Rate yourself from 1-10 for each of the following statements.
1= 100% Disagreement     10 = 100% Agreement

1.  ___ I exercise too much/not enough/inconsistently/not at all because ________________.
2.  ___ I don't enjoy my health.
3.  ___ My health is not very important to me.
4.  ___ Exercising will not improve my health.
5.  ___ Proper nutrition is not very important to me.
6.  ___ Proper nutrition will not improve my health.
7.  ___ Exercise will take time away from more important things, such as __________________________.
8.  ___ I dislike healthy and good looking people.
9.  ___ I doubt that I can achieve health because my past is so unhealthy.
10. ___ Becoming healthy is too much work.
11. ___ If I become healthy, certain people will disapprove of me.
12. ___ Being healthy and looking good is mostly for self-centered people.
13. ___ Most healthy people aren't truly happy because they always have to eat or act healthy.
14. ___ It's easier to be unhealthy than healthy.
15. ___ I'm not smart enough to be healthy and successful.
16. ___ I'm not good enough to be healthy and successful.
17. ___ I will feel like a failure if I try to achieve health and don't succeed.
18. ___ I don't really want to be healthy.
19. ________________________________________ is more important than my health.
20. ___ I don't enjoy the habits and rituals (lifestyle) of healthy people.
21. ___ I'm too unhealthy right now to ever become healthy.
22. ___ Trying to achieve health is stressful.
23. ___ It's too expensive to be healthy.
24. ___ I wish I didn't have to think about being healthy.
25. ___ I don't have time to eat healthy.
26. ___ I'm too busy to take time and learn about becoming healthy.
27. ___ I resent some people because they are healthy and successful.
28. ___ People's opinions of me influence my health habits.
29. ___ I'm already satisfied with my health.
30. ___ I don't need help from others to achieve health.
31. ___ Once I eat and exercise appropriately I will be healthy.
32. ___ I will finally prove myself once I am healthy and successful.
33. ___ Being healthy is not a skill I can learn.
34. ___ I don't want to be called one of those "healthy" people.
35. ___ Health is not for me.
36. ___ I can't eat healthy.
37. ___ Most of my friends or family are unhealthy so it is easier for me to be unhealthy like them.
38. ___ There is too much to learn in order to be healthy.
39. ___ I don't want to change my lifestyle to become healthy.
40. ___ I don't have the patience for meditation or "quiet time."
41. ___ My main coping mechanism for stress is exercise.
42. ___ Being healthy doesn't matter. I know people with cancer or who have died and they were healthy.
43. ___ My theory is this; as long as I am happy, I am healthy.
44. ___ Healthy people are just too weird.