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Starvation Syndrome & Eating Disorders

Source: Slate Magazine

Starvation syndrome is a key feature of eating disorders, which hold the highest mortality rate of any psychiatric illness (Morris & Twaddle, 2007). This guide will help you understand starvation syndrome, its relation to eating disorders, the importance of weight restoration in recovery.

What is Starvation Syndrome?

Starvation Syndrome, also known as Semi-Starvation, encompasses a range of symptoms experienced by anyone undergoing a caloric deficit, regardless of their body shape or weight (Chaudhary et al., 2010).

During starvation, the body undergoes hormonal and metabolic changes. It conserves energy by breaking down muscles and using fat instead of glucose for fuel. This can lead to weight loss and alterations in bodily functions. Insulin levels decrease while glucagon levels rise, prompting the body to use stored glycogen, fat, and protein for energy. Consequently, fats and ketones become the primary sources of energy instead of glucose.

How Do We Know This?

Reports of unexpected deaths among prisoners of war who endured severe food deprivation after World War II prompted scientific inquiry into starvation's effects.

Source: Follow the Intuition

In 1948, Ancel Keys conducted the "Minnesota Starvation Experiment" in Minnesota, USA. Healthy young men underwent a period of semi-starvation, replicating conditions experienced by prisoners of war. The study revealed profound physical and psychological responses to food restriction, emphasizing the importance of understanding starvation's impact (Kalm & Semba, 2005; Keys et al., 1950).

Signs & Symptoms

Symptoms of starvation syndrome include:


●       Low energy

●       Reduced heart muscle mass

●       Lower heart rate and blood pressure

●       Headaches

●       Decreased hormone levels

●       Sensitivity to noise and light

●       Feeling cold

●       Loss of strength

●       Extreme fatigue

●       Hair loss

●       Dry skin

●       Weak nails

●       Impaired immune system

●       Dizziness and fainting

●       Extreme weight loss

●       Edema

●       Cold/blue extremities

●       Amenorrhea (absence of menstruation)

Emotional & Cognitive:

●       Increased depression and anxiety

●       Irritability and mood swings

●       Decreased enthusiasm

●       Reduced motivation

●       Impaired cognitive ability

●       Increased rigidity and obsessional thinking

●       Reduced alertness

●       Preoccupation with body image


●       Critical of others

●       Withdrawn and isolated

●       Loss of sense of

●       Feeling socially inadequate

●       Neglect of personal hygiene

●       Strained relationships

●       Decreased libido

Eating Attitudes & Behaviour:

●       Preoccupation with food

●       Abnormal eating habits

●       Altered hunger cues

●       Binge eating

●       Unusual food rituals

The World Health Organization (WHO) has observed a rise in mental health issues in developed countries alongside dietary changes, underscoring the link between nutrition and emotional well-being (Inside Out Institute, n.d.).

It's important to note that these symptoms can occur even if an individual is not underweight, highlighting the significance of recognizing and addressing calorie deficits.

Long-Term Effects

Starvation syndrome can lead to a sudden death, which is why awareness and advocacy is so important. Starvation syndrome leads to severe health complications, including:

●       Cardiac arrhythmias

●       Electrolyte imbalances

●       Bradycardia

●       Heart failure

●       Sudden cardiac arrest

●       Organ damage

●       Poor bone health

●       Suppressed immune system

●       Increased risk of heart and gastrointestinal complications

●       Hormonal imbalance and infertility

●       Impaired brain function

●       Increased risk of suicidality and substance misuse

Source: BJA Education


Renourishment is the first step in treating eating disorders, as the starved brain cannot effectively engage in therapy. Refeeding involves gradually increasing calorie intake to restore weight. However, fear of weight gain may trigger binge eating or a loss of control.

Weight restoration is essential for addressing malnutrition, organ damage, and psychological symptoms associated with starvation. It's important to note that not all eating disorders are characterized by starvation syndrome, but weight restoration remains a crucial aspect of recovery for many individuals.

Therapeutic approaches recognized for treating eating disorders include:

●       Maudsley Family Based Treatment (FBT)

●       Cognitive Behavioral Therapy for Eating Disorders (CBT-E)

●       Dialectical Behavior Therapy (DBT)

●       Interpersonal Therapy (IPT)

●       Specialist Supportive Clinical Management (SSCM)

●       And others found here

If you are experiencing symptoms of an eating disorder, it's essential to reach out to your GP or a healthcare professional for support and guidance.

Source: The Conversation

Resources for Clients

●       The Butterfly Foundation (

●       Eating Disorders Queensland (

●       National Eating Disorders Collaboration (NEDC) (

●       Inside Out Institute (

●       Lifeline: 13 11 14 (24/7)

●       Kids Helpline: 1800 55 1800 (24/7)


➔    Choudhary, S., Kumar, S., & Akhtar, S. (2010). The biology of starvation. Journal of Bangladesh Society of Physiologists.

➔    Inside Out Institute. (n.d.). The effects of starvation.

➔    Kalm, L. M., & Semba, R. D. (2005). They starved so that others be better fed: remembering Ancel Keys and the Minnesota Experiment. Journal of Nutrition, 135(6), 1347–1352.

➔    Keys, A., Brožek, J., Henschel, A., Mickelsen, O., & Taylor, H. L. (1950). The biology of human starvation: Volumes I & II. University of Minnesota Press.

➔    National Eating Disorders Collaboration (NEDC). (n.d.). The starved brain: Can what we eat determine how we think?.

➔    Morris, J., & Twaddle, S. (2007). Anorexia nervosa. BMJ, 334, 894–898.


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