Definition of starvation:  suffering or death caused by hunger.

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Starvation is a severe deficiency in caloric energy intake, below the level needed to maintain an organism's life. It is the most extreme form of malnutrition. In humans, prolonged starvation can cause permanent organ damage[1] and eventually, death. The term inanition refers to the symptoms and effects of starvation. Starvation may also be used as a means of torture or execution.

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According to the World Health Organization, hunger is the single gravest threat to the world's public health.[2] The WHO also states that malnutrition is by far the biggest contributor to child mortality, present in half of all cases.[2] Undernutrition is a contributory factor in the death of 3.1 million children under five every year.[3] Figures on actual starvation are difficult to come by, but according to the Food and Agriculture Organization, the less severe condition of undernourishment currently affects about 842 million people, or about one in eight (12.5%) people in the world population.[4]

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The bloated stomach represents a form of malnutrition called kwashiorkor. The exact pathogenesis of kwashiorkor is not clear, as initially it was thought to relate to diets high in carbohydrates (e.g. maize) but low in protein.[5] While many patients have low albumin, this is thought to be a consequence of the condition. Possible causes such as aflatoxin poisoning, oxidative stress, immune dysregulation and altered gut microbiota have been suggested.[6] Treatment can help mitigate symptoms such as the pictured weight loss and muscle wasting, however prevention is of utmost importance.[5]

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Signs and Symptoms

Early symptoms include impulsivity, irritability, and hyperactivity. Atrophy (wasting away) of the stomach weakens the perception of hunger, since the perception is controlled by the volume of the stomach that is empty. Individuals experiencing starvation lose substantial fat (adipose tissue) and muscle mass as the body breaks down these tissues for energy.[7] Catabolysis is the process of a body breaking down its own muscles and other tissues in order to keep vital systems such as the nervous system and heart muscle (myocardium) functioning.[8] The energy deficiency inherent in starvation causes fatigue and renders the victim more apathetic over time. As the starving person becomes too weak to move or even eat, their interaction with the surrounding world diminishes. In females, menstruation ceases when the body fat percentage is too low to support a fetus.

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Victims of starvation are often too weak to sense thirst, and therefore become dehydrated. All movements become painful due to muscle atrophy and dry, cracked skin that is caused by severe dehydration. With a weakened body, diseases are commonplace. Fungi, for example, often grow under the esophagus, making swallowing painful. Vitamin deficiency is also a common result of starvation, often leading to anemia, beriberi, pellagra, and scurvy. These diseases collectively can also cause diarrhea, skin rashes, edema, and heart failure. Individuals are often irritable and lethargic as a result.

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There is insufficient scientific data on exactly how long people can live without food.[9] Although the length of time varies with an individual's percentage of body fat and general health, one medical study estimates that in adults complete starvation leads to death within 8 to 12 weeks.[10] Starvation begins when an individual has lost about 30%, or about a third, of their normal body weight.[11] Once the loss reaches 40% death is almost inevitable.[11]

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Causes

Starvation is an imbalance between energy intake and energy expenditure. The body expends more energy than it takes in. This imbalance can arise from one or more medical conditions or circumstantial situations, which can include:

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Medical reasons

• Anorexia nervosa

• Bulimia nervosa

• Eating disorder, not otherwise specified

• Celiac disease

• Coma

• Major depressive disorder

• Diabetes mellitus

• Digestive disease

• Constant vomiting

 

Circumstantial causes

• Child, elder or dependent abuse

• Famine – for any reason, such as political strife and war

• Hunger striking

• Excessive fasting

• Poverty