Starvation: Symptoms, Causes & Treatment

Starvation is an extreme form of malnutrition that happens when the body does not get essential nutrients for a prolonged period of time. This can lead to severe weakness, significant weight loss, and impaired bodily functions.

This condition is mainly caused by lack of food. However, it can also happen due to diseases that prevent the body from properly absorbing or using nutrients, such as certain digestive, metabolic, or psychological disorders.

Starvation needs to be treated as soon as possible because it can cause serious, potentially life-threatening complications. Treatment usually involves slowly reintroducing nutrients, close medical monitoring, and, in some cases, mental health support depending on the cause.

Main symptoms

The main symptoms of starvation are:

• Extreme weight loss

• Severe muscle wasting and loss of body fat

• Bones becoming more visible under the skin

• Fatigue and weakness that make it difficult to perform daily activities

• Dizziness and fainting

• Swelling in the legs, feet, or abdomen

• Confusion, disorientation, trouble concentrating, and memory loss

• Irritability, with frequent mood changes, depression, or apathy

Hair may also become brittle, dull, and fall out easily, and the skin may become dry, flaky, and loose.

The person may also feel cold all the time due to lack of body fat. They may have a slow pulse and low blood pressure because the heart is not working properly, as well as persistent diarrhea and anemia.

These symptoms can vary depending on the severity and duration of starvation and malnutrition. Therefore, it is important to act immediately if starvation is suspected to prevent irreversible complications.

Symptoms in children

In children and adolescents, delayed growth and development may also occur. According to the World Health Organization (WHO), severe acute malnutrition can include severe wasting, also known as marasmus, and kwashiorkor, including cases with or without swelling.

Children and adolescents are among the groups at highest risk for starvation.

Confirming a diagnosis

Starvation is diagnosed by a general practitioner, pediatrician, or registered dietitian based on the person’s symptoms and medical history.

The healthcare provider may also order tests, such as blood and urine tests, an electrocardiogram (ECG), and sometimes a bone density test.

Possible causes

The main causes of starvation are:

• Lack of food

• Diseases, cancer, HIV/AIDS, or prolonged parasitic infections

• Liver insufficiency or liver failure

• Celiac disease, Crohn’s disease, ulcerative colitis, or malabsorption syndrome

• Eating disorders, such as anorexia or bulimia.

Other factors can also contribute to hunger and starvation, including discrimination or social exclusion, vulnerable living conditions such as homelessness, cultural or religious practices, unemployment, and food insecurity.

The causes of starvation are varied and may involve social, economic, psychological, or medical factors, or a combination of these. Identifying the underlying causes is important to guide appropriate treatment and help prevent serious complications.

Starvation vs malnutrition

Starvation is the complete absence of food intake, while malnutrition happens when a person still eats, but not enough to maintain body weight and proper body function.

Setarvation can cause death within a few weeks. Malnutrition does not always lead to death, and long-term consequences such as short stature, weak bones, learning difficulties, and reduced immunity are more common.

Treatment steps

Treatment for starvation should be overseen by a general practitioner or pediatrician together with a registered dietitian. The approach depends on how severe it is, the person’s overall health, and the underlying cause.

The main treatments for starvation are:

1. Gradual reintroduction of food

Gradual reintroduction of food allows the body to adapt to the nutrients and calories provided. This helps prevent nutritional and electrolyte deficiencies.

It also helps prevent metabolic complications, such as refeeding syndrome, which can happen when food is reintroduced too quickly. 

Depending on the person’s nutritional and health status, food may be reintroduced in the following ways:

• By mouth

• Enteral nutrition using a nasoenteric (NG) tube

• Parenteral nutrition, which involves giving nutrients directly into a vein

At first, food reintroduction starts with a low calorie intake. The first foods are usually liquid or semi-liquid, with low fat and protein content.

As the body adapts, calories and nutrients are gradually increased. The goal is to restore weight and nutritional health without causing metabolic shock.

2. Correcting vitamin and mineral deficiencies

The doctor or registered dietitian should recommend vitamin and mineral supplements, such as potassium, magnesium, phosphate, calcium, and vitamins A, D, and B12. These are crucial for recovery from starvation.

It is also essential to monitor and correct any electrolyte imbalances, such as potassium, sodium, calcium, magnesium, phosphorus, or chloride. Low levels of these elements can cause heart and muscle problems.

3. Mental health support

When starvation is caused by eating disorders or emotional distress, such as a natural disaster, displacement, or loss in a remote area, mental health support is important.

This type of treatment may include cognitive behavioral therapy (CBT), psychotherapy, or medication.

4. Specific treatment

If starvation is caused by chronic diseases, such as cancer or gastrointestinal disorders, the underlying condition should be treated. This may include chemotherapy, surgery, or medications that improve nutrient absorption.

In cases of complications, such as heart failure or multiple organ failure, the person should be hospitalized and receive specific treatment.

5. Nutritional follow-up

Throughout recovery, regular follow-up with a registered dietitian is essential to assess eating habits, track weight gain, and monitor certain blood markers to evaluate the person’s nutritional status.

It is also important for both the affected person and their family to receive nutrition education about the importance of a balanced and adequate diet to prevent malnutrition from returning.

Potential complications

In advanced stages, starvation can lead to serious complications, such as impaired immune function, vascular collapse, heart failure, multiple organ failure, and even death if treatment is not started in time.

During treatment, especially when food is reintroduced, there is also a risk of refeeding syndrome. According to the American Society for Parenteral and Enteral Nutrition (ASPEN), this condition can involve drops in phosphorus, potassium, and/or magnesium after calories are reintroduced, which is why food should be restarted carefully under medical monitoring.