Quick note: this condition was officially renamed from PCOS to PMOS in May 2026. I use both terms here — PCOS because that’s what most people are searching for, and PMOS because it’s the current name.
It was a public holiday, which meant nothing was planned and I had nowhere to be. The day before I had gone to the supermarket with full intentions and bought groceries I meant to cook. By mid-afternoon I was on the couch watching TV, still thinking vaguely about what I might make, and then thinking about tiramisu.
I ordered fried rice instead. About an hour after eating, I got a major food noise episode craving a big box of tiramisu. Definitely not a vague wanting, and certainly with a sense of urgency that felt out of proportion to the situation.
This happens often enough that I have started paying attention to the sequence. I love buying groceries. Looking at fresh produce, getting excited about all the healthy food I am going to make, the dopamine hit of actually buying the stuff. Getting over the hump into actually doing the work once I am home is something else entirely. They are different parts of the same process that require two completely different kinds of mental bandwidth. So, I order food instead – not necessarily what my body needs, but whatever requires the fewest decisions. Then the sweet craving follows.
This is what insulin resistance does – a high-carb or high sugar meal moves glucose into the bloodstream quickly, insulin rises to match it. With PMOS, that response can overshoot. Glucose drops quickly, and as a result the body starts asking for more sugar, and boy can the body be convincing.
I came across a 2024 review in Nutrients about food cravings specifically in PCOS. The researchers found that appetite regulation is consistently disrupted, driven by insulin resistance, elevated androgens, and how the body handles satiety signals after eating. Also, food craving scores in women with PCOS are significantly higher than in women without it. What I can tell you for sure is that for me, cravings feels like an uncontrollable demand – my mind constantly shouting “I need something sweet right now” and getting louder the more I ignore it.
What has frustrated me for years is that PCOS sugar cravings are routinely framed as a willpower problem, or that I don’t know enough about the condition. Ignore the craving and it will pass, or eat better and you will stop wanting it. I know what to eat, I know 5 different high protein white-bean salad variants. But, on a day with nothing important to do and nowhere to be, I still can never make myself get there.
I work in finance, and a lot of what I do involves identifying where systems break down. Taking a step back, the groceries in the fridge were the correct first step, but I ran out of capacity before step two – actually doing something with the groceries.
I do not have the solution just yet, but at least I’ve started to understand where this pattern starts from. What I have stopped doing, though, is to treat me giving in to the tiramisu craving as being a me failure. Instead, it is the last step in a sequence that started hours earlier, and that feels like a more useful and productive place to start working from.
I do not have the solution yet, but at least I’ve started to understand where this pattern starts from. What I have stopped doing, though, is to treat me giving in to the tiramisu craving as being a failure. It is the last step in a sequence that started hours earlier, and that feels like a more useful place to start working from.
If this pattern sounds familiar, it is worth talking through the full picture with whoever manages your PMOS care, not the craving in isolation but what came before it. I am not a doctor. This is what I have been noticing.
About the author: Sapna writes about PMOS and insulin resistance from the perspective of someone figuring most of this out in real time. She works in finance, is based in Kuala Lumpur, and is not a doctor or nutritionist. Nothing here is medical advice.
Last reviewed: Aug 2026
Sources:
- Stefanaki et al. (2024): Food Cravings and Obesity in Women with PCOS, Nutrients
- Jeanes et al. (2017): Binge eating behaviours and food cravings in women with PCOS, Appetite
- NHS: Polycystic ovary syndrome and insulin resistance
- The Lancet: Polyendocrine metabolic ovarian syndrome, the new name for PCOS
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