The complex symptoms of hunger: the example of the Minnesota Starvation Experiment
Now many years ago Ancel Keys set up a study to observe for six months, what were the physiological and psychological effects of a diet with a strong calorie restriction and on the best way to feed and rehabilitate those who had suffered from hunger and extreme malnutrition conditions.
Advertising message On November 19, 1944, with the Second World War that was about to end and the allied forces making their way between the destruction and misery of a Europe devastated by bombs, a controversial and exhausting experiment began in the United States which, however much dated, still arouses considerable clinical interest. The advance of American soldiers towards Berlin brought together civilians every day, who, fleeing from the fury of the battle, had managed to survive with bread, potatoes and little more, enduring every type of psychophysical deprivation.
Still relatively little did science deal with human hunger and the global effects it could have on the human organism. So Ancel Keys, a young professor from the University of Minnesota and a consultant to the war department, set up a study to observe for six months, what were the physiological and psychological effects of a diet with a high calorie restriction and the best way to nourish and rehabilitate those who had suffered from hunger and extreme malnutrition.
For the study, which later took the name of “Minnesota Starvation Experiment”, 36 young normal-weight and healthy conscientious objectors were selected, who had volunteered by answering a strange flyer asking: Will you starved that they be better fed ? (Will you starve to be better fed?).
During the study, the various participants were free to attend their university courses, but had the obligation to sleep in the university’s hygiene laboratory and to perform various tasks during the week, such as walking at least 35 kilometers on foot and consuming about three thousand calories per day with various activities, against a daily calorie intake from the diet of only 1800 calories. The goal was to lose at least 1 kg per week, until reaching a weight reduction of 25% at the end of the fasting period. The amount of food each man received during meals depended on how fast he was progressing towards his weekly goal.
As the experiment progressed, participants began to become more hungry, initial enthusiasm began to wane, and the powerful effect of food limitation began to take effect.
The men reported numerous physiological changes such as: reduced tolerance to low temperatures, dizziness, extreme tiredness, muscle soreness, abdominal pain, disappearance of sexual desire, hair loss, reduced coordination, hypersensitivity to noise and light and ringing in the ears. In addition to these symptoms, important psychological changes were also detected: depression, irritability, apathy, anxiety, mood swings.
Many left university classes because they simply did not have the energy and motivation needed to attend consistently and concentrate.
Advertising message This protracted starvation slowly fed obsessive ideas about feeding, an act that soon became ritualized, in order to alleviate the enormous suffering given by forced fasting. Many diluted their food with water to make it look more, others crumbled the food into very small pieces, still others held the bite in their mouths for a long time to taste it better. Everyone began to eat more slowly in an attempt to lengthen the time spent in contact with food and most came to chew an exaggerated multitude of chewing gum and drink a large amount of tea and coffee to alleviate the feeling of hunger.
Many men began collecting cookbooks and recipe books. By now the food had become a fixed and nagging thought that they could no longer get out of their heads. Several of the objectors failed to adhere to the diet and manifested bulimic episodes, followed by reproaches to themselves and feelings of guilt. A participant passing in front of a bakery, was so attracted by the smell of sweets inside, that he even bought a dozen donuts and then distributed them to children on the street, with the sole intent of being able to watch them while they stuffed themselves in front of him .
Once the experiment was over, most of the participants, having no more restrictions on their diet, were unable to return to a normal diet for many months, eating excessively and becoming overweight. Some, following frequent binge eating, were forced to go to the emergency room to undergo gastric lavage.
This experiment, as already mentioned, although concluded for almost eighty years, still has great importance from a clinical and diagnostic point of view. In fact, the symptoms that accused the young people are those that are commonly found in an eating disorder, specifically anorexia nervosa.
The emotional, social, cognitive, physical and dietary changes observed in the conscientious objectors are the same that, in fact, are found in people with anorexia nervosa and can, in many respects, be considered direct consequences of fasting.
In clinical practice therefore, a fundamental aspect to be clarified from a psychoeducational point of view, is to understand how the complex emotional and cognitive symptoms that were thought to be exclusive of anorexia nervosa, are to be considered actually caused by the sudden drop in weight and the conditions of extreme underweight in which patients with this disorder often go.