NIVERSITY OF SAINT ANTHONY

(Dr. Santiago G. Ortega Memorial)

City of Iriga

JUNIOR HIGH SCHOOL DEPARTMENT

Print and fill out the table of a weight management program within 2 weeks as a personal
guide to monitor your eating habits.

Name: ______________________________________ My weight (kg) today:________________

Date: _______________________________________ My weight (kg) goal: _________________

Lose __________% of my body weight ___________ kilo by ___________ (date)

Record weight at least __________ per week for __________ (number of weeks)
Record food intake every day for 14 DAYS
More intake of fruits
More intake of vegetables
Less intake of sweet foods
Less intake of fast foods
Month: _______________ Week: _______________ My weight today: ___________
Meal *If in school / If with family
DATE DAY A.M. P.M. MIDNIGHT
BREAKFAST LUNCH DINNER
SNACK SNACK SNACK
Mon.

Tues.

Wed.

Thurs.

Fri.

Sat.

Sun.

Month: _______________ Week: _______________ My weight today: ___________

Meal *If in school / If with family
DATE DAY A.M. P.M. MIDNIGHT
BREAKFAST LUNCH DINNER
SNACK SNACK SNACK
Mon.

Tues.

Wed.

Thurs.

Fri.

Sat.

Sun.
Reflection:

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