WHAT IS STARVATION SYNDROME?
When starved of energy, the human body responds in a way known as “Starvation Syndrome”.
Starvation syndrome (or semistarvation) refers to the physiological and psychological effects of prolonged dietary restriction.
The effects of starvation syndrome are commonly observed in individuals with eating disorders, due to severe restriction of energy intake, irregular eating, and compensatory behaviours (e.g., purging), which reduce energy absorption.
Many of the symptoms once thought to be primary symptoms of eating disorders are actually symptoms of starvation.
THE MINNESOTA STARVATION EXPERIMENT
The Minnesota Starvation Experiment is the best example of the wide-ranging physical, cognitive, social and behavioural effects of starvation.
Between 1944 and 1945, Ancel Keys ,for the University of Minnesota, studied the effects of dietary restriction and the effectiveness of dietary rehabilitation strategies.
The study recruited 32 fit, young male volunteers, who were conscientious objectors to the military service.
The study had three phases: ·
3-month control: participants ate normally ·
6-month semi-starvation period: caloric intake of each participant was reduced by 50% ·
3-month recovery: participants were re-nourished
During the semi-starvation period, men lost on average 25% of their baseline body weight.
What the researchers didn't expect, was that semistarvation also had a dramatic impact on the physiological, psychological, cognitive, and social functioning of the men.
PHYSICAL CHANGES
Heart muscle mass reduced by 25%
Heart rate and blood pressure decreased
Basal metabolic rate slowed down
·Feeling cold all the time ·
Fluid retention (oedema) ·
Dizziness and blackouts ·
Loss of strength, high fatigue ·
Hair loss, dry skin ·
Decreased hormone levels, causing lack of sexual desire and other changes
EMOTIONAL CHANGES.
Depression
Anxiety
Irritability
Loss of interest in life
Changes in Thinking
Impaired concentration, judgement and decision-making
Impaired comprehension
Increased rigidity and obsessional thinking
Reduced alertness
SOCIAL SYMPTOMS
included:
Withdrawal and isolation
Loss of sense of humour
Feelings of social inadequacy
Neglect of personal hygiene ·
Strained relationships
Attitudes and Behaviour Relating to Eating
Thinking about food all the time
Meticulous planning of meals ·
Eating very fast or very slowly
Increased hunger, binge-eating
Tendency to hoard (e.g. collecting recipes)
Increased use of condiments (e.g., spices) for flavour
Symptoms of starvation syndrome are observed in any individual who has prolonged restricted access to food, no matter what the reason (e.g., prisoners of war or effects of an eating disorder).
Physical re-nourishment and weight restoration is therefore essential to reverse these symptoms.
This study tells us so much about eating disorders
The physiological, psychological and social effects of semistarvation observed in the Minnesota Experiment are experienced by those struggling with eating disorders.
This tells us that many eating disorder symptoms are actually a direct result of semi-starvation.
A person can experience the symptoms of starvation , even if they are at a 'normal' or technically obese weight.
Starvation syndrome may be observed if a person’s nutritional intake is poor, irregular, or unbalanced, or if they engage in compensatory behaviours that reduce energy absorption, irrespective of their weight.
Individuals with anorexia nervosa, bulimia nervosa and binge eating disorder are therefore all vulnerable to experiencing symptoms of semi-starvation.
A crucial distinction between the subjects in the Minnesota Study and individuals with eating disorders is that, in addition to experiencing symptoms of starvation, individuals with eating disorders have significant fears about their shape, weight, appearance and eating.
When a person who is in starvation has the opportunity to eat, they will eat. A person with an eating disorder will continue to restrict what they are eating due to often incapacitating fear and anxiety.
This is why it's essential that the first phase of eating disorder recovery focuses on physical re-nourishment as well as psychological treatment to address anxiety and fear about eating.
REVERSING SYMPTOMS OF STARVATION
Participants in the Minnesota Experiment were re-nourished during a 3- month recovery phase.
By normalising their eating through regular rations, the men recovered from many of the physiological and psychological effects of starvation.
Rate of recovery varied among the men, with some taking longer than others to normalise their eating.
Many also reported persistence of symptoms well into the re-nourishment phase (e.g., feeling ‘out of control’, experiencing low mood, inability to identify hunger/fullness cues, episodes of binge eating).
Importantly, these symptoms subsided over time with consistent, adequate nutrition.
RECOVERY FROM AN EATING DISORDER
The good news is that the effects of semi-starvation are reversible.
By consuming nutritionally balanced meals regularly throughout the day, the body will return to normal physical and psychological functioning.
Remember, it takes time, and symptoms of semistarvation may persist during physical re-nourishment.
When the brain is properly nourished, it can carry out vital processes such as perception, problem solving, planning, memory, decision making, and emotion regulation. These processes are essential for a person to engage in psychological treatment for their eating disorder. This is why eating disorder treatment begins with physical re-nourishment. Once semistarvation has been corrected, an individual will be in a better position cognitively to address the underlying thoughts, feelings and beliefs that keep disordered eating behaviours going. Recovery coaching or working with a specialist therapist or other professional can really help support with re-nourishment and help manage anxiety while you are making changes.