Transform Your Body with MD4 Fitness
Patient self-Screening Questionnaire to help determine if Dr. Homer can help you
Instructions: Please consider the following questions honestly. Your responses may help to understand how your weight or physical fitness may be affecting your mental health.
Emotional Well-being:
Do you often feel unhappy or depressed about your weight or physical fitness?
Self-esteem and Body Image:
Do you frequently feel embarrassed or self-conscious about your body in social situations?
Social Avoidance:
Do you avoid social gatherings or activities (e.g., swimming, gym, or parties) due to concerns about your weight?
Eating Behaviors:
Do you find yourself eating in response to stress, anxiety, or depression?
Dieting Frustrations:
Have you experienced feelings of frustration or irritability from unsuccessful attempts to lose weight despite trying various diets and exercises?
Compulsive Eating:
Do you feel compelled to eat even when not hungry, or do you experience episodes of binge eating?
Health Concerns:
Are you frequently worried about the impact of your weight on your health?
Sleep and Fatigue:
Do you experience sleep disturbances or excessive fatigue that you believe may be related to your weight or physical fitness?
Motivation and Energy Levels:
Do you often feel a lack of motivation or energy that you attribute to your weight or physical fitness?
Previous Weight Loss Attempts:
Have you previously used medication, therapy, or other interventions to help with weight loss?
Interpretation:
- If you answered "Yes" to any of the questions, further evaluation is likely warranted. and if a comprehensive treatment plan, including weight loss, may be beneficial.
Next Steps:
Please discuss your responses with your healthcare provider, who can guide you in creating a personalized plan to address both your mental health and weight management or physical fitness needs. You are certainly invited to book an initial free online appointment.