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Check In & Self Assessment

This Check In & Self Assessment is a two part document.

The Check In portion has a number of questions that can help the group participants take a look at their overall status since your last meeting and can be a good jumping off point for further discussions.

The Self Assessment portion lets members look at various aspects of the general WLS “program” and grade their compliance. Keep in mind these are based on some overall guidelines, and may or may not fully agree with each member’s specific surgery program. For example, the item about drinking during/after meals is pretty universal, but not all programs restrict drinking just before meals.

One way to use these forms is to give everyone a few minutes to review and fill out their copy then go around the group giving each person a few minutes to review with the group. Another is for the facilitator to ask some of the Check In questions to the group as a whole and get individual and/or group feedback.

Check In Sample Questions:

I would rank the importance of the following to me (most to least):
A: How much I weigh – B: How I feel – C: How I look to me – D: How I look to others

These days, when I see someone who is losing/struggling with the battle with morbid obesity, I …

I grieve or regret __________ since having made the decision to have WLS.

Self Assessment Sample Questions:

I avoided grazing and unplanned snacks
I made wise food choices, protein first
I avoided caffeinated beverages and alcohol

Check In & Self Assessment.pdf