DEBs WAY Insight – Self-Evaluation (EN)

About You

Name

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Email

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Mobile number

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Date of birth

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Self-Evaluation

What have you noticed about your body, energy, or how your clothes fit lately?

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What type of exercise do you do, and how often per week?

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What have you already tried to manage your weight or habits? If yes, what have you done?

How is your sleep? How many hours? What's the quality of your sleep? Do you wake up rested?

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Do you smoke?

Yes

No

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Do you take any medicines and/or supplements? If yes, what and what for?

Do you take HRT? If yes, since when, and what?

Allergies and intolerances

Anything else you want to tell me?

Measurements

Not sure how to measure? See our guide.

Weight in kg

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Height in cm

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Waist in cm

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Hip in cm

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Neck in cm

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Food and Drink

This works best with what you actually ate, not what you wish you'd eaten. There's no wrong answer here, only useful or not useful ones.

If other, please specify

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Do you drink alcohol? What and how often?

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Do you mostly cook your own meals, or rely more on convenience or ready-made foods?

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Weekday food log

A usual working day, any regular Tuesday.

Include any sauces, dressings, spreads, or added extras.

Please be as specific as possible. Instead of 'yoghurt', write 'Greek yoghurt 0% Danone, 150g'. Instead of 'sandwich', write '2 slices whole wheat bread, 30g cheese, tomato'. The more detail you give, the more useful your Insight report will be.

Breakfast

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Lunch

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Dinner

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Snacks

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Weekend day food log

A Saturday or Sunday, a more relaxed or social day.

Include any sauces, dressings, spreads, or added extras.

Please be as specific as possible. Instead of 'yoghurt', write 'Greek yoghurt 0% Danone, 150g'. Instead of 'sandwich', write '2 slices whole wheat bread, 30g cheese, tomato'. The more detail you give, the more useful your Insight report will be.

Breakfast

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Lunch

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Dinner

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Snacks

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How many times per month do you eat out?

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