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Written by Diet Bites

Use the following free diet planner to help you create a diet game plan. Follow the directions in the questionnaire. Be sure and visit Diet Bites for motivation and diet guidance. Good luck and keep us posted on your success!


1. My height is ______ feet and ______ inches.

2. My current weight is ___________ pounds.

3. FINAL WEIGHT LOSS GOAL - I need to lose _________ pounds.  

Determine this amount by using the standard weight charts at Diet Bites found here: Weight Charts.  

Please follow all the directions on this page when you weigh, as well as when you are calculating your FINAL weight loss goal.

We recommend that you choose the HIGHEST number in the chart for your height, regardless of your frame.  Once you reach that weight, you can decide at that point if you need to lose more.

4. I plan to begin my diet on this date: __________________

5. I will reach my weight goal on this date: _________________  

Determine this number by calculating 2 pounds per week.  For example, if Joan plans to lose 58 pounds, it is going to take her 29 weeks.

6. These are my tiered weight goals:

_______        _______        _______        _______        _______        _______        _______        _______

Determine your goals weights according to this example: Jim weighs 277 pounds and wants to lose down to 175 pounds.  His first goal weight will be 270.  His next goal is 260 pounds.  Then 250, and so forth (240, 230, 220, 210, 200, 190, 180, 175) until he reaches 175 pounds.  You will lose weight much easier if you break your OVERALL WEIGHT LOSS GOAL into smaller increments.

7. Here are a few of my favorite foods:

_________________________        _________________________        _______________________

8. These are my favorite activities:

_________________________        _________________________        _______________________

9. My hobbies include:

_________________________        _________________________        _______________________


10.  Whenever I reach a weight loss goal, this is how I plan to reward myself:

____  Enjoy a favorite goody.  I'll be sure to count it as part of my daily calorie intake, however.

____  Purchase something for my home.

____  Go to a movie.  I'll be sure to resist the hot buttered popcorn.

____  Purchase something personal for myself, such as a new piece of clothing, or a special treasure.

____  A night out on the town OR a day out on the town.

11.  I plan to exercise by doing the following, at least every other day: __________________________

12. Check the amount of calories that you are going to eat per day until you have reached your final weight goal.  

If you have 100 or less pounds to lose, circle 1,200 - 1,350.  If you have 100 to 150 pounds to lose, circle 1,600.  If you have 150 to 200 pounds to lose, circle 1,750.

If you have more than 200 pounds to lose, please get with your physician as soon as possible for a supervised weight program.

_____ 1,200 to 1,350 calories per day

_____ 1,600 calories per day (when you are within 100 pounds of your goal, drop to 1,200 to 1,350 per day)

_____ 1,750 calories per day (when you are within 150 pounds of your goal, drop to 1,600 calories per day)

13.  Personal notes:


14.  My Daily Menus: (Cal = Calories)



Breakfast = ____ Cal

Snack = ____ Cal

Lunch = ____ Cal

Snack = ____ Cal

Dinner = ____ Cal















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