Document text
Name: [FULL NAME]
Start date (first weigh-in): [DATE]
Weight now: [NUMBER] kg · Goal weight: [NUMBER] kg · Height, cm: [NUMBER]
My numbers
Now Goal
Weight, kg [NUMBER] [NUMBER]
BMI [NUMBER] — [CATEGORY] [NUMBER] — [CATEGORY]
My weekly pace: [0.45 OR 0.9] kg a week · Weeks to my goal: [NUMBER] · Goal date: [DATE]
Why I want this
1. [MY FIRST REASON — e.g. TO FEEL BETTER, TO MOVE MORE EASILY]
2. [MY SECOND REASON]
3. [MY THIRD REASON]
How I will keep track
☐ Weigh in once a week — same scale, same day, same time
☐ Write the number in my tracker below
☐ Look at the plan with my doctor or the barangay health center at 12 weeks
My check-up
Doctor or clinic: [NAME] · Next visit: [DATE]
Weekly weigh-ins
Week Date Planned, kg My weight, kg ✓
1 [DATE] [NUMBER] ☐
2 [DATE] [NUMBER] ☐
3 [DATE] [NUMBER] ☐
4 [DATE] [NUMBER] ☐
5 [DATE] [NUMBER] ☐
6 [DATE] [NUMBER] ☐
7 [DATE] [NUMBER] ☐
8 [DATE] [NUMBER] ☐
9 [DATE] [NUMBER] ☐
10 [DATE] [NUMBER] ☐
11 [DATE] [NUMBER] ☐
12 [DATE] [NUMBER] ☐
What the numbers mean (CDC)
BMI, adults 20 and older Category
Under 18.5 Underweight
18.5 to under 25 Healthy weight
25 to under 30 Overweight
30 and over Obesity
People who lose weight at a gradual, steady pace — about 1 to 2 pounds a week — are more likely to keep the weight off (CDC). BMI is a screening measure, not a diagnosis.
I set this goal and this pace myself.
Signature: ______________________ Date: [DATE]
This plan does not replace a doctor and gives no diet or medicine advice.
Reply to this document or get a deadline reminder: https://layers.md/ph/weight-loss-tracker-printable?from=reply-ph-weight-loss