Survey c

Reboot & Rewire -- Stress Eating Recovery

ZLucky.com

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Lucky Joy Wells -- Coach - Specialist
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STRESS & EATING SURVEY--
See your challenges and options in perspective
and consider forward moves to beat your eating issues and build a better future.
Thank you for your valuable Feedback!

Stress Eater's Survey

1. How long have you had trouble with stress eating or weight? *

18 months or less 2 - 5 years 5 years or more 15 + years Most of my life

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2. What are your top concerns with overeating and stress? (Check as many answers as apply for you.) *

Health & clothing costs, etc., of yo-yo dieting My repeated lack of willpower Remorse, shame &/or feelings of defeat My health My appearance

If Other please specify: *

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3. How many times have you lost and regained weight? *

I seldom diet so I don’t have the problem several times 10 - 20 It's countless

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4. How have you tried to resolve your eating challenges? (Check as many as apply for you.) *

A. eating certain foods only B. willpower, going public, solemn oaths, health fears, etc. C. banning certain foods from home or work, etc. D. working less, more or avoiding triggering situations E. Checking in, &/ or using support F. Online/ outside help

Check as many as apply for you.

Did any of these work long- term? *

Yes No

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How important is stopping stress eating to you? *

5-- Most important 4--Very important 3-- Important 2-- Somewhat important 0 or 1-- Not important

5. What areas would you want to learn about? (Check as many as apply for you.) *

Neuroscience Brain Re-wiring Tools Lifestyle. Eating & Weight Reduction Diet / Fitness / Health & Weight Willpower / Self- Mastery Holistic/ Natural Wellness Emotional Wellness & Eating Issues

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7. If I could help you out with this would you prefer... (Check as many as apply for you.) *

1 -to-1 support Online live video congerence --small group By email, messaging &/or phone An app on your phone Watching video, reading & acting on your learnings

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