What you need to know about PCOS
An interview with nutritionist, Aditi Guha
If you’ve been hearing more about PCOS lately, you’re not imagining it. Polycystic Ovarian Syndrome affects up to 1 in 5 women worldwide, and within the South Asian community, that number may be even higher. It is not uncommon to learn about it after years of irregular cycles, stubborn weight gain, fatigue, or skin and hair problems that were dismissed as just stress or “hormonal issues.”
Aditi Guha is a nutritionist who has made it her mission to demystify PCOS for South Asian women through the lens of food as medicine. With a practice rooted in evidence-based nutrition, cultural sensitivity, and lived experience, Aditi helps women reconnect with their bodies—and their traditional cuisines—in a way that’s both healing and sustainable.
Aditi and I met when we took a course together, and I found her origin story fascinating (read more below) and love how passionate she is about her work. In this conversation, we dig into what is tricky about PCOS diagnosis, her approach to treating PCOS, and bite-size takes on everything from exercise to fasting.
Let’s dive in.
Q&A with Aditi Guha, PCOS nutritionist
Origin Story
I graduated with a Master’s from Oxford along with 30 extra pounds. At the time, I thought the degree would change my life. But in reality, it was the weight that did. It was the first time I had gained significant weight, and suddenly I saw how differently people treat you when you’re in a bigger body. Nothing about me had changed on the inside, but the world’s perception of me had. The judgment, the unsolicited advice, the medical gaslighting - it all came rushing in. That experience taught me firsthand how much self-esteem and identity can get tangled up in weight, especially for young women.
I eventually lost the weight by reverse-engineering my own symptoms, left my corporate job and briefly became a corporate nutritionist - working with companies like Unilever and Google to design workplace wellness programs. That’s where I noticed something curious: there was a group of women who, no matter how well they followed the plan, weren’t losing weight. All of them had PCOS!. That’s what led me down the hormonal rabbit hole. Though I don’t have PCOS myself, working with these women taught me more than any textbook could. In fact, it was through that work that I was able to be pain free with endometriosis. I lost both my fallopian tubes to endo and conceived my kids through IVF on the first attempt - something I credit to the knowledge I had gained from helping my clients.
Today, I’m a PCOS nutritionist, a mom, and someone who’s deeply committed to helping women stop guessing and start understanding their bodies—for real this time.
I live in Hoboken, New Jersey, with my husband and our two toddlers.
What is the most surprising thing you’ve learned about PCOS?
There isn’t just one type. PCOS looks very different from person to person. In fact, it can even look completely different between siblings. So, the idea that it’s just one condition is misleading.
To think there’s only one type of diet, one type of workout, or one supplement that will help with PCOS is absolute nonsense.
How does one know they have PCOS?
One of the most surprising things about PCOS is how it’s diagnosed. Most people assume it’s based entirely on an ultrasound. But that’s not true. In my five years of working with women with PCOS, I haven’t met a single person who actually knew how the diagnosis is made. Yes, you read that right. Not even one.
The official diagnostic method is called the Rotterdam Criteria. It’s evidence-based, widely accepted, and yet incredibly misunderstood.
Here’s how it works:
There are three possible criteria, and to be diagnosed with PCOS, you must meet at least two out of the three. It’s a diagnosis made by inclusion and exclusion. If you don’t meet at least two, you do not have PCOS.
Irregular periods or infrequent ovulation - You might skip periods, go months without one, or have cycles that are too short or too long.
Signs of high androgens (male hormones) - This can look like acne, hair thinning, or unwanted facial/body hair.
Polycystic ovaries or high AMH levels - You may have many small follicles on your ovaries or elevated hormone levels that signal PCOS—even if you're getting a period.
What is your approach to treating PCOS with food?
What I’ve found over the years is that jumping straight into nutrition without addressing the root cause is often what keeps people stuck. Here is the framework I follow:
Step 1: Identify the Root Cause
No two cases of PCOS are the same. So the first step is identifying what’s actually driving the hormonal chaos. There are typically five major root causes:
Inflammation
Insulin resistance
Adrenal fatigue
Thyroid dysfunction
Androgen excess
In my experience, 95% of women have more than one. This matters because your food strategy should be built around your root causes.
