esv-thera.operaticsites.com
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34.226.124.137
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https://esv-thera.operaticsites.com/
Submission: On February 21 via api from US — Scanned from US
Submission: On February 21 via api from US — Scanned from US
Form analysis
2 forms found in the DOM<form id="quiz_form">
<div id="quiz_area">
<div class="row">
<fieldset>
<legend>I feel frustrated and/or upset by the changes in the size and shape of my abdomen/belly.</legend>
<div class="options grid col-2">
<div class="radio-container"><input type="radio" id="question_1_yes" name="question_1"><label for="question_1_yes">Yes</label><span class="checkmark"></span></div>
<div class="radio-container"><input type="radio" id="question_1_no" name="question_1"><label class="no" for="question_1_no">No</label><span class="checkmark"></span></div>
</div>
</fieldset>
</div>
<div class="row">
<fieldset>
<legend>How long ago did you notice these changes?</legend><input type="text" id="question_2" name="question_2">
</fieldset>
</div>
<div class="row">
<fieldset>
<legend>My abdomen/belly feels hard, taut (stretched out), bloated and/or uncomfortable.</legend>
<div class="options grid col-2">
<div class="radio-container"><input type="radio" id="question_3_yes" name="question_3"><label for="question_3_yes">Yes</label><span class="checkmark"></span></div>
<div class="radio-container"><input type="radio" id="question_3_no" name="question_3"><label class="no" for="question_3_no">No</label><span class="checkmark"></span></div>
</div>
</fieldset>
</div>
<div class="row">
<fieldset>
<legend>I have difficulties bending over and tying my shoes.</legend>
<div class="options grid col-2">
<div class="radio-container"><input type="radio" id="question_4_yes" name="question_4"><label for="question_4_yes">Yes</label><span class="checkmark"></span></div>
<div class="radio-container"><input type="radio" id="question_4_no" name="question_4"><label class="no" for="question_4_no">No</label><span class="checkmark"></span></div>
</div>
</fieldset>
</div>
<div class="row">
<fieldset>
<legend>I have noticed shortness of breath.</legend>
<div class="options grid col-2">
<div class="radio-container"><input type="radio" id="question_5_yes" name="question_5"><label for="question_5_yes">Yes</label><span class="checkmark"></span></div>
<div class="radio-container"><input type="radio" id="question_5_no" name="question_5"><label class="no" for="question_5_no">No</label><span class="checkmark"></span></div>
</div>
</fieldset>
</div>
<div class="row">
<fieldset>
<legend>I have noticed changes in the way my clothes fit my abdomen/belly.</legend>
<div class="options grid col-2">
<div class="radio-container"><input type="radio" id="question_6_yes" name="question_6"><label for="question_6_yes">Yes</label><span class="checkmark"></span></div>
<div class="radio-container"><input type="radio" id="question_6_no" name="question_6"><label class="no" for="question_6_no">No</label><span class="checkmark"></span></div>
</div>
</fieldset>
</div>
<div class="row">
<fieldset>
<legend>I am having trouble sleeping at night.</legend>
<div class="options grid col-2">
<div class="radio-container"><input type="radio" id="question_7_yes" name="question_7"><label for="question_7_yes">Yes</label><span class="checkmark"></span></div>
<div class="radio-container"><input type="radio" id="question_7_no" name="question_7"><label class="no" for="question_7_no">No</label><span class="checkmark"></span></div>
</div>
</fieldset>
</div>
<div class="row">
<fieldset>
<legend>I have tried diet and exercise, and it has not affected how my abdomen/belly feels and/or looks.</legend>
<div class="options grid col-2">
<div class="radio-container"><input type="radio" id="question_8_yes" name="question_8"><label for="question_8_yes">Yes</label><span class="checkmark"></span></div>
<div class="radio-container"><input type="radio" id="question_8_no" name="question_8"><label class="no" for="question_8_no">No</label><span class="checkmark"></span></div>
</div>
</fieldset>
</div>
<div class="row">
<fieldset>
<legend>My waist circumference exceeds 37.4 inches for men or 37 inches for women or my waist-to-hip ratio exceeds 0.94 for men or 0.88 for women.</legend>
<div class="options grid col-3">
<div class="radio-container"><input type="radio" id="question_9_yes" name="question_9"><label for="question_9_yes">Yes</label><span class="checkmark"></span></div>
<div class="radio-container"><input type="radio" id="question_9_no" name="question_9"><label class="no" for="question_9_no">No</label><span class="checkmark"></span></div>
<div class="radio-container"><input type="radio" class="unsure" id="question_9_unsure" name="question_9"><label for="question_9_unsure">Unsure</label><span class="checkmark"></span></div>
</div>
</fieldset>
</div>
<div class="row large wasit_hip_ratio" id="wasit_hip_ratio" style="display: none;">
<div class="waist-block">
<p class="text-md bold w-85">Ask your Healthcare Provider to measure you and fill out this equation together</p>
<p class="text-md w-85">One of the indicators for excess visceral abdominal fat is an increased waist-to-hip ratio. It is simple to calculate. Here’s how:</p>
<div class="calculator">
<div class="head">
<p class="text-md primary bold mt-0 mb-0">Waist-to-Hip Ratio</p>
