Weekly Weight Loss Report Card (Evaluation)

Date:_____________________ Week #:________
Weight lost over the last 1 week (lbs):______
Total weight loss to date (lbs):________

Did you:

Always Mostly Rarely
Eat at level 7?
Eat slowly & chewed till food was liquid in the mouth?
Take 20 minutes or more to eat?
Eat within a brief mealtime window (BMW)?
Skip breakfast (or dinner) and eat 1-2 meals per day?
Drink one to three 8 oz glasses of water everytime you felt hungry and at the beginning of each meal?
Drink a total water intake of 2.5 to 3.5 liters of water a day and until your urine color is clear like water?
Eat less by controlling your portion sizes?
Eat protein and fiber with each meal?
Eat real food?
Eat healthy low-carb high-fat meals?
Eat your favorite food first and eat one food at a time?
Use snacks appropriately (i.e.healthy snacks only to delay hunger until mealtimes)?
Exercise / Stay physically active?
Rest, Relax, and Sleep more (6-8 hrs/day)?
Create an environment that sets you up for success?
Avoid eating due to sensory, emotional, and habitual hunger?
Avoid sweets/sugars
Avoid breads?
Avoid alcohol?

 

Diluted orange juice initially to help skip breakfast if hungry. Use sparingly later because of possible carries or tooth decay.

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