Be sure to include food you
Internet, magazines, and
ate at home, at school, at restaurants, or
books
anywhere else.
87.
During the past 7 days, how many
times did you eat fruit or drink 100%
The next 4 questions ask about body
fruit juice? (Do not count punch,
weight.
sports drinks, energy drinks, or other
fruit-flavored drinks.)
83.
How do you describe your weight?
A.
I did not eat fruit or drink
A.
Very underweight
100% fruit juice during the
B.
Slightly underweight
past 7 days
C.
About the right weight
B.
1 to 3 times during the past 7
D.
Slightly overweight
days
E.
Very overweight
C.
4 to 6 times during the past 7
days
84.
During the past 30 days, did you go
D.
1 time per day
without eating for 24 hours or
E.
2 times per day
more (also called fasting) to lose
F.
3 times per day
weight or to keep from gaining
G.
4 or more times per day
weight?
A.
Yes
B.
No
85.
During the past 30 days, did you
take any diet pills, powders, or
liquids without a doctor's advice to
lose weight or to keep from gaining
weight? (Do not include meal
replacement products such as Slim
Fast.)
A.
Yes
B.
No
-13-
2009 YRBS
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