Name: Therapy Planning
SKU: 6549
Availability: InStock

Your Name *

Contact Number *

Email Address if you want feedback in PDF

Date of Birth

Number of months you are taking active remedy for Obesity / Weight control *

Mention your gender and any other health issues you have *

1. I am able to adapt to changing situations, keep thinking about negative experiences *

2. Feel calm and relaxed by distracting attention from negative thoughts *

3. I don’t suppress my emotions *

4. I think I can handle stress – so that I don’t prefer any new stress management sessions *

5. People suggest me many things, but personally I feel my health issue is permanent *

6. I started getting used with my obesity and related issues *

7. I was spending money and time to improve my health *

8. I am ready to spend money and time to achieve my health goal *

9. I am actively searching through known people for new sources who can help me reduce weight *

10. I am not able to reduce some mistakes I do *

11. I never can meet expectations of my family members or other important people *

12. I want to achieve better quickly than others *

13. People appreciate the way I keep things neatly at home or office *

14. When I see something very delicious, I have to eat right away *

15. I am always hungry enough to eat at any time *

16. Sometimes when I start eating, I just can’t stop how much I eat *

17. When I feel sad, I often eat too much *

18. When I am tense, or feel lonely or nervous, I eat to relax or calm down *

19. When I am depressed, I want to eat *

20. I deliberately take small helpings to control my weight *

21. I don’t eat some foods because they make me fat *

22. I consciously hold back on how much I eat at meals to keep from gaining weight *

23. I find difficult to relax myself *

24. People say I react excessively in situations *

25. I feel I am emotionally sensitive *

26. I worry about many things *

27. When I am engaged in work, still automatic thoughts worry come to mind *

28. I worry about future *

29. I feel life is meaningless *

30. I feel dull and depressed *

31. I don’t enjoy things in life that I was enjoying earlier *

32. Do You feel you require more rest *

33. Do you start things without difficulty but get weak as you go on? *

34. Do you have problems starting things? *

35. Do you find it more difficult to find the correct word? *

36. Do you make slips of the tongue when speaking? *

37. Do you find difficulty and take time to think clearly? *

38. I feel short of breath while walking, talking or doing some physical work *

39. I keep noticing my breathe and I have some difficulty in breathing *

40. I often have irregular breathe or deep breathe *

1. Obesity Therapy Planning - Suppressing Emotions (out of 15)

2. Obesity Therapy Planning - Amotivation (out of 15)

4. Obesity Therapy Planning - Perfectionism - Concern for Mistakes (out of 5)

5. Obesity Therapy Planning - Perfectionism - Others' Expectation (out of 5)

6. Obesity Therapy Planning - Perfectionism - Personal Standard (out of 5)

7. Obesity Therapy Planning - Perfectionism - Organization (out of 5)

3. Obesity Therapy Planning - Motivation (out of 15)

7-C. Obesity Therapy Planning - Perfectionism Total (out of 20)

8. Obesity Therapy Planning - Uncontrolled Eating (Total (out of 15)

9. Obesity Therapy Planning - Emotional Eating (Total (out of 15)

10. Obesity Therapy Planning - Cognitive Restraint (Total (out of 15)

11. Obesity Therapy Planning - Stress (Total (out of 15)

12. Obesity Therapy Planning - Anxiety (Total (out of 15)

13. Obesity Therapy Planning - Depression (Total (out of 15)

14. Obesity Therapy Planning - Fatigue - Physical (Total (out of 15)

15. Obesity Therapy Planning - Fatigue - Psychological (Total (out of 15)

16. Obesity Therapy Planning - Dyspnea (Total (out of 15)

Therapy Planning

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