A 57-Year Follow-Up Investigation and Review of the Minnesota Study on Human Starvation and Its Relevance to Eating Disorders

Review by Anne Marie O’Melia

Elke D Eckert , Irving I Gottesman, Susan E Swigart, Regina C Casper Archives of Psychology, vol. 2, issue 3, March 2018

Dr. Eckert and her colleagues have published a follow up study to the Minnesota Starvation Experiment.  The original study, led by Ancel Keys, was performed at the University of Minnesota during 1944 – 1945. The investigation was designed to determine the physiological and psychological effects of severe and prolonged dietary restriction and the effectiveness of dietary rehabilitation strategies. Participants included 36 healthy young volunteer males, recruited from conscientious objector population during World War II. It consisted of a 3 month baseline control period, 6 months of semi-starvation, followed by 3 months of controlled nutritional rehabilitation. Semi-starvation was observed to produce profound psychological effects as well as down regulation of physiological functions. These effects were found to be reversible with qualitatively and quantitatively adequate food intake.

In 2002, the authors of this