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* 1. Please indicate your sex

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* 2. Please indicate your age

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* 3. What is your current body mass index (BMI)? To calculate your BMI, please use this BMI calculator

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* 4. If your BMI is 25 to 29.9, have you been told by your health care provider that you are overweight?

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* 5. If your BMI is 30 or greater, have you been told by your health care provider that you are obese?

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* 6. Has your health care provider talked to you about managing your weight through any of the following (Check all that apply):

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* 7. What do you wish your health care provider would talk more about, in terms of you being overweight or obese? (Check all that apply)

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* 8. Do you believe there is a negative attitude by the health care profession in general, about diagnosing and treating people that are overweight or obese?

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* 9. Do you feel that your health care provider has a negative attitude toward people that are overweight or obese?

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* 10. Which of the following do you use for weight management? (Select all that apply)

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* 11. Which of the following statements best reflects your level of satisfaction with how your health care provider is treating your overweight or obesity?

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* 12. If you are currently being treated with a medication for your weight, what would you change about your current treatment?

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* 13. Please indicate which of the following would improve your satisfaction with your weight management 

  Yes No Already Utilize N/A
Patient-focused educational materials
More time with my physician
Access to a dietician or lifestyle coach
More treatment options
Patient advocacy network
Patient web portal to access my healthcare team
Tools to improve medication adherence

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* 14. Please provide any additional comments regarding concerns about your weight management below:

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