Food Noise, Cravings and PMOS: Why Willpower Isn't the Answer

Do you think about food far more than you would like to?

Perhaps you have only just finished lunch and are already planning what comes next. Perhaps there is a running commentary in the background of your day: what you have eaten, what you should not eat, what is in the cupboard, whether you have been "good".

For years, many women with PMOS, previously known as PCOS, have assumed this was simply a personal failing.

There is now a name for it: food noise. And the fact that it is being named, measured and researched tells us something important.

What Is Food Noise?
Food noise is not a medical diagnosis. The phrase came from patients, particularly people who had started taking GLP-1 medicines and noticed that the constant chatter about food had gone quiet.

Researchers have since tried to pin it down. One group described it in 2023 as a heightened and persistent reaction to food cues, often leading to intrusive thoughts about food. Another, in 2025, defined it as persistent thoughts about food that are unwanted or distressing and that may cause harm, whether social, mental or physical.

The important words are persistent and unwanted.

Wondering what to cook at five o'clock is not food noise. Nor is enjoying food or looking forward to a meal out. Food noise is when the thoughts keep coming, are not welcome and get in the way of everything else.

This is a young area of science. The first questionnaires designed to measure food noise were only published in 2025, and to my knowledge it has not yet been measured directly in women with PMOS.

Hunger, Cravings and Food Noise Are Not the Same
It helps to separate three things that often get lumped together.

Hunger is the body's need for energy. A craving is an intense desire for a particular food. Food noise is the persistent mental preoccupation that can sit behind both, and it can be present even when you are not physically hungry at all.

That is why "just eat when you're hungry" is such unhelpful advice for some people.

Why Might This Matter in PMOS?
Although food noise itself has not been studied in PMOS, its close relatives have.

In a UK survey of women with PCOS, food cravings were common, and 60% of the women who were also living with obesity were categorised as having binge-eating behaviour. This was an online survey, so it may over-represent those who struggle most, but the numbers are striking.

A 2024 meta-analysis went further. Drawing on 20 studies and almost 29,000 women with PCOS, it found roughly double the odds of binge eating disorder compared with women without the condition, and higher odds of bulimia nervosa. Disordered eating scores were higher in women with PCOS regardless of body weight.

Why might this be?

As we explored at the start of the month, insulin resistance, differences in how fullness signals respond after meals, poor sleep and chronic stress can all influence appetite. Add years of being told to eat less and lose weight, often without much support, and it is not hard to see how food becomes a preoccupation.

Why Willpower Isn't the Answer
Willpower assumes that the problem is a decision.

But the brain's response to food cues is largely automatic. The sight, smell or even the thought of food can trigger wanting before any conscious choice has been made. How strongly that happens varies between people, and it is shaped by hunger, sleep, stress, biology and the food environment around us.

Strict rules can turn the volume up as well. Experimental studies suggest that when people are asked to avoid a particular food for a short time, cravings for that food tend to increase, especially in those already prone to cravings. Trying hard not to think about something is a reliable way of thinking about it more.

The picture is not completely one-sided. In longer, structured programmes, cravings often reduce over time. But it does help to explain why another round of cutting things out so often makes the noise louder, not quieter.

How GLP-1 Medicines Changed the Conversation
You will have seen the headlines.

GLP-1 medicines mimic the gut hormone we met earlier this month. They act on the gut and on areas of the brain involved in appetite and reward. In a two-year trial, people taking one of these medicines reported fewer cravings and found them easier to resist than people taking a placebo. This was an exploratory analysis in a subgroup of participants, so it is a signal and not the final word.

What interests me most is not the medicines themselves, but what they have revealed.

When a treatment that acts on appetite pathways quietens thoughts about food, it becomes very difficult to argue that those thoughts were ever a character flaw. That has helped to move the conversation from blame towards biology, and many women have found that a relief in itself.

Some context matters here. These are prescription-only medicines with specific eligibility criteria and potential side effects. NICE is clear that they should be used alongside support with nutrition and physical activity, and the International Evidence-Based Guideline says they may be considered in PMOS in line with general population guidance, weighing up benefits and side effects. The MHRA advises that they should not be used during pregnancy, when trying to conceive or while breastfeeding, and that they should only be obtained through a registered prescriber and pharmacy.

Whether they are appropriate for you is a conversation for your GP or specialist. It is not something I can advise on.

What Can Help Turn the Volume Down?
Food and lifestyle changes do not work in the same way as a medicine, and I would be cautious about any product that claims to.

What they can do is address some of the things that amplify food noise.

Eating enough, and eating regularly, matters more than most people expect. Food thoughts tend to be louder when the body is under-fuelled. Meals built around protein, fibre and plenty of vegetables, as we covered in the top tips blog, give fullness signals the best chance of being heard.

Sleep and stress deserve attention too, because both can make food more rewarding and harder to resist.

Your surroundings count. If the trigger is a cue, changing the cue is usually easier than resisting it. Moving the biscuits out of sight is not weakness. It is sensible design.

And loosening rigid food rules, ideally with support, often does more to quieten things than tightening them.

When to Seek More Support
Please speak to your GP if you recognise any of the following:

• regularly eating large amounts while feeling out of control
• eating in secret, or feeling intense guilt or distress after eating
• making yourself sick, using laxatives or severely restricting food
• thoughts about food, weight or eating that dominate your day.

Eating disorders are treatable. The charity Beat offers information and helplines.

The Bigger Picture
Food noise is not evidence that you are greedy, weak or broken.

It is what happens when appetite biology, a food environment designed to grab attention and years of dieting messages meet in one person. PMOS can add to that load.

So perhaps the question is not "Why can't I just stop thinking about food?"

It might simply be: what is turning the volume up, and what support would help to turn it down?

This article is for educational purposes only and is not a substitute for medical advice. BANT-registered nutrition practitioners do not diagnose or treat medical conditions, nor do they prescribe or alter medication. Always consult your GP before making any changes to your medications or supplements.