If you are like me, you are constantly searching for the latest research on anorexia. During one of my countless searches, I found a research study that caught my attention. I immediately thought that it was most likely the best research we have on anorexia to date. Ironically, this study wasn’t designed to help anorexics, and it wasn’t at all recent either. It is a landmark study about the effects of food restriction and weight restoration on the human mind and body, and it was completed in 1945, more than 70 years ago.
There is so much helpful information in this study that I wish I had been made aware of as soon as my daughter was diagnosed with anorexia. In my opinion, all parents of anorexic teens should know about The Minnesota Starvation Experiment.
By the end of World War II, widespread food deprivation had resulted in starvation for many Europeans. In an effort to determine how to best refeed them, Dr. Ancel Keys designed a medical experiment to study the effects of starvation on the human mind and body, as well as the effects of refeeding.
The Minnesota Starvation Experiment was conducted in four parts over a one year period:
Part 1–6 weeks of normal controlled eating;
Part 2–6 months of restricted eating, named the starvation period of the experiment, where calories were reduced to achieve a weight loss of 25% of original body weight.
Part 3–a 3-month restorative period where a controlled number of calories were increased to restore weight; and
Part 4–an 8-week unrestricted restorative period in which the men could eat whatever they wanted.
36 men were chosen to participate, with 32 men completing the study. Volunteers were selected based on superior physical and psychological health.
The Minnesota Starvation Experiment offers valuable information to help us understand what is happening to our anorexic teens during the course of their illness, and also provides insight into what we can expect during different phases of recovery.
1. Cognitive and behavioral changes began in the starvation period of the study.
The study showed that the restriction of food leads to changes in thinking and behavior, especially a preoccupation with food and all things related to food:
The men had constant thoughts about food and eating.
They participated in food rituals such as playing with food, hoarding food, mixing food, cutting food into small pieces, prolonged time to complete meals (up to 2 hours) and increased use of salt and spices.
They reported pleasure watching others eating.
Smelling food became very pleasurable.
They developed a new interest in cookbooks, recipes, menus and agriculture.
Participants also experienced negative changes in mood as well as distorted body image.
2. Psychological changes persisted during the weight restoration phase of recovery.
Most of the food-related behaviors continued through the first 2 weeks of refeeding.
Some individuals experienced a worsening of anxiety during the 1st six weeks of refeeding.
3. Prolonged restriction of food negatively impacts mood.
Some had significant emotional decline that interfered with normal functioning and most had periods of extreme emotional distress.
Depression was common and worsened over the course of the experiment.
Some experienced extreme mood swings.
Irritability, angry outbursts, and increased anxiety were common even though the personalities of the participants showed none of these prior to the research.
2 men had psychotic episodes. During the refeeding period, one man became increasingly depressed and negative, resulting in his decision to amputate 3 of his own fingers.
4. The calorie needs to restore weight were much higher that expected. 4000 calories per day were required for a small weight gain.
5. Physical and psychological symptoms resolved with time and adequate nutrition. No lasting physical or psychological effects were reported 8 months after the completion of the study.
So, why do the findings matter?
The findings of the Minnesota Starvation Experiment normalize the extreme behaviors we see in our anorexic teens. The study shows that these behaviors are exactly what is expected when food is restricted over a prolonged period of time. So, what we consider symptoms of anorexia are actually symptoms of starvation. It’s very useful for parents to be able to frame their teen’s behavior as normal under the circumstances.
1. It is helpful to know that many of your teen’s symptoms are the result of food restriction.
The Minnesota Starvation Experiment provides parents with an explanation for the extreme cognitive and behavioral symptoms they are seeing in their teen. Clearly, the symptoms that are usually attributed to anorexia are more accurately described as symptoms of starvation. In other words, the extreme changes in behavior don’t cause the food restriction. The food restriction causes the extreme changes in behavior.
When you are watching your teen’s physical and emotional well-being diminish before your eyes, it isn’t easy to imagine that anything about it is normal. The results of the study show that your teen’s behavior leading up to diagnosis, during the period of weight loss, and in the early part of recovery is predictable. The ability to see what your teen is going through as “normal” under the circumstance of anorexia, can really help put your teen’s behavior in perspective. By thinking about the behaviors as expected for someone who is in a state of starvation, it can be easier to feel compassionate toward your teen.
2. It is helpful to know that it can take more calories to achieve weight gain than expected.
The results of this study can guide parents to provide more nutrition than they may have anticipated in order to restore their teen’s weight. Their teen may require significantly more calories than expected during the refeeding process. The findings of the study can help prepare parents for the large number of calories that will be needed in order for their teen to gain even a small amount of weight.
Not only are you going to have to get your teen to eat, you are going to have to get her to eat a lot. Knowing from the very beginning that your teen may need 4000 calories or more per day is very helpful. You will go into the recovery process with a better understanding of how much nutrition it is going to take to see an increase in your teen’s weight. You will know to expect a lot of resistance at the beginning of the refeeding process, and you will also know that a need for a high number of calories is normal.
3.It is helpful to know that psychological symptoms can worsen even after your teen has increased calorie intake significantly.
Also normal, as the results of the experiment show, are mood swings, anxiety, and depression. The study demonstrates that when very healthy men were put into a situation of prolonged food deprivation, their personalities changed, and their emotional health deteriorated. The findings of the experiment further point out that psychological symptoms may become worse when food intake is increased. So, parents can expect that in the first weeks of refeeding, they may not see an improvement in their teen’s mood and behavior, and that it is also normal for mood and behavior to become worse during this time.
Recognize that although you may be getting your teen to eat more and to begin restoring weight, that it may take a while longer to see improvements in mood and behavior. In fact, as shown in the study, it may not be until some time after weight restoration that your teen will have relief from the psychological effects of food restriction.
4. The best news of all that comes from the study is that there were no long-term health implications.
8 months after the completion of the experiment, no remaining physical or psychological effects were found upon follow up of the participants. Knowing that the symptoms will subside with time and food as they did with the participants in the study, can help parents stay the course.
When you know that your teen’s extreme behaviors, a need for very high calories, and continued anxiety and depression beyond weight restoration are to be expected, it makes it much easier to keep working toward recovery. In fact, The Minnesota Starvation Experiment gives you every reason to believe your teen will reach a full recovery!
The Minnesota Starvation Experiment helps clear up many of the misperceptions about the causes of and the persistence of anorexia. One of the most important implications of the study is the need for weight restoration to be the first goal of treatment. Treatment that supports parents in getting their teen to eat and to gain weight is vital in the early part of recovery. The findings of the study make it clear that adequate nutrition over an adequate amount of time can reverse the effects of food
restriction on the human mind and body.
Armed with the findings that The Minnesota Starvation Experiment provides, you can be better prepared to support your teen’s recovery. Instead of feeling constantly devastated by the effects of your teen’s illness, you can focus on the positives that came out of this study. Best of all, The Minnesota Starvation Experiment gives you the reassurance that once your teen starts eating again, that full recovery is likely.
One day there will be a clearer understanding of anorexia and how to effectively treat it. For now, one of the best things we have to go on is the evidence gathered in The Minnesota Starvation Experiment. I think parents should not only know about the study, but should also find comfort and hope in it.
If you would like to learn how to take charge of your teen’s anorexia treatment and recovery, contact me at firstname.lastname@example.org.