Reproductive disorders and psychological distress are common co-morbidities of obesity in young women. Psychological and reproductive disturbances may also be associated with increased food cravings but the relationships between these factors have not been explored. This study aimed to explore the pattern of food cravings and to determine the relationship between psychological distress, reproductive health and food cravings in overweight and obese young women using baseline data in a weight loss trial. A total of 198 young women were included in this analysis (BMI 33.3+/-0.3 kg/m(2), age 28+/-0.3 years). The most frequently craved food item was chocolate (3.9+/-0.08 i.e., sometimes-often). The most frequently craved food categories were fast foods (2.6+/-0.07) and sweets (2.5+/-0.05). Psychological distress was significantly correlated with food cravings (R(2)=0.18, P<0.05). High fat (r=0.2), sweets (r=0.17) and overall cravings (r=0.20) were significantly correlated with energy intake (P<0.05). Psychological distress did not correlate with energy intake (P>0.05). Participants with menstrual disturbances had greater fast food cravings independent of age, BMI and PCOS status (P<0.05). Participants with hyperandrogenemia had greater high fat food cravings independent of age, BMI and PCOS status (P<0.01). Energy intake did not differ with menstrual disturbances or hyperandrogenemia (P>0.05). These results suggest that psychological distress, hyperandrogenemia and menstrual disturbances are associated with greater food cravings. Further investigations are required to elucidate the relationship between hyperandrogenemia and food cravings in young women.