DoctorSaputo.com

1) How overweight are you? *

10 pounds or less

10-30 pounds

More than 30 pounds

2) Does eating satisfy your hunger? *

Yes

No

3) Do you eat a healthy diet? *

Yes

No

4) Do you use artificial sweeteners? *

Yes

No

5) Do you have trouble sleeping? *

Yes

No

6) Do you have an eating disorder such as bulimia, binge eating, or anorexia nervosa? *

Yes

No

7) Is most of your weight around your waist? *

Yes

No

8) Are you hypothyroid? *

Yes

No

I don't know

9) Do you exercise five days a week and are you fit? *

Yes

No

10) Are you stressed out or depressed? *

Yes

No

11) Do you take any of these medications that are associated with weight gain? *

Atypical antipsychotics

Antidepressants

Beta blockers

Anti-seizure medications

Diabetes medications

I do not take any of these medications

12) Do you take measures to avoid environmental toxins? *

Yes

No

13) Do you take medication to lose weight? *

Yes

No

14) Do you smoke? *

Yes

No

15) Are you interested in lifestyle, dietary, and supplement recommendations to help you? *

Yes

No

Weight Assessment