For example, let’s say your gut is struggling, but you’ve been told to eat lentils, dal, or cottage cheese because they’re “healthy.” If your digestion is impaired, these foods can leave you bloated, uncomfortable, and still craving sugar. They may be great for someone else but right now, they’re not serving you. This is why personalization is key.
If you’re struggling with PCOS, take my quiz - Discover your PCOS Weight Loss Type to help identify your own root cause.
Step 2: Repair What’s Not Working
Once we know what’s going on under the hood, the next step is repair. In the case of gut issues, I’ll use my TAME Gut Protocol, which most of my 1:1 clients go through in some form if their gut health needs attention.
Before we start loading your plate with “good” food, I want to make sure your body can actually digest and absorb it. Because the truth is, you are not what you eat. You are what you digest. This step also includes correcting deficiencies or imbalances that need to be addressed before food can truly act as medicine.
Step 3: Introduce Nutrition
Only after steps 1 and 2 do we bring in nutrition. And my food philosophy is this:
Overlay your preferences, then elevate them to become PCOS-friendly.
For example, I had a client who absolutely loved her coffee creamer and didn’t want to give it up. Instead of removing it, we made a plan: she could keep the creamer, but we paired her coffee with a proper breakfast that included protein.
Another client had a tradition of eating pizza every Friday night. So we didn’t take that away either. Instead, we added fiber beforehand, included a protein-rich side like a chicken salad, and switched to a thin crust version - small tweaks that elevated her habit while respecting her lifestyle.
I use your existing food habits as the template, then overlay two things:
Your root cause strategy
Small, sustainable upgrades
That’s how we make it both effective and enjoyable. If you’re struggling with PCOS, get my exclusive 7-Day Meal Plan here.
Bite Size Takes
Protein
Protein is essential but not all protein is created equal, and this is where I see a lot of well-intentioned mistakes.
If you’re vegetarian and relying on dal, lentils, or pulses, remember: these are incomplete proteins. They only become complete when paired with complementary foods like grains.
That’s why traditional meals like khichdi (dal + rice) or Mexican beans + rice just make sense.
There was wisdom in those combinations.
Intermittent Fasting
I’m not against intermittent fasting, but how you do it matters.
The version I recommend follows your circadian rhythm: you eat while the sun is up.
The worst way to do IF when you have PCOS is skipping your breakfast.
That can backfire by worsening your adrenal fatigue.
Carbs
Carbs are not your enemy. In fact, for women with PCOS, they’re often essential, especially if you struggle with blood sugar crashes or intense cravings.
If you’re getting hit by late-night or mid-day cravings, chances are you’re not eating enough carbs or not pairing them properly.
The key is to:
Understand your carb threshold (too much = spike, too little = crash)
Always pair carbs with protein or fat to slow the blood sugar response
Exercise
Exercise is important, but not just for weight loss.
Think of it as a way to:
Build strength and muscle
Improve insulin sensitivity
Support mental health and overall quality of life
Stress & Nervous System Regulation
Stress isn’t just mental. It can be physiological too. It’s about how regulated or dysregulated your nervous system is.
Your body stays stuck in fight-or-flight or freeze mode when your nervous system isn’t regulated. And when you’re stuck there, it won’t prioritize weight loss or hormonal repair.
Ask yourself:
How quickly do small things throw you off?
Do you bounce back or spiral?
The goal is to expand your window of tolerance - so you’re not constantly reacting or shutting down. Because nervous system health is hormonal health.
Also blood sugar spikes cause a stress response - that’s why a balanced meal helps with blood sugar & stress response.
Rapid fire round
My favorite PCOS-busting..
Beverage is Spearmint Tea
Breakfast is..eggs with veggies + carb of your choice
Purse Snack is..Chomp Stick
Cooking oil is..Avocado oil
Spice is..Cinnamon
Dessert is..Anything that makes you not feel deprived
Airport Snack is..Chicken Jalapeno Pocket from Starbucks
Supplement is.. Inositol
Thank you Aditi, for sharing your wisdom through this Q&A! You can follow Aditi on Instagram here.
Good to see that awareness is getting out about PCOS. Great post!