<fieldset><label class="radio-container" for="cm_ratio">CM<input type="radio" id="cm_ratio" name="ratio_type" checked=""><span class="checkmark"></span></label><label class="radio-container" for="in_ratio">IN<input type="radio"
id="in_ratio" name="ratio_type"><span class="checkmark"></span></label></fieldset>
</div>
<div class="formula">
<div class="waist">
<fieldset><label class="number-container" for="waistnumber">
<div class="custom-number-field"><input type="number" placeholder="0" id="waistnumber" name="waistnumber"></div>Waist circumference
</label></fieldset>
</div><span>÷</span>
<div class="hip">
<fieldset><label class="number-container" for="hipnumber">
<div class="custom-number-field"><input type="number" placeholder="0" id="hipnumber" name="hipnumber"></div>Hip circumference
</label></fieldset>
</div><span class="equal">=</span>
<div class="final"><span id="final">0.0</span></div>
</div>
</div>
<div class="grid col-2">
<div class="block">
<p class="text-md primary bold text-underline mb-0">Waist Circumference:</p>
<p class="text-md mt-0">Measure around waist starting at the belly button. Make sure the tape is horizontal to the floor and around the waist. </p>
</div>
<div class="block">
<p class="text-md primary bold text-underline mb-0">Hip Circumference: </p>
<p class="text-md mt-0">Measure starting at the widest area of the hips around the buttocks, making sure the tape is horizontal.</p>
</div>
</div>
<p class="text-md primary bold">Indicators for excess visceral abdominal fat*</p>
<table>
<thead>
<tr>
<th></th>
<th>Assigned Male at Birth</th>
<th>Assigned Female at Birth</th>
</tr>
</thead>
<tbody>
<tr>
<td class="bold">Waist circumference</td>
<td>≥37.4 in (95 cm)</td>
<td>≥37 in (94 cm)</td>
</tr>
<tr>
<td class="bold">Waist to hip </td>
<td>≥0.94</td>
<td>≥0.88</td>
</tr>
</tbody>
</table>
<p class="text-sm">* Based on inclusion criteria for clinical trials.</p>
</div>
</div>
</div>
<div class="row" id="submit_area">
<fieldset>
<legend class="text-center">Save the results of the quiz</legend>
<div class="btns"><button type="button" id="email"><img src="/email-icon.svg" alt="">Email</button><button type="button" id="download"><img src="/download-icon.svg" alt="">Download</button></div>
</fieldset>
</div>
</form>
<form id="custom_email" class="custom-email">
<legend>Email:</legend><input type="email" placeholder="Email" id="customemail" required="" name="customemail" value=""><input type="hidden" id="custompdflink" data-link="" name="custompdf" value="">
<div class="load-container">
<div id="loadinner"><img src="/check_black.png" alt=""></div>
</div>
<div class="custom-button"><button type="submit" class="hover"><img src="/email-icon.svg" alt="">Send</button></div>
</form>
Text Content
HIV AND EXCESS VISCERAL ABDOMINAL FAT Start the Conversation with Your Healthcare Provider Today! Check off the boxes that apply to you and share your results with your Healthcare Provider during your appointment. I feel frustrated and/or upset by the changes in the size and shape of my abdomen/belly. Yes No How long ago did you notice these changes? My abdomen/belly feels hard, taut (stretched out), bloated and/or uncomfortable. Yes No I have difficulties bending over and tying my shoes. Yes No I have noticed shortness of breath. Yes No I have noticed changes in the way my clothes fit my abdomen/belly. Yes No I am having trouble sleeping at night. Yes No I have tried diet and exercise, and it has not affected how my abdomen/belly feels and/or looks. Yes No My waist circumference exceeds 37.4 inches for men or 37 inches for women or my waist-to-hip ratio exceeds 0.94 for men or 0.88 for women. Yes No Unsure Ask your Healthcare Provider to measure you and fill out this equation together One of the indicators for excess visceral abdominal fat is an increased waist-to-hip ratio. It is simple to calculate. Here’s how: Waist-to-Hip Ratio CMIN Waist circumference ÷ Hip circumference = 0.0 Waist Circumference: Measure around waist starting at the belly button. Make sure the tape is horizontal to the floor and around the waist. Hip Circumference: Measure starting at the widest area of the hips around the buttocks, making sure the tape is horizontal. Indicators for excess visceral abdominal fat* Assigned Male at BirthAssigned Female at BirthWaist circumference≥37.4 in (95 cm)≥37 in (94 cm)Waist to hip ≥0.94≥0.88 * Based on inclusion criteria for clinical trials. Save the results of the quiz EmailDownload Email: Send If you are living with HIV and checked yes to one or more statements, you may have a build-up of hard fat in your abdomen/belly called excess visceral abdominal fat. Visceral fat is different from the soft, squishy fat that can build up under the skin called subcutaneous fat. Subcutaneous fat is easy to grab and pinch between the fingers and can be managed with diet and exercise. Excess visceral abdominal fat can make it difficult to perform certain physical activities and may reduce your quality of life. It may also be associated with serious health issues, including: High Blood Pressure Fatty Liver High Cholesterol Digestive Problems Insulin Resistance and Diabetes Mental Health Heart Disease Excess visceral abdominal fat can be treated, ask your Healthcare Provider about it. Keep in mind that reducing excess visceral fat may not decrease the risk of other health issues. © 2024 Theratechnologies Inc. All rights reserved. US-EVA-2300018 * Privacy Policy * Legal statement