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The Healthier and Smarter Weight Management System
User Id
Gender
Age
User Details
Height (Inch) | Weight | BMI | Waist Circ | Hip Circ | Waist Hip Ratio |
|---|---|---|---|---|---|
Page 1 of 3
Start:
Current Weight | Total Weight Lost | Current BMI |
|---|---|---|
Biometrics(Current)
Goal Initial | Goal Current |
|---|---|
Goals
Create Time
On Meds | SBP | DBP | Med Change |
|---|---|---|---|
On Meds | chol | TG | HDL | LDL | Med Change |
|---|---|---|---|---|---|
Hypertension
Cholesterol
Diabetes
Personal Issues | Family History | Weight Loss Drug | Bariatric Surgery |
|---|---|---|---|
History
On Meds | Hypoglycemic Meds | HgA1C | Med Change |
|---|---|---|---|
Body type | TOFI in the family | Ancestry |
|---|---|---|
Weight Loss Determinants
What has worked well for wt loss | Past weight loss challenges |
|---|---|
Bigger Stomach | Hangry | Think about eating |
|---|---|---|
PROUD of? | Baiology journey? |
|---|---|
What do you crave? | Eat healthy? (1=not healthy) |
|---|---|
Motivated (1=not) | Disciplined (1=not) | Pleasure Eater (1=not) | Stress Eater (1=not) |
|---|---|---|---|
How many times a week do you cook? |
|---|
Cooking (Every 3 months)
Vegetarian or vegan | Lactose intolerace | Gluten intolerance |
|---|---|---|
Dietary Restrictions
Sleep
Wake up refreshed |
|---|
Exercise
Exercise Experiences |
|---|
Stress
"Energy Level (1=low energy, 5=good energy)" | Stress (1=stress, 5=no pressure) | Mood (1=sad, 5=happy) |
|---|---|---|
*Only display the positive dietary restriction
Block #
Block # | Block Name | Start Date | Is Activate | Is Question Pause |
|---|---|---|---|---|
User Name
Biometrics
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