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      Weight & Life Style Management          

     Day 23     Name: ___________________________     Date ______________

    Morning Weight ______________                      Evening Weight __________________

    Reflection:  The  greatest strength and wealth is self-control.   -    Pythagoras

    Goal of the Day ____________________________________________________________________________________________

        Activities of the Day                              Goal in Minutes            Actual Minutes

     1) ____________________                   ___________              _____________

     2) ____________________                   ___________              _____________

     3)____________________                    ___________              _____________

       Prescriptions    1)____________,   mg ___    2) ____________, mg ___   

                                     3)____________,   mg ___,   4) ____________, mg ___

       Coffee  Y / N  oz ____   Soda Pop  Y / N  oz ____     Fruit Juice _________, oz ___

       Water      ________________ oz       Alcohol type  _________________, ________ oz  

   Sweets and Empty Calorie Food  - Food with no nutritional value  -    Tobacco _________ #_____

 _____________________________________________________________________________________________

 

   Fruits and Vegetables 

   Proteins - What kind and how many grams (include powders, i.e. Whey)                  

   Whole Grains__________,__________,_____________  Spices____,____,_____,____

   Daily Supplements  Y / N   Other _______________________________

                                                                           

                                                                               8 Step Weight & Life Style Management  copyright(c)2005