SECTION 1: Awareness — Where Are You Now

1. How often do you think about food, weight, or your body?

A: Constantly — it’s like background noise in my mind.

B: Only when I’m stressed or emotional.

C: Rarely — I mostly feel disconnected from it.

2. When you try to “get back on track” with food or exercise, what usually happens?

A: I go all-in, burn out, then quit.

B: I feel deprived and rebel against the plan.

I can’t even get started — I feel numb or unmotivated.

3. How does this struggle affect your energy or focus?

A: I’m exhausted but can’t slow down.

B: My energy spikes and crashes depending on food or mood.

C: I feel drained and disconnected most of the time.

SECTION 2: Stress Patterns

4. How would you describe your stress level most days?

A: High — I’m always juggling 10 things.

B: Moderate — but emotions hit me hard.

C: Low — but I feel flat or unmotivated.

5. When you’re overwhelmed, what’s your go-to coping strategy?

A: Work harder or control something.

B: Eat, drink, scroll, or comfort myself.

C: Tune out and withdraw.

6. How often do you prioritize others over yourself?

A: Constantly — I’m the dependable one.

B: Often — it feels selfish to focus on me.

C: Sometimes — it’s easier to check out than engage.

SECTION 3: Food & Emotional Connection

7. When you’re stressed, what role does food play?

A: Reward after a long day — I earned it.

B: Comfort — it helps me calm down.

C: Honestly, I forget to eat or eat mindlessly.

8. How often do you feel guilt or shame after eating?

A: Occasionally — mostly when I’m off plan.

B: Often — I promise to “start over tomorrow.”

C: Rarely — but I also don’t feel much at all.

SECTION 4: Mind-Body Awareness

9. How connected do you feel to your body’s signals (hunger, rest, emotion)?

A: I try, but stress usually overrides them.

B: I feel emotions in my body but they overwhelm me.

C: I barely notice — I live in my head.

10. What best describes your pace of life?

A: Fast — always moving, achieving, producing.

B: Up and down — I crash after busy periods.

C: Numb — I go through motions without passion.

Section 5: Readiness

11. How ready are you to heal what’s really causing the stress and cravings?

A: 100% ready — I just need the right guidance.

B: I’m scared but willing — I can’t do this alone.

C: I’m tired of feeling disconnected — I want to feel alive again.

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