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Diet Survey 8.20.16

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* What is most painful or difficult for you about being overweight?
   
 
 
* What do you hate about diets?
   
 
 
* What makes you angry or frustrated about being overweight?
   
 
 
* Why do you feel people want to lose weight?
   
 
 
What do you feel is most important to you in a weight loss program?
   
 
 
* What is the biggest pleasure you’ll achieve from reaching your goal weight?
   
 
 
* What is the symbol or image that represents support and accountability? (For example, $ represents money, the sun represents summer).
   
 
 
Name (optional)
   
 
 
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