Ask Lisa Q&A: Why Do I Have Constant Cravings With PCOS – Even When I’m Eating “Well”?

If you have PCOS and feel like you’re constantly thinking about food, especially sugar or carbs, you’re not the only one who's struggling. This is one of the most common questions I hear from women who feel they’re doing “all the right things” but still feel overwhelmed by cravings, energy dips, and appetite swings.

This can feel confusing and frustrating, particularly if you’ve been told to just “eat less sugar” or “be more disciplined”. But for many women with PCOS, cravings are not a willpower issue.

They’re a physiological response driven by how PCOS affects blood sugar regulation, insulin, stress hormones, and appetite signalling.

Let’s look at what’s really going on and what actually helps.

Why do women with PCOS have constant cravings?

Women with PCOS are more likely to experience cravings because PCOS commonly affects metabolic and hormonal systems that regulate appetite and energy.

These include:

• blood sugar stability

• insulin sensitivity

• stress hormone (cortisol) levels

• appetite hormones that control hunger and fullness

When these systems are disrupted, the brain receives stronger signals to seek quick energy, often in the form of sugar or refined carbohydrates. This happens even when someone is eating regular meals or choosing “healthy” foods. Cravings, in this context, are a biological signal, not a personal failure.

Are PCOS cravings caused by blood sugar imbalance?

Blood sugar imbalance is one of the most common drivers of cravings in PCOS, even when standard blood glucose tests appear normal.

Here’s what often happens:

• meals digest quickly due to low protein, fibre, or fat

• blood sugar rises and then drops too fast

• the brain interprets this drop as an energy threat

• cravings kick in to restore glucose levels

This pattern often shows up as:

• mid-morning hunger shortly after breakfast

• afternoon energy crashes

• evening cravings, even after a full meal

In PCOS, these fluctuations can be more pronounced due to underlying insulin resistance or stress-related glucose release.

How insulin resistance affects appetite and cravings in PCOS

Insulin does more than manage blood sugar, it also plays a role in appetite regulation and satiety signalling.

With insulin resistance:

• insulin levels stay higher for longer

• cells don’t respond efficiently

• hunger and fullness cues become less precise

This can lead to:

• feeling hungry soon after eating

• difficulty feeling satisfied

• stronger pull towards quick-energy foods

Importantly, this doesn’t require a diagnosis of diabetes. Many women with PCOS experience insulin resistance years before blood tests flag any concerns.

This is why cravings can persist even when calorie intake seems adequate.

Why cravings happen even when you’re eating “healthy” with PCOS

Many women tell me:

“I eat whole foods, avoid sugar, and still feel out of control around food.”

Eating “healthy” doesn’t always mean eating in a way that supports blood sugar and hormones.

Common issues I see include:

• meals too low in protein

• relying heavily on carbohydrates without enough fat or fibre

• under-eating earlier in the day

• long gaps between meals

These patterns can unintentionally increase blood sugar swings and stress hormone output — both of which fuel cravings.

With PCOS, meal structure matters as much as food quality.

What role do stress and sleep play in PCOS cravings?

Stress and sleep are often overlooked drivers of cravings — especially for professional women with PCOS.

Chronic stress can:

• increase cortisol

• raise blood glucose via liver output

• worsen insulin resistance

• increase appetite for quick energy

Poor or disrupted sleep further affects:

• hunger hormones

• insulin sensitivity

• decision-making around food

This is why cravings often feel worse:

• during busy work periods

• after poor sleep

• when meals are skipped or rushed

Supporting cravings without addressing stress and sleep often leads to limited results.

Does cutting sugar actually help with PCOS cravings?

Cutting sugar may reduce cravings short-term, but for many women with PCOS it does not address the underlying cause.

Longer term, strict restriction can:

• increase food preoccupation

• raise stress levels

• worsen rebound cravings

• damage trust in hunger cues

For PCOS, the goal isn’t elimination — it’s regulation.

When blood sugar is stable, cravings often reduce naturally without rigid rules or avoidance.

What helps reduce cravings with PCOS? (Evidence-based steps)

The most effective approach focuses on supporting physiology, not fighting appetite.

1. Build meals that support blood sugar

Aim for meals that include:

• a clear protein source

• fibre-rich carbohydrates

• healthy fats

• enough overall energy

This is especially important at breakfast, as it sets appetite regulation for the rest of the day.

2. Eat regularly to prevent physiological stress

Long gaps between meals can:

• increase cortisol

• worsen insulin response

• intensify cravings later

Regular meals don’t mean rigid schedules, they mean avoiding extremes that push the body into energy-seeking mode.

3. Address sleep and stress alongside nutrition

Cravings won’t fully settle if:

• sleep is consistently poor

• stress remains unaddressed

• caffeine is replacing meals

Even small improvements in sleep routines or stress recovery can noticeably affect appetite.

4. Reframe cravings as information, not failure

Cravings often signal:

• inadequate meal balance

• under-fueling

• stress overload

• disrupted recovery

Responding with curiosity rather than restriction allows you to adjust what your body actually needs.

When should cravings be a sign to seek extra support?

If cravings feel:

• constant

• intense

• emotionally draining

• resistant to basic nutrition changes

that’s often a sign deeper metabolic or lifestyle support is needed.

Cravings don’t mean something is “wrong” with you, they mean your body needs more stability, not more control.

A gentle place to start

If all this sounds familiar and you want a calm, practical starting point, my 3-Day PCOS Blood Sugar Reset is designed to help you:

• understand why cravings happen with PCOS

• structure meals to support blood sugar

• feel more stable and confident with food

It’s a low-commitment WhatsApp mini course focused on education and simple, realistic changes — not restriction or tracking.

Final thought

Cravings with PCOS are not a lack of willpower. They’re a signal.

When blood sugar, insulin and stress are better supported, food can start to feel calmer — and your energy more predictable — without extremes.

Disclaimer: The information provided is for educational and informational purposes only and should not be considered medical advice. While I provide guidance based on my expertise as a BANT registered nutritionist and health coach, all health-related decisions should be made in consultation with your GP, specialist, or healthcare provider. Any changes to medication, supplements, or treatment plans should only be made under the supervision of a qualified medical professional. The suggestions outlined are intended to support general well-being and do not replace medical treatment or diagnosis. Always consult a healthcare professional before making significant lifestyle or dietary changes.