What is Starvation Syndrome? Starvation Syndrome  Feeling cold all the time When starved of energy, the  Fluid retention () body responds in a way  Dizziness and blackouts known as “Starvation Syndrome”.  Loss of strength, high Starvation syndrome (or semi-  Hair loss, dry skin starvation) refers to the  Decreased hormone levels, causing physiological and psychological lack of sexual desire and other changes effects of prolonged dietary Emotional Changes restriction. The effects of starvation syndrome are  Depression commonly observed in individuals with disorders,  Anxiety who often severely restrict their energy intake, eat  Irritability irregularly, and engage in compensatory behaviours (e.g.,  Loss of interest in life purging), which reduce energy absorption. Many of the symptoms once thought to be primary symptoms of Changes in Thinking eating disorders are actually symptoms of starvation.  Impaired concentration, judgement and decision-

The Minnesota Starvation Experiment making  Impaired comprehension The Minnesota Starvation Experiment is the best  Increased rigidity and obsessional thinking example of the wide-ranging physical, cognitive, social  Reduced alertness and behavioural effects of starvation. Between 1944 and 1945, the University of Minnesota studied the Social Changes effects of dietary restriction and the effectiveness of  Withdrawal and isolation dietary rehabilitation strategies. The study recruited 32  Loss of sense of humour fit, young male volunteers, who were conscientious  Feelings of social inadequacy objectors to the military service. The study had three  Neglect of personal hygiene phases:  Strained relationship  3-month control: participants ate normally  6-month semi-starvation period: caloric intake of Attitudes and Behaviour Relating to Eating each participant was reduced by 50%  Thinking about all the time  3-month recovery: participants were re-nourished  Meticulous planning of meals During the semi-starvation period, men lost on average  Eating very fast or very slowly 25% of their baseline body weight. Unexpectedly, semi-  Increased , binge-eating starvation also had a dramatic impact on the  Tendency to hoard (e.g. collecting recipes) physiological, psychological, cognitive, and social  Increased use of condiments (e.g., spices) for flavour functioning of the men. Symptoms of starvation syndrome are observed in any

individual who has prolonged restricted access to Physical Changes food, no matter what the reason (e.g., prisoners of  Heart muscle mass reduced by 25% war or effects of an ). Physical  Heart rate and blood pressure decreased re-nourishment and weight restoration is  Basal metabolic rate slowed down therefore essential to reverse these symptoms.

This document is for information purposes only. Please refer to the full disclaimer and copyright statement available at entre for http://www.cci.health.wa.gov.au regarding the information from this website before making use of such information. C linical See website www.cci.health.wa.gov.au for more handouts and resources. Last updated 25/01/18. C I nterventions •Psychotherapy•Research•Training What is Starvation Syndrome? How is Starvation Syndrome Relevant men recovered from many of the to Eating Disorders? physiological and psychological effects of starvation. The physiological and psychological effects of semi- Rate of recovery varied among the starvation observed in the Minnesota Experiment men, with some taking longer than mirror the experience of many individuals with others to normalise their eating. eating disorders. Many eating disorder symptoms Many also reported persistence of are actually a direct result of semi-starvation. symptoms well into the re-nourishment phase (e.g., You may be thinking: feeling ‘out of control’, experiencing low mood, inability “This information isn’t relevant to me because I’m in to identify hunger/fullness cues, episodes of binge eating). the average or range” Importantly, these symptoms subsided over time with However, research shows that a person does not consistent, adequate nutrition. have to be to experience symptoms of starvation. Starvation syndrome may be observed if a Recovery from an Eating Disorder person’s nutritional intake is poor, irregular, or The good news is that the effects of semi-starvation are unbalanced, or if they engage in compensatory reversible. By consuming nutritionally balanced meals behaviours that reduce energy absorption, regularly throughout the day the body will return to irrespective of their weight. Individuals with anorexia normal physical and psychological functioning. (*see handout ‘Regular Eating for Recovery’ for more information). nervosa, and binge eating disorder are therefore all vulnerable to experiencing Remember, it takes time, symptoms of semi-starvation. and symptoms of semi- starvation may persist in the A crucial distinction between men in the Minnesota short-term during physical Study and individuals with eating disorders is that, in re-nourishment. addition to experiencing symptoms of starvation, individuals with eating disorders have significant fears When the brain is properly about their shape, weight, appearance and eating. nourished, it can carry out When a person who is starving has the opportunity vital processes such as to eat, they will eat. A person with an eating perception, problem solving, disorder will continue to restrict what they are planning, memory, decision making, and emotion eating due to their fears. It is therefore crucial that regulation. These processes are essential for a person to eating disorder recovery focuses on physical re- engage in psychological treatment for their eating nourishment as well as psychological treatment to disorder. This is why eating disorder treatment often address anxiety and fear about eating. begins with physical re-nourishment. Once semi- starvation has been corrected, an individual will be in a Reversing better position cognitively to address the underlying Symptoms of thoughts and feelings that keep disordered eating Starvation behaviours going.

Participants in the You may need to consult a medical practitioner, Minnesota Experiment were psychologist, dietitian or other health professional for re-nourished during a 3- support with re-nourishment or to help you manage month recovery phase. By your anxiety while you are making changes. Remember, normalising their eating the effects of semi-starvation are reversible with through regular rations, the consistent, adequate nutrition!

entre for C linical This document is for information purposes only. Please refer to the full disclaimer and copyright statement available at C nterventions http://www.cci.health.wa.gov.au regarding the information from this website before making use of such information. I See website www.cci.health.wa.gov.au for more handouts and resources. Last updated 25/01/18. •Psychotherapy•Research•Training