Nutrition Day 1 Journal
What specific physical goals do you currently desire? (I.e. body weight, body fat, muscle gain, health marker improvements, confidence)
What barriers have you encountered before or do you think/feel will affect your success?
Rate your overall confidence (1-10)
1
2
3
4
5
6
7
8
9
10
No self confidence
I truly love and accept myself
1 is No self confidence, 10 is I truly love and accept myself
Rate your confidence in your ability to change (1-10)
1
2
3
4
5
6
7
8
9
10
I don’t think I can
I GOT THIS!
1 is I don’t think I can, 10 is I GOT THIS!
How do you think you could increase your confidence?
Describe how your unhealthy behavior affects you on a daily, weekly, and monthly basis. In what ways might your behavior might be affecting those around you?
What is your perception of the healthy behavior that you are considering?
How long do you think your goal will take to achieve?
1-6 months
6-12 months
13- 24 months
More than 2 years
Answer the following questions as to how you feel:
Strongly Agree (Daily)
Agree (Sometimes)
Neutral
Disagree (Rarely)
Strongly Disagree (Never)
I know what to eat and when to eat
I track my macros
I am happy with how I look
I feel healthy
I have sustainable energy throughout the day
I like the foods I eat daily
I go out to eat
Describe how your unhealthy behavior affects you on a daily, weekly, and monthly basis. In what ways might your behavior might be affecting those around you?
Upload Pictures of your body here:
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Weight in lbs
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Body Fat %
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Waist Inches (around belly button)
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