Professional Documents
Culture Documents
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○ Part II Please choose one, best choice according to you from the
options provided. No answer is right or wrong. It is how you feel about
it.
v. How many meals do you usually consume per day (not including small snacks)?
Please circle one answer
1 2 3 4 more than 4
vi. Can you differentiate between physical hunger meaning your body’s need for fuel
and your mental “desire” to consume food?
1. Yes
2. No
3. Don't know
ix. For the majority of time, do you base your food intake decisions mainly on your
cravings or other factors such as advertisement, smell or sight of food, people‘s
suggestions. Please circle one answer
1. Cravings
2. Other factors: advertisement, smell or sight of food, people‘s suggestions
3. Don’t know
x. Do you take into consideration your previous feedback after a similar meal,
specifically how you felt physically, mentally or emotionally?
1. Yes
2. No
3. Don’t know
xii. Are you able to have control over your food intake when you are stressed?
1. Yes
2. No
3. I am never stressed
xiii. Are you able to have control over foods you tend to consume quickly or have a
tendency to overeat?
1. Yes
2. No
3. Don’t know
xvi. Do you usually experience any of these signs of overeating after your meal: so full
you can’t breathe, have to loosen your belt, can’t get off the chair
1. Yes
2. No
3. Don’t know
xvii. If you are not hungry or don’t wish to eat, are you able to consistently refuse food
offered to you by your close family members or significant other (wife, husband)?
1. Yes
2. No
3. Don’t know
xviii. If you are not hungry or don’t wish to eat, are you able to consistently refuse food
offered to you by other people?
1. Yes
2. No
3. Don’t know
xix. Are you satisfied with your meal choices: specifically related to your ability to
balance your consumption of foods that are “healthy for you” and those that are “not
healthy for you”?
1. Yes
2. No
3. Don’t know
xx. Are you satisfied with your snack choices: specifically related to your ability to
balance your consumption of snacks that are “healthy for you” and those that are
“not healthy for you”?
1. Yes
2. No
3. Don’t know
xxi. Are you satisfied with your body weight?
1. Yes
2. No
3. Don’t know
xxii. Do you feel your current eating options and choices are restrictive?
1. Yes
2. No
3. Don’t know
xxiii. Do you usually feel uncomfortable after eating because of bloating, indigestion or
acid reflux?
1. Yes
2. No
3. Don’t know
xxiv. Do you usually experience guilt (feeling you should have avoided eating or not eaten
so much), regret or shame after your meal?
1. Yes
2. No
3. Don’t know
xxvi. Are you still complying with the diet plan you have been trained on ?
1. Yes
2. NO
3. Don’t know
xxvii. Do you feel confident that you will be able to follow this eating methodology in the
long term ?
1. Yes
2. NO
3. Don’t know