1. Do you struggle to lose weight?

0 = Never

2 = Frequently

4 = Constantly

2. Have you been on multiple calorie restriction diets in your life?

0 = Never

2 - Frequently

4 = Constantly

3. Have you been gaining weight even though you haven’t changed anything with your diet or exercise plans?

0 = Never

2 = Frequently

4 = Constantly

4. If you are in menopause, did you gain belly fat?

0 = Not really

2 = A little 5-10 lbs

4 = More than 10lbs

N/A

5. Do you get “hangry” if you go without food?

0 = Never

2 = Frequently

4 = Constantly

6. Do you need food when you first get up in the morning?

0 = Never

2 = Frequently

4 = Constantly

7. Do you need to eat every few hours to keep your energy up?

0 = Never

2 = Frequently

4 = Constantly

8. Do you get sleepy after you eat?

0 = Never

2 = Frequently

4 = Constantly

9. Do you get brain fog after you eat?

0 = Never

2 = Frequently

4 = Constantly

10. Do you crave sugar?

0 - Never

2 = Frequently

4 = Constantly

11. Do you crave carbohydrates?

0 = Never

2 = Frequently

4 = Constantly

12. Do you crave alcohol?

0 = Never

2 = Frequently

4 = Constantly

13. Do you forget to eat enough vegetables?

0 = Never

2 = Frequently

4 = Constantly

14. Have you been on more than 5 rounds of antibiotics in your life?

Yes = 4

1-5 times = 2

Never = 0

15. Have you taken the birth control pill for more than 2 years?

Yes = 4

No = 0

16. Have you been diagnosed with high blood pressure?

Yes = 4

No = 0

17. Are you on a statin for high cholesterol?

Yes = 4

No = 0

18. Are you currently taking one of the weight loss drugs?

Yes = 4

No = 0

19. Are you over 40 years old?

Yes

No

20. Are you postmenopausal?

Yes = 4

No = 0

21. If you have a cycle, is it regular?

N/A

Yes = 0

Sometimes = 2

Never = 4

22. Is your Hemoglobin A1C 5 or less?

Yes =0

No = 4

23. Is your fasting glucose <100 ng/dl?

Yes = 0

No = 4