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WEIGHT GAIN QUESTIONNAIRE

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Instructions

  • Read through each question, and only tick the one that applies to you.
  • Please complete this questionnaire as honestly as you can.
  • There are no right or wrong answers, and everything you share will be kept strictly confidential.
  • 1 point is scored for each ‘yes’ answer. Maximum score is 20. Minimum score is 0.
  • The Weight Gain Probability Score indicates how easily a person can put on weight, and also provides recommendations specific to each category.
  • The higher the score, the more likely you are to continue gaining weight – or to regain it after a weight loss regime!
Name(Required)
o Do you eat white rice, white flour or white bread rather than whole grain more than three times per week?(Required)
o Do you have more than a pint (approx. 600 mls) of full fat dairy (milk, yoghurt) or more than 200 grams of full fat cheese a week?(Required)
o Do you have caffeinated drinks (green or black tea, coffee) after 4pm?(Required)
o Do you have snacks from vending machines (roasted / salted nuts, crisps, chocolate bars, M&M’s, wine gums, fruit juice) more than twice a week?(Required)
o Do you add sugar to food or drink almost every day?(Required)
o Do you have foods or drinks with added sugars and / or fruit juice (e.g. natural orange juice) almost every day?(Required)
o Do you eat fried food more than twice a week?(Required)
o Do you use products containing hydrogenated oils (e.g. margarine, vegetable oil, mayonnaise, commercial sauce) more than twice a week?(Required)
o Do you use extra salt on your food almost daily?(Required)
o Do you drink more than 10oz (28g) of alcohol (one glass of wine, 1 pint or 600mls of beer, or one measure of spirits) a day?(Required)
o Do you eat processed ‘fast food’ (McDonald’s, KFC, Pizza Express, supermarket party foods, etc.) more than twice a week?(Required)
o Do you eat processed meats (such as sausages, ham, salami, bacon, smoked salmon, deli meats) more than twice a week?(Required)
o Do you eat foods containing artificial additives and preservatives daily (e.g. canned food, long-life milk, deli meats, jelly, jam, sweets, crisps)?(Required)
o Do you eat dessert (ice cream, pies, pudding, pastries, cakes, cookies, or sweets) more than twice a week?(Required)
o Are there some foods you feel ‘addicted’ to, or tend to overeat (even when not hungry)?(Required)
o Do you eat more than four slices of commercial bread a day, on average?(Required)
o Does less than a third of your diet consist of vegetables?(Required)
o Do you eat less than 2 servings of fresh fruit a day?(Required)
o Do you drink less than ½ pint (300mls) of plain water each day?(Required)
o Do you eat oily fish or Omega 3 foods (e.g. flaxseed or egg with the yolk) less than twice a week? [Ignore if you take Omega 3 supplements](Required)
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o Do you eat white rice, white flour or white bread rather than whole grain more than three times per week?(Required)

Weight Gain Probability Score

0 to 2: SAFE ZONE

You are a health-conscious individual and the minor indiscretions are unlikely to affect your weight. Any weight gain experienced would be the result from consuming more calories than those expended, so keep track of that!

3 to 4: MINOR WEIGHT GAIN PROBABILITY

The habits that you answered “yes” to may sabotage your weight loss efforts – or cause weight regain! Try to move to the “Safe Zone” within one month. Provided you support your diet with more fibre, proper hydration and essential vitamins and minerals, together with the suggestions from a Clinical Weight Loss Specialist, you can look forward to a successful weight loss process and smooth weight maintenance.

5 to 9: MEDIUM WEIGHT GAIN PROBABILITY

You can easily put on weight from your “yes” answers, so you must be vigilant. Rather than giving up all the bad habits at once, set short-term goals. For instance, for one month go without two or three of the foods or drinks that aren’t good for you. Observe how you feel afterwards. You may decide to have some occasionally, while leaving others out forever without any effects of feeling ill. Stick to these changes for one month – your cravings will only be short-term withdrawal symptoms. Aim to have your score below 5 within three months. Provided you add more fibre to your diet, and follow the recommendations of a Clinical Weight Loss Specialist to experience noticeable results.

10 to 14: HIGH WEIGHT GAIN PROBABILITY

Your diet is not good and you will need to make changes in order to be able to lose weight and enjoy better health. Take one step at a time. Aim to have your score below 5 within six months. You will need the support of a Clinical Weight Loss Specialist. You will find that some of your bad dietary habits will change for the better as you witness the results from your efforts. The bad habits that remain should be dealt with one at a time. Remember that sugar, pastries, sweets, chocolate, white bread, cookies, full fat dairy, junk foods, and alcohol are all addictive. Your cravings for them will dramatically decrease or go away altogether after one month without them.

15 to 20: DANGER ZONE

There is no way you can continue to eat like this and remain in good health. You are consuming too much fat, refined foods, sugar and artificial stimulants. You will need the support and encouragement of a Clinical Weight Loss Specialist for a longer period of time to make gradual and permanent changes to your lifestyle. You can start by taking two questions to which you answered “yes” and discuss with your specialist what changes need to take place so that one month later you could answer “no” (one example would be to stop buying the foods you are addicted to during the first month). Keep doing this until your score is 5 or less. You may feel worse for the first two weeks, but within a month you will begin to feel positive effects of healthy eating!

Thank you for filling the questionnaire! Now you may know some of the reasons you keep gaining weight or why you keep regaining the weight you have lost. Are you tired of going back and forth in your weight loss journey? Would you need a long-lasting solution to your weight loss struggles? Would you want to lose weight and keep it off and be healthy? Then you may need the support of a Clinical Weight Loss Specialist.

Book a consultation to get started on a HEALTHIER YOU. Click here to book your consultation.

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Email: support@halamnature.com

Phone: +2347041851495

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