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Worksheet

S-UNCOPE: SCREENING FOR SUGAR ADDICTION

Congratulations! It takes courage to look at yourself and want to change.
This survey will only take a minute or two of your time. All you have to do is answer the following 6 YES or NO Questions. 

Note:
Sugar/Food refers to any kind of processed carbohydrates, such as pasta, bread, desserts, cookies, soda, ice cream, pizza, cereal, potatoes, rice, sweeteners, junk food (with or without fat), etc.Note: 

This tool is based on the UNCOPE (Unplanned Use, Neglected, Cut Down, Objected, Preoccupied, Emotional Discomfort) which is a screening tool used for alcohol and/or drug addiction. It was adapted for Sugar Addiction by Bitten Jonsson RN and Dave Wolfe MS, RD.

1. ➜

Question 1. U = UNPLANNED USE

In the past year, have you ever eaten more sugar/food than you intended or spent more time eating sugar/food than you intended?

2. ➜

Question 2. N = NEGLECTED

Have you ever neglected any of your usual daily responsibilities due to overeating and/or using sugar/food?

3. ➜

Question 3. C = CUT DOWN

In the last year, have you felt that you wanted or needed to cut down on eating sugar/food?

4. ➜

Question 4. O = OBJECTED

If anyone (family, friends, healthcare professional) knew about your eating habits with sugar/food would they object/protest?

5. ➜

Question 5. P = PREOCCUPIED

Have you ever found yourself preoccupied with wanting sugar/food? Have you found yourself thinking a lot about sugar/food?

6. ➜

Question 6. E = EMOTIONAL DISCOMFORT

Have you ever used sugar/food to relieve fatigue and/or emotional discomfort, such as sadness, anger, or boredom?

7. ➜

TOTAL YES's

How many yes answers have you marked above?