Check-In Questionnaire Check-In Questionnaire Answer the following questions as best you can - clicking the + sign will give you more detailed instructions + Enter your average weight for the week. If we decided that weighing daily was best then take the average of all 7 days (or the number of days you were able to do). If twice a week is what we talked about then just average the two days together. If once/week, just enter that weigh-in. Leave blank if we decided not weighing was best. What were your tape measurements? + Take the following measurements at the largest part of each area and then consistently measure in that place each time. These are only done once every 2 weeks, so skip them this time if you did it last week. Ideal Body Assessment Rate your relationships with food, body, exercise, and mind1 = not very, 10 = very + How consistent were you with your eating? How satisfied were you? Do you eat mindfully? Do you practice moderation with a guilt-free mindset? Do you view all foods on a level playing field? Do you label foods "good" or "bad"? Are you always thinking about your next meal? Do you feel restricted or deprived? Do you eat what you want at restaurants? Does food control you? Etc 12345678910 + Body image has nothing to do with how you look and everything to do with how you see yourself. It is perception - not truth. So it can be changed without a change in appearance. Do you love your body? Does it prevent you from living your full life experience? Do you say things to yourself you wouldn't say to another person? Are you influenced by other people's judgements of you? Do you feel healthy, strong, energetic? Do you accept yourself as-is without contingencies? Etc. 12345678910 + Would you choose the exercise you do even if you could never lose another pound? Do you exercise for the sheer joy of it? Or are you doing it for an outcome? Do you associate exercise with weight loss? Are you motivated to work out or do you have to push yourself to get out and do it? Do you look forward to your workouts? Do you use exercise to compensate for eating too much? Do you feel rested and recovered? Etc 12345678910 + Are you emotionally triggered by the number on the scale? Do you get happy when you see a low number but upset when it's higher than expected? Are you coping with stress well? Do you feel motivated? Are you engaged with the process or are you frustrated with the current outcome? Do you judge your progress mostly by what your weight says? Do you value non-scale victories equally? Do you feel like a failure when you mess up? 12345678910 Breakthroughs & Goals Answer the following questions as best you can + For this try to focus on the process and behaviors. This is where transformation occurs. Did you change the way you think about a certain situation? Did you make better choices at a restaurant? Did you eat more mindfully? Did you hit a new personal best with your exercise? Etc. + Identify a couple of struggles you had from doing the ideal body assessment above and try to come up with a couple of action items (goals) for the week ahead. Think in terms of new thoughts and behaviors (process-based actions).