Healthy Eating Contract

    

I, {Name}, hereby vow to abide by this contract in order to create and maintain a healthy lifestyle and {reach a healthy weight/reduce my blood pressure/feel better}.

I agree to eat in such a way that I do not weigh more than {maximum targeted, healthy weight for body type} and no less than {minimum targeted, healthy weight for body type}. I will drink 8 glasses of water a day and exercise at least twice a week.

I will not eat in such a way as to become obese, bulimic or anorexic. The purpose of this diet is to maintain a healthy body type and weight.

I will avoid the following foods:

- {Food type}

- {Food type}

- {Food type}

- {Food type}

I will eat the following foods at least three times a week:

- {Food type}

- {Food type}

- {Food type}

- {Food type}

I will eat only limited amounts the following foods:

- {Food type}

- {Food type}

- {Food type}

- {Food type}

This week my goals are:

1. {Goal}

2. {Goal}

3. {Goal}

I, {Witness} agree to help {Name} by not bringing any of the prohibited foods into the house and by encouraging {Name} to stick with the diet.

_________________________________________

Signature Date

_________________________________________

Witness Date

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