Weight Loss Assessment Questionnaire

Scoring the weight loss readiness quiz to score the quiz look at your answers next to items 1 2 4 5 7 and 9.

Weight loss assessment questionnaire. Are you concerned about your weight. How long have you been considering weight loss surgery. Losing weight is hard.

Score 1 if you answered true and 0 if you. What is your desired goal weight at 12 18 months after surgery. Weight history 2.

Weight management questionnaire patient name date please answer each of the questions below. Very overweight obese slightly overweight healthy weight underweight 2. Nutrition assessment questionnaire welcome to deaconess weight loss solutions.

Simple appetite questionnaire predicts weight loss in community dwelling adults and nursing home residents december 2005 american journal of clinical nutrition 82 5 1074 81. Toronto health and wellness centre brookfield place suite 3000 181 bay st po box 818. What is your current weight.

How do you feel about the way you look at this weight circle one. The military diet the military diet claims that it can help you lose weight at the fastest speed and that is up to 10 pounds or 4 5 kilograms in just a single week. The information you share will help the registered dietitian have a better understanding of your needs.

Begin your free weight loss assessment now it s quick and easy. In the past month have you. Weight questionnaire complete this page only if you are interested in weight loss or weight gain 1.