This is the third and final post on the findings of the Minnesota Starvation Experiment, relating it to restrictive eating disorders and highlighting why it is important to know about if you have and/or are overcoming an eating disorder. The first post covers what the experiment involved and some of the key findings and the second post related the experiment and findings to restrictive eating disorders and the recovery process. This post is about what the Minnesota Starvation Experiment teaches us about starvation syndrome and which of the commonly seen symptoms with a restrictive eating disorder could be purely symptoms of starvation, rather than more directly related to an addiction to energy deficit (an eating disorder).
If you can understand a restrictive eating disorder as the brain being addicted to the state of energy deficit, it's possible to recognise that any energy-deficit-creating behaviours, such as restrictive eating and compensatory methods, create a high reward response and so in themselves become addictive behavioural symptoms that are then very hard to stop. But there are also several other behaviours commonly seen in people with restrictive eating disorders that don't directly create energy deficit. These arise instead as a result of being in an energy deficit (or semi-starved) state.
A Restrictive Eating Disorder Creates Semi-Starvation & Energy Deficit
With a restrictive eating disorder, your body becomes under-fuelled and undernourished, effectively entering a semi-starved state. You might not believe this is the case for you because you think someone who is starving must look emaciated and if your body isn’t so visually starved, it’s likely that you falsely believe that you can’t be affected by malnourishment and starvation. Another common misconception is that to be starved, you would be living on a diet that’s barely more than an apple or salad a day. As your restrictive diet is very likely more than this, you will also doubt that you are physically and mentally 'starved'. But a restrictive eating disorder will leave your body in a state of energy deficit, which means that it is not at the genetic weight it should be to function optimally, no matter what your body shape, weight or size. And as a result of being in a state of energy deficit, your body and brain will be affected by starvation syndrome.
Starvation Syndrome
Starvation syndrome (or semi-starvation) affects anyone who is in an ongoing state of energy deficit and below their genetic body weight and size. It describes the physical and psychological changes due to prolonged energy restriction, which might be through an eating disorder or any other factors that lead someone to take in less energy than they are using.
The symptoms observed in the men who were semi-starved for six months during the Minnesota Starvation Experiment give us the best experimental evidence there is of the physical, psychological, cognitive and social consequences of semi-starvation. These findings have since also been reported in similar studies on prisoners of war or those who have faced starvation from famine situations. This has led medical experts to understand the typical signs and symptoms of starvation syndrome. These are listed below.
Physical Symptoms
A reduction in heart muscle mass. The men in the Minnesota Experiment, lost an average 25% of their heart mass.
Body metabolism slows down (see separate post on metabolism). An average 40% drop in metabolism was seen in the men in the Experiment.
Hormonal changes can result in low or no sex drive. Women can experience changes to their menstrual cycle, and men can experience difficulties with erections and sperm motility.
Other symptoms include:
A reduction in heart rate and blood pressure;
Dizziness, vertigo and blackouts;
Oedema;
Loss of strength and extreme tiredness;
Muscle cramps;
Nerve tingling;
Feeling cold all the time;
Dry and brittle hair, as well as hair loss;
Dry skin and weak nails;
Frequent urination;
Lanugo—a fine hair that grows on the body; and
Slow gut motility and constipation or other digestive symptoms.
Emotional Changes
Depression
Anxiety
Irritability
Lack of motivation
Social withdrawal
Loss of ambition and interest in life
Increased noise sensitivity
Feeling frustrated with oneself
Sudden bursts of anger
Cognitive Changes (changes to thinking)
Impaired concentration, judgment and decision-making
Increased rigid thinking
Increase in obsessional thoughts
Reduced alertness
Impaired comprehension
Social Changes
Withdrawal and isolation
Strained relationships
Less interest in appearance or personal hygiene
Loss of a sense of humour and the ability to laugh
Feelings of social inadequacy
Behaviours Related to Food and Eating
Food obsession; thinking about food all the time
Meticulous meal planning
Focus only on mealtimes
Eating very fast or very slowly
Playing with food or creating strange food combinations
Acceptance of boring or tasteless food
Binge eating episodes, meaning eating large amounts in a short space of time with an associated sense of loss of control
Hoarding behaviours, e.g., collecting recipes, food or food-related items, such as cups, spoons, containers, etc.
Anger if food is seen to be wasted
Increased fluid consumption, particularly coffee, and excessive gum chewing
Using more condiments, spices and salt for flavour
If you can identify with any of the symptoms listed above, then it’s very likely you are affected by starvation syndrome. It will very likely also be the case that some of these typical behaviours that initially arose from starvation syndrome will have formed part of the rituals and addictive behaviours that your brain found reward in and so kept driving you to repeat. When you have an eating disorder, it can be difficult to know which of these behaviours will improve spontaneously through re-nourishment alone and which will require more reprogramming efforts to overcome. This just means that, as ever, re-nourishment and physical healing have to be key priorities.
It is also worth repeating:
You can have starvation syndrome at any weight or size. You don't need to be underweight by BMI charts to have a severe and medically dangerous restrictive eating disorder or malnourished body. Starvation syndrome affects anyone who is not taking in enough energy to meet their body’s needs.
Someone who has starvation syndrome because of something other than an eating disorder will have a drive to eat to restore their energy balance as soon as it becomes possible for them to do so. When you have an eating disorder, with a powerful addiction to the state of energy deficit, overcoming it is not as simple.
As I said in the previous post, with an eating disorder, you are likely to have had the behaviours that arose from starvation syndrome for a lot longer than six months. Therefore, some of these symptoms have become more deeply embedded into your brain and formed into behavioural habits or habits of thought or emotion. This will require more brain reprogramming to overcome than getting out of energy deficit alone. Of course, this is not impossible. It just requires a focus on changing all these behaviours and thought patterns as you work through the process to overcome the eating disorder.
Starvation syndrome will be impacting you in more ways than you realise when you have a restrictive eating disorder and until you fully restore your body, allowing for any necessary overshoot. Of course, starvation syndrome just adds more layers of discomfort and symptoms to face with an eating disorder, but just as the men in the Minnesota Starvation Experiment found, it is all reversible and even the elements that have become more deeply embedded habits and part of the eating disorder's addictive pursuit, can still be changed and overcome with enough time, focus, behaviour, thought pattern and habit changes, accepting it will be incredibly hard but believing it can be done and doing it!
**For more information on eating disorders and how to overcome one, please don't miss my newly available books,
And,
The information for this post was largely taken from Addicted to Energy Deficit.
If you like to listen, as well as (or instead of read!) then this blog post is the transcript of a podcast episode which you will find on my podcast series,
available on this website, all mainstream podcast platforms and on YouTube.