Can you tell us more about you?

Birthdate

Gender by Birth

Sexual Orientation

Congratulations for taking your first step towards good health!

NutriCoach has helped thousands of users lose weight while keeping their sanity.

How often do you eat fast food or takeout?

Almost everyday

About once a week

Rarely or never

What do you typically eat or drink when you experience stress or negative emotions?

How do you feel about your portion sizes during meals?

I often eat more than I should

I sometimes eat more than I should

My portion sizes are reasonable

How often do you find yourself skipping meals?

Never

Once a week

Two or three times a week

Always

How many meals do you have per day (including snacks)?

1-2 meals

3-4 meals

5 or more meals

How often do you use a food diary to track your food intake?

Always

Often

Sometimes

Rarely or never

How do you describe your physical activity?

Sedentary (mostly resting with little or no activity) Light (mostly sitting/desk work or standing for long hours with occasional walking) Moderate (with exercise 2-3x a week or brisk walking or bicycling) Very Active (with exercise 5-7x a week or tasks requiring strenuous effort like long period of running, rapid movement, or bicycling uphill)

How often do you eat with others (eg, family, friends, etc.)

Never

Sometimes

Always

How supportive is your social network in terms of reaching your health goals?

Never

Sometimes

Always

What are your reasons for wanting to lose weight?

Improve health Improve physical appearance Improve energy levels

Others please specify

How will achieving your goal make you feel?

What will motivate you more?

Receive a sticker, a reward or compliment?

A constant reminder

A challenging and unfamiliar task

As you start on your weight loss journey, what's the most important change you're looking forward to?

Better relationship with food preparation

Finding Joy in what I do!

More self-love and self-care

Connecting with like-minded individuals

More confidence in my body

On a scale of 1 to 10, how committed do you feel to reaching your goal?

Consider the reasons behind your desire to lose weight and the positive changes it will bring to your life.

Do you feel ready to take action to improve your diet in the next 30 days?

Yes, I'm ready

I'm not sure if I'm ready yet

No, I'm not ready

Metric Imperial

What's your height?

Eg. 170 cm

What's your weight?

Eg. 90 kg

Your ideal body weight based on your height is ranging from kg - kg

What's your goal weight?

Your BMI is approximately

you're within category

Analyzing your responses...

We predict that you will be

kg by

and lose 10 kg by the end of the program.

Weight Target kg

Achieve healthy BMI by .
Continue developing healthy habits to keep weight off after reaching goal
Feel comfortable and confident in your body.

Terminating the assessment will lose your progress!

Can you tell us more about you?

How often do you eat fast food or takeout?

What do you typically eat or drink when you experience stress or negative emotions?

How do you feel about your portion sizes during meals?

How often do you find yourself skipping meals?

How many meals do you have per day (including snacks)?

How often do you use a food diary to track your food intake?

How do you describe your physical activity?

How often do you eat with others (eg, family, friends, etc.)

How supportive is your social network in terms of reaching your health goals?

What are your reasons for wanting to lose weight?

How will achieving your goal make you feel?

What will motivate you more?

As you start on your weight loss journey, what's the most important change you're looking forward to?

On a scale of 1 to 10, how committed do you feel to reaching your goal?

Do you feel ready to take action to improve your diet in the next 30 days?

What's your height?

What's your weight?

Your ideal body weight based on your height is ranging from kg - kg

What's your goal weight?

Your BMI is approximately

Analyzing your responses...

Lastly, can we get your email address?

We'll use this information to create your NutriCoach account!