WHICH PROGRAM IS RIGHT FOR ME?
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Nourishment 101 Pre-Course Assessment

Name
MM slash DD slash YYYY
I try to avoid certain foods high in fat, carbs, or calories.
If I’m craving a certain food, I don’t allow myself to have it.
I get mad at myself for eating something I’ve deemed unhealthy.
I follow eating rules or diet plans that dictate what, when, and/or how to eat.
I have forbidden foods that I don’t allow myself to eat.
I pay attention to the sensory elements of food, including taste, texture, and flavors.
I pay attention to the I treat each meal and snack as its own experience (not as a way to compensate for previous food choices). elements of food, including taste, texture, and flavors.
I use food to help me soothe my negative emotions (such as anxiety, sadness, and loneliness).
I’m unable to cope with my negative emotions (i.e. anxiety, sadness, and loneliness) without turning to food for comfort.
When I’m bored, I eat just for something to do.
I trust my body to tell me WHEN to eat.
I trust my body to tell me WHAT to eat.
I trust my body to tell me HOW MUCH to eat.
I trust my body when to stop eating.
When engaging in physical activity, I keep my focus on the non-cosmetic benefits (i.e. the benefits to my health and well-being, NOT the benefits to my looks).
I choose styles of physical activity that bring me joy.
I avoid using physical activity to compensate for my eating or body judgments.
I take days off from physical activity without feeling guilty.
I limit “body checking” and comparisons to others’ bodies.
I try to speak to myself kindly.
My food and physical activity choices come from a place of self-care, kindness, and compassion.
Most of the time, I desire to eat nutritious foods.physical activity choices come from a place of self-care, kindness, and compassion.