Instructions: Please go ahead and answer to each of the questions below. Each question will give you a score between 1 and 5.

After your answer, write down the score for each question on a paper. At the end, simply sum up and you’ll get the final score.

If it is over 25, you might be addicted to foods and eating. Also, you might have a low self-body image. And you should reprogram your brain if you want things to change for the better in your life. .

The good news is that you will learn everything about reprogramming your brain to lose weight 10 times easier and start loving your body, in video #2 and video #3.

Go ahead and start answering to the questions below J

1. I overeat:

• Never (1 point)
• Once per month (2 points)
• 2-4 times per month (3 points)
• 2-4 times per week (4 points)
• 4+ times per week (5 points)

Question 1 score is: ……..

2. I think about food:

• Never (1 point)
• Once per week (2 points)
• Once each day (3 points)
• More than 3 times a day (4 points)
• More than 1 hour per day (5 points)

Question 2 score is: ……..

3. I find myself consuming certain foods even though I am no longer hungry:

• Never (1 point)
• Once per month (2 points)
• 2-4 times per month (3 points)
• 2-4 times per week (4 points)
• 4+ times per week (5 points)

Question 3 score is: ……..

4. Do you turn to food during stressful situations:

• Never (1 point)
• Once per month (2 points)
• 2-4 times per month (3 points)
• 2-4 times per week (4 points)
• 4+ times per week (5 points)

Question 4 score is: ……..

5. I have had physical withdrawal symptoms such as agitation and anxiety when I cut down on certain foods

• Never (1 point)
• Once per month (2 points)
• 2-4 times per month (3 points)
• 2-4 times per week (4 points)
• 4+ times per week (5 points)

Question 5 score is: ……..

6. I have spent time dealing with negative feelings from overeating certain foods:

• Never (1 point)
• Once per month (2 points)
• 2-4 times per month (3 points)
• 2-4 times per week (4 points)
• 4+ times per week (5 points)

Question 6 score is: ……..

7. I worry about cutting down on certain foods:

• Never (1 point)
• Once per month (2 points)
• 2-4 times per month (3 points)
• 2-4 times per week (4 points)
• 4+ times per week (5 points)

Question 7 score is: ……..

8. Issues related to food and eating decrease my ability to function effectively (daily routine, job/school, social or family activities, health difficulties):

• Never (1 point)
• Once per month (2 points)
• 2-4 times per month (3 points)
• 2-4 times per week (4 points)
• 4+ times per week (5 points)

Question 8 score is: ……..

9. My behavior with respect to food and eating causes me distress:

• Never (1 point)
• Once per month (2 points)
• 2-4 times per month (3 points)
• 2-4 times per week (4 points)
• 4+ times per week (5 points)

Question 9 score is: ……..

• Do you like your body?
• Yes, I am proud of how I look (1 point)
• I like myself though I would like to get a little toned (2 points)
• I have been trying to lose weight, however the results come slow (3 points)
• I don’t like my body. Each time I go out, I get stressed about what to wear and I am always conscious of people looking at me (4 points)
• I hate my body. I can’t even look in the mirror and my partner hasn’t seen me naked in a while (5 points)

Question 10 score is: ……..

TOTAL SCORE is ….

Don’t worry if it is over 25, because in our next 2 videos you will learn how reprogram your brain and lose weight 10 times easier and how to transform yourself into an amazing woman.

You will love your body! I promise!

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