The diet cure quick symptom questionnaire

Many thanks to Julia Ross, the author of The Diet Cure, for her permission to place this questionnaire on the Total Fitness website. My goal in The Diet Cure is to stop your food cravings, address your eating and weight problems, and eliminate your mood swings and negative obsessions about your body. But first we have to determine what is causing these problems. Here is a mini-questionnaire similar to the ones we administer at our clinic. Its eight key sections will help you to identify your particular physical imbalances. Circle the number next to any symptom that applies to you and follow the directions at the end of each section to calculate your score. For each section there are corresponding chapters in the Diet Cure that will tell you exactly what to do to correct your imbalances and clear away your symptoms.
1. Is depleted brain chemistry the problem?
4 Sensitivity to emotional (or physical) pain; cry easily
4 Eat as a reward or for pleasure, comfort, or numbness
4 Worry, anxiety, phobia, or panic
4 Difficulty getting to sleep or staying asleep
3 Difficulty with focus, attention deficits
2 Low energy, drive, and arousal
4 Obsessive thinking or behavior
4 Inability to relax after tension, stress
3 Depression, negativity
4 Low self-esteem, lack of confidence
4 More mood and eating problems in winter or at the end of the day
3 Irritability, anger
4 Use alcohol or drugs to improve mood
Total Score ____________ If your score is over 10, the answer is YES to the above question and read
chapter 1 in The Diet Cure.

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2. Are you suffering because of low-calorie dieting?
4 Increased cravings for and focus on food; overeating
4 Regain weight after dieting, more than was lost
3 Increased moodiness, irritability, anxiety, or depression
3 Less energy and endurance
3 Usually eat less than 2,100 calories a day
3 Skip meals, especially breakfast
3 Eat mostly low-fat carbohydrates (bagels, pasta, frozen yogurt, and others)
2 Constantly think about weight
2 Use aspartame (Nutrasweet) daily
2 Take Prozac or similar serotonin-boosting drugs
2 Have become vegetarian
3 Have decreased self-esteem
4 Have become bulimic or anorectic
Total Score ____________ If your score is over 12, the answer is YES to the above question. read Chapter 2
in The Diet Cure
3. Are you struggling with blood sugar instability and stress?
4 Crave a lift from sweets or alcohol, but later experience a drop in energy and mood after ingesting them
3 Dizzy, weak, or headachy, especially if meals are delayed
4 Family history of diabetes, hypoglycemia, or alcoholism
3 Nervous, jittery, irritable on and off throughout the day; calmer after meals
3 Crying spells
3 Mental confusion, decreased memory
3 Heart palpitations, rapid pulse
4 Frequent thirst
3 Night sweats (not menopausal)
5 Sores on legs that take a long time to heal
4 Crave salty foods
4 Often feel stressed, overwhelmed
4 Dark circles under eyes
4 More awake at night
Total Score ____________ If your score is over 12, the answer is YES to the above question. read Chapters 3
and 11 in The Diet Cure

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4. Do you have unrecognized low thyroid function?
4 Low energy
4 Easily chilled (especially hands and feet)
4 Other family members have thyroid problems
4 Can gain weight without overeating; hard to lose excess weight
3 Have to force yourself to do even moderate exercise
4 Find it hard to get going in the morning
3 High cholesterol
3 Low blood pressure
4 Weight gain began near the start of menses, a pregnancy, or menopause
3 Chronic headaches
3 Use food, caffeine, tobacco, and/or other stimulants to get going
Total Score ____________ If your score is over 15, the answer is YES to the above question. Read Chapters
4 and 12 in The Diet Cure
5. Are you addicted to foods you are actually allergic to?
3 Crave milk, ice cream, yogurt, cheese, or doughy foods (pasta, bread, cookies, among others) and eat them
frequently
3 Experience bloating after meals
4 Gas, frequent belching
3 Digestive discomfort of any kind
3 Chronic constipation and/or diarrhea
4 Respiratory problems, such as asthma, postnasal drip, congestion
3 Low energy or drowsiness, especially after meals
4 Allergic to milk products or other common foods
3 Undereat or often prefer beverages to solid food
3 Avoid food or throw up food because bloating after eating makes you feel fat or tired
4 Can't gain weight
3 Hyperactivity or manic-depression
3 Severe headaches, migraines
4 Food allergies in family
Total Score ____________ If your score is over 12, the answer is YES to the above question. Read Chapters 5 and 13 in The Diet Cure 6. Are your hormones unbalanced?
4 Premenstrual mood swings
4 Premenstrual or menopausal food cravings
4 Irregular periods
3 Experienced a miscarriage, an abortion, or infertility
4 Use(d) birth control pills or other hormone medication
3 Uncomfortable periods cramps, lengthy or heavy bleeding, or sore breasts
4 Peri- or postmenopausal discomfort (e.g., hot flashes, sweats, insomnia, or mental dullness)
3 Skin eruptions with period
Total Score ____________ If your score is over 6, the answer is YES to the above question. Read Chapters
6 and 14 in The Diet Cure
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Note: Some men experience male menopause as a result of hormonal imbalance. Men, please see the box on
page 79 if you are experiencing weight gain and emotional stress.
7. Do you have yeast overgrowth triggered by anti-biotics, cortisone, or birth control pills?
4 Often bloated, abdominal distention
3 Foggy-headed
2 Depressed
4 Yeast infections
4 Used antibiotics extensively (at any time in life)
4 Used cortisone or birth control pills for more than one year
4 Have chronic fungus on nails or skin or athlete's foot
3 Recurring sinus or ear infections as an adult or child
3 Achy muscles and joints
3 Chronically fatigued
4 Rashes
3 Stool unusual in color, shape, or consistency
Total Score ____________ If your score is over 13,. the answer is YES to the above question. Read Chapters
7 and 15 in The Diet Cure
8. Do you have fatty acid deficiency?
4 Crave chips, cheese, and other rich foods more than, or in addition to, sweets and starches
4 Have ancestry that includes Irish, Scottish, Welsh, Scandinavian, or coastal Native American
3 Alcoholism and depression in the family history
3 High cholesterol, low HDL levels
4 Feel heavy, uncomfortable, and "clogged up" after eating fatty foods
4 History of hepatitis or other liver or gallbladder problems
4 Light-colored stool
4 Hard or foul-smelling stool
4 Pain on right side under your rib cage
Total Score ____________ If your score is over 12, the answer is YES to the above question. Read Chapters
8 and 16 in The Diet Cure.

Source: http://totalfitness.net/wp-content/uploads/pdfs/free-downloads/The_Diet_Cure_Quick_Symptom_Questionnaire.pdf