| Name | Sanjeev2 Kumar2 |
|---|---|
| What is your current height (enter as centimeters)? | 173 |
| What is your current weight (enter as kg)? | 75 |
| What is your age? | 50 |
| What sex were you born as? * | Male |
| Do you do 3 or more hours of some form of moderate exercise a week? | Yes |
| Do you do regularly drink alcohol? | No |
| Do you Smoke? | No - I have never smoked |
| Have you tried any other weight loss programmes in the past such as dieting or exercise? | Yes |
| If Yes, please specify which programmes you have tried in the past: | walking |
| Are you currently taking any weight loss medication? | No |
| Have you taken any weight loss medication in the past? | No |
| Have you been diagnosed with high blood sugar levels or diabetes? | No |
| Do you currently suffer from either heart disease, high blood pressure or are you being prescribed a treatment for high blood pressure? | No |
| Have you ever suffered from obstructive sleep apnoea? | No |
| Are your daily activities currently affected by your weight? | No |
| Even after being rested, do you still feel tired and lacking energy? | NO, I'M NOT |
| The Contraceptive Pill | No |
| Ciclosporin | No |
| Warfarin or DOAC (also known as a Direct Oral Anticoagulant or NOAC) such as Apixaban, Rivaroxaban, Edoxaban or Dabigatran | No |
| Epilepsy Medication | No |
| Thyroid Medication | No |
| Amiodarone | No |
| Are you taking any prescription-only medicines, over-the-counter medicines, alternative medicines or recreational drugs? | No |
| Do you have any other known allergies? | No |
| We need to check if you are at risk of heart disease. Please tick all that apply: |
|
| I am a man over the age of 40 | |
| Have you ever been diagnosed with a problem of absorbing your food, sometimes called chronic malabsorption syndrome? | No |
| Do you have a history of kidney or liver disease? | No |
| Have you ever been diagnosed with gallbladder, bile duct or pancreas disease? | No |
| Have you ever had any form of gastric surgery, such as removal of any part of your GI tract? | No |
| Do you have or have you ever been diagnosed with an eating disorder such as anorexia or bulimia? | No |
| Are you pregnant or planning to become pregnant within the next six months? | No |
| Are you breastfeeding? | No |
| Have you noticed it difficult when it comes to thinking, remembering or making decisions? | NO, I DO NOT |
| Do you feel sad or anxious for 2 weeks or more on a continuous basis? | Yes |
| Phone Number | 917769079516 |
| Your Email | sanjeev.du@hotmail.com |
