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1. How many salads and vegetables do you eat a week?

  1 or less
  1 to 2
  3 to 6
  7 to 10
  11 or more

2. How many times a week do you drink wine or a cocktail?

  None (I don't drink)
  Once
  2 to 3
  4 - 7
  Every day, religiously

3. How many vegetables do you actually like and have found a way to make them taste good?

  None
  1 to 3
  4 to 6
  7 to 10
  11 or more

4. What is your ability to make vegetables taste good?

  Not at all, I wish I could.
  I have a few go to recipies.
  I can make all vegetables taste great.

5. Tell us what you eat for a typical breakfast and then, what you would eat if it was your ideal breakfast for energy and weight loss?



6. Select the more nutritious meal:

  Whole grains, turkey sausage, with a light skim milk
  A salad with bacon, chicken, and avocado
  Egg whites, light cream cheese w/ whole grain english muffin and pineapple on the side.


7. For your best meal ever, which one appeals to you most?

  Something sugary
  A huge bowl of awesome pasta
  Filet mignon with garlic rosemary mashed potatoes, a large salad, creme brulee,
        and a glass of port
  Tofu, vegetables wraps with teriyaki
  All of the above at once

8. If I was going to take a food away from you, what is your biggest nightmare?

  Bread and pasta
  Milk, cream, and cheese
  Sugar in your coffee
  Eggs
  Eh, I don't really care.

9. Which do you find hardest to eat healthy?

  Breakfast
  Lunch
  Dinner
  Snacks
  At night


10. What percentage of the time during your meals are you eating a traditional protein? I.e. eggs, meat, fish, chicken, some sort of animal protein (not soy based)

  Every single meal and snack
  1 or 2 meals a day
  A few times a week
  Maybe once a week
  Never, I'm a vegetarian

11. How much soy do you eat? (tofu, animal protein replacements)

  Every single meal
  1 to 2 meals a day
  A few times a week
  Maybe once a week
  Maybe once in a while
  None, I avoid soy like the plague

12. How much dairy do you eat? (cheese, milk, cream)

  Every single meal
  1 to 2 meals a day
  A few times a week
  Maybe once a week
  Maybe once in a while
  None, I really avoid all dairy


13. How many eggs do you eat?

  Every single meal
  1 to 2 meals a day
  A few times a week
  Maybe once a week
  Maybe once in a while
  None, I really avoid eggs

14. How much fruit are you eating?

  Very Little / Rarely
  Once or twice a week
  A few times a week
  Usually once a day
  Seems like I eat fruit all the time

15. What percentage of your breakfast is sugar?

  Zero
  A bit of it
  Probably loaded with about half sugar
  It's mostly sugar
  It's all sugar, who am I kidding?


16. How much water do you drink a day?

  1 to 2 glasses
  3 to 4
  5 to 6
  1/2 my weight in ounces

17. When you eat fruit, what fruit do you eat the most?

  Grapefruit and tomatoes (yes, tomato is a fruit!)
  Grapes and pineapple
  Oranges and bananas
  Berries (of any sort)
  I don't eat fruit

18. Describe your typical breakfast:

  Eggs and a bagel
  Oatmeal with berries
  A muffin
  A protein shake
  An egg omelet with vegetables
  Only coffee / I skip breakfast


19. Where do you have the most trouble with good choices? (Check all that apply)

  At home.
  At work.
  Out and about.
  On vacation.
  2 or more.
  All of these places.

20. How often do you find yourself mindlessly snacking and you suddenly find the entire snack gone?

  Never.
  Once in a while.
  Often.
  I feel like this happens every night.

21. How do you prefer your coffee?

  Black
  Cream and sugar (or some other fancy concoction)
  Skim milk and stevia (or another sweetener other than sugar)
  Coconut milk, soy milk or almond milk
  None, I don't drink coffee


22. How many cups of coffee are you drinking a day?

  0
  1
  2
  3 to 4
  Sometimes I find myself drinking a whole pot

23. Which best describes your kitchen?

  Cookies, cake, anything I want. I have kids
  A few sweets, mostly good food
  No control. My husband or roommate has so many out of control foods I could scream
  Very healthy; I only get danger foods when I'm out of the house

24. Do you find youself always doing the right thing, eating the right things, exercising and you still can't lose weight?

  Yes, this is SO me
  No, I don't do the right things and I'm not losing weight.
  Not applicable


25. How much sugar do you eat?

  Constantly. I can't think of life without sugar
  Once or twice a day
  A few times a day, as a treat
  Maybe once or twice a week, when I'm out
  Whenever I'm upset, I turn to sugar
  None

26. When it comes to solving the challenges in your life, do you tend to dig down and figure it out yourself, or do you tend to involve others even if involves doing something out of your comfort zone?

  Figure it out myself.
  Sometimes I do it on my own, sometimes I involve others.
  ALWAYS involve others, so much more fun to do things with people

27. Do you tend to seek out challenges, or do you avoid them?

  Avoid.
  Depends on my mood.
  I am a challenge seeker

28. Is change something you have a negative or positive association with?

  I hate change.
  I'm ok with it. It seems to be a part of life.
  If I don't have change all the time, I'm bored.

29. If we asked you to do something new (and positive) this week, could you identify one thing and do it?

  Sure.
  Yes, absolutely!
  Not really. I have a hard time knowing where to start.

30. In your experience, is a positive outlook on life something you just have, or can it be generated no matter the circumstance?

  Something people just have.
  Can ALWAYS be generated.
  Depends, as I get older, I think it's both.

31. On a scale of 1 to 10 how much do you feel like your weight loss and health efforts are moving you forward in a sustainable, permanent way?

  1
  2 to 3
  4 to 6
  7 to 8
  9
  10

32. Are you the kind of person who believes that success is a place you get to with quantifiable results, or are you the kind of person who views success as a journey?

  I wish I thought of it as a journey, I’m supposed to think of it as a journey, but I just don't
  Total Journey
  I want and measure success every day

33. In the last year, how many things have you done that are creative or that express who you are or want to be?

  Never. Wow, this bums me out just picking this one.
  A few times. I would do it more with more time.
  Many. I've had a pretty good year.
  I do this every day. Only way to live.

34. What is your reaction to this quiz?

  Wish it was shorter
  Just Right
  I love it! I love answering questions to figure things out.

35. If I asked you to go run 2 miles right now, what best describes your reaction?

  OMG, you've got to be kidding.
  I really don't want to but I will.
  Sure. Sounds fun.
  Yippee! Will we be ranked?

36. How many times a week do you engage in a sport or activity involving movement that you like to do?

  Never
  Rarely
  A couple of times a week
  Several times a week
  Every day, couldn't imagine not working out

37. During your workouts, what percentage of the time are you red faced, huffing, puffing, and exhausted?

  Never
  Rarely
  Sometimes, depending on the workout
  Much of the time
  The entire time

38. How many of your workouts involve periods of all-out intensity?

  None
  One in a blue moon
  A few of them
  Many of them
  All of them

39. How many times would you workout a week if you had more time, babysitting or weren't so stressed by work or other things?

  Once
  Twice
  Three times
  Five or more
  I already workout all the time

40. How strong are you during your daily tasks?

  Very, I'm always looking for the hard way out
  Not at all, I'll get anyone to carry my groceries or do any other household task
  Somewhere in between

41. When you work out, you mostly…

  Pump iron
  Run or do other aerobic work--mostly low intensity
  Aerobic exercise, but with varied intensity
  Engage in a sport, like soccer, yoga, pilates, etc.
  I like to mix it up

42. If you were asked to do some push-ups right now, how many could you do?

  You're kidding, right?
  0
  1-3
  4-7
  8-10
  More than 10

43. If you were asked to do some sit-ups right now, how many could you do?

  I couldn't be bothered
  0
  1-3
  4-7
  8-10
  More than 10

44. How often do you stretch (including activities which include stretching)?

  I have the elasticity of a frozen rubber band
  Once a week
  A few times a week
  Every day

45. How many days a week do you sleep 7 to 9 hours?

  0 to 1
  2 to 3
  4 to 5
  6 to 7

46. How much pain do you feel during the day? - This means any body pain

  Never. I am pain free
  Every once in a while, I feel some pain in my knee or an old shoulder injury
  Sometimes, at least once a day I feel my "old age" and aches and pains
  Often and I often take something for it
  All the time. I can't remember what it's like to live without pain

47. How often are you taking meds for pain, sleep, or digestion?

  Never or fewer than once every three months
  Once a month
  Once a week
  A few times a week
  Several times a week
  Every day

48. How different are you from what you used to be? Weight wise, energy wise...

  Very different. I used to be hot and full of life
  Different, I'm getting older, but I still have it sometimes
  I feel like I did when I was younger
  SO much better than 20 years ago!

49. Descibe your weight...

  Where I want it to be
  Always fluctuating between 5 and 10 pounds
  Trying to lose the last 10 to at least 30 pounds away from my ideal weight
  Between 50 and 70 pounds away from my ideal weight
  Over a hundred pounds over my ideal weight
  Between 150 and 250 pounds away from health (or more)

50. How many friends do you have that genuinely help guide your life in a positive direction?

  Zero
  1 to 2
  3 to 4
  5 or more

51. How many medications are you taking?

  Zero
  1 to 2
  3 or more

52. Describe where you live:

  In an urban center
  In the country, lots of space
  Suburbs

53. Have you been in a car accident? (or bike, skiing, or other accident that you feel shook you up?)

  Yes
  No
  Maybe, I'm not sure if it would be considered serious

54. How many times a season do you find yourself sick?

  Zero
  1 to 2
  3 to 4
  5 or more

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