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1
When you think about the last 90 days, how would you describe your eating?
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Pretty much whatever, whenever. I don't really have a structure around food.
I eat okay most of the time but weekends and family events throw me off completely.
I try to eat well but I'm not sure if what I'm eating is actually right for fat loss.
I'm fairly consistent with my food and I know roughly what I should be eating.
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2
How would you describe your weight over the last 6 months?
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All over the place. It goes up and down depending on what's happening in life.
Pretty much the same. I'm not really gaining but I'm not losing either.
Slowly creeping up even though I feel like I'm trying.
I've lost a little but it's been slow and inconsistent.
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3
Do you have a clear, repeatable routine around your eating and movement each week?
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No. I just try to make good choices when I can but there's no real plan.
Sort of. I have some habits but nothing consistent or written down.
I have a routine but I fall off it constantly and struggle to get back on track.
Yes and I stick to it most of the time, I just don't know if it's the right routine.
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4
How many days in the last 30 days would you say you were genuinely active?
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0 to 4 days. I barely moved outside of what daily life requires.
5 to 10 days. I made some effort but it was scattered.
11 to 20 days. I was active most weeks but not consistently.
More than 20 days. I move regularly, exercise just isn't shifting the weight.
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5
What is your experience with trying to lose weight?
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I haven't really tried anything structured before.
I've tried diets or programs before but gave up and went back to old habits.
I'm currently trying something but the results are inconsistent.
I've had some success before but I can never seem to keep the weight off long term.
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6
How clearly do you understand what is actually causing you to not lose weight?
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Not sure at all. I feel like I'm doing okay but nothing is working.
I have some idea but I keep second guessing myself and don't know where to start.
I think I know the problem but my habits and follow through aren't consistent enough.
I know exactly what I need to fix. I just haven't been able to do it on my own.
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7
What is your primary goal for the next 12 months when it comes to your health?
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Just feel a bit better and have more energy day to day.
Lose weight steadily and build healthier habits that actually stick.
Get back to how I looked and felt when I was at my fittest.
Completely transform my health, feel confident in my body, and stay that way for life.
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8
Name
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First Name
Last Name
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9
Phone Number
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Please enter a valid phone number.
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10
Enter your email to see your results:
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example@example.com
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11
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