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Emsculpt
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Weight Loss Readiness Test
What is Your Diet Personality?
Are you ready to lose weight?
Your attitude about weight loss affects your ability to succeed.
Take this Weight-loss Readiness Quiz to learn if you need to make any attitude adjustments before you begin.
Weight Loss Readiness Quiz
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*
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Step
1
of
5
20%
Appetite
Select the answer that best describes your normal reaction
A. When food is mentioned in a conversation or reading, do you want to eat even when you are not hungry?
*
Never
Rare
Sometimes
Often
Always
B. How often do you have trouble controlling your appetite when your favorite foods are accessible?
*
Never
Rare
Sometimes
Often
Always
C. How often do you eat because of physical hunger?
*
Always
Often
Sometimes
Rare
Never
D. How often do you eat because of cravings?
*
Never
Rare
Sometimes
Often
Always
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Appetite Score
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Appetite 4-10
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Appetite 11-16
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Appetite 17-20
Control
For the next questions, would you eat more or less than planned?
A. A friend talks you into eating out with them
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Much Less
Bit Less
No Difference
Bit More
Much More
B. You break your diet for a cheat meal or snack.
*
Much Less
Bit Less
No Difference
Bit More
Much More
C. While doing idle tasks (watching tv, reading, etc)?
*
Much Less
Bit Less
No Difference
Bit More
Much More
D. Excluding holidays, how often do you “overeat” or “feel stuffed” after eating?
*
Never
Less than once per month
Once per month
Few times per month
Once per week
Three per week
Daily
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Control Score
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Control 4-11
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Control 12-17
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Control 18-21
Emotional Eating
Do you eat more than normal when you...
A. Have negative feelings such as anxiety, depression, anger or loneliness ?
*
Never
Rare
Sometimes
Often
Always
B. Have positive feelings, such as to celebrate by eating ?
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Never
Rare
Sometimes
Often
Always
C. Have unpleasant interactions with others in life, at work, etc?
*
Never
Rare
Sometimes
Often
Always
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Emotional Eating Score
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EMOTIONAL EATING 3-8
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EMOTIONAL EATING 9-11
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EMOTIONAL EATING 12-15
Readiness
Select the best answer
A. How motivated are you to lose weight right now?
*
Not at all
Slightly
Somewhat
Confident
Extremely
B. Can you stay committed during the time it takes to reach your goal?
*
Not at all
Slightly
Somewhat
Confident
Extremely
C. Can you tolerate the effort required to stick to a diet and exercise, considering the current state of your life (stress at work, family, obligations, etc)
*
Not at all
Slightly
Somewhat
Confident
Extremely
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Readiness Score
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READINESS 3-7
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READINESS 8-12
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READINESS 13-15
Name
*
Phone
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Email
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