OWLS Weight Loss Questionnaire Having difficulty deciding which weight loss procedure is best for you? We have developed the below confidential questionnaire to determine your current lifestyle situation and from this information which OWLS procedure would be best for you. Upon completion our OWLS Team Assistant will analyse your results and be in touch with you. How would you describe your lifestyle? I try to be healthy, fit and active I have struggled with exercise and dieting, but I feel healthy I do not enjoy exercise and I eat foods I enjoy, I'm not sure I am healthy I need to make a change Do you want to lose weight? If so how much would you like to lose? I need to lose 50kg or more I would like to lose 25 kg I would feel better if I lost 10 - 20 kg I need to lose a lot of weight, not sure. What do you struggle with the most? I do not enjoy exercise I find it hard to stick to diets or "healthy" eating I enjoy too many treat foods and tend to over indulge I have weight I have not been able to lose no matter what I do I have serious health issues that are related to my weight Do you know what weight loss procedure you would prefer? Surgery, for a permanent change in my life. Non-surgical, I would prefer to avoid surgery What is your current BMI? How motivated are you to lose weight? I am very motivated, I want to make a change. I am somewhat motivated I am not motivated but I want to be Do you think you can maintain the diet and lifestyle changes during and after a weight loss procedure? I will need support, but I think I can I am definitely ready to make a permanent life change I am not sure yet Do you think you need a jump start to start the weight loss journey? Yes No Unsure Is there anything else you would like us to know? Thank you for completing the OWLS questionnaire. The OWLS Team Assistant will contact you within one working day after reviewing your answers. Name Email Phone Time's up Posted: November 2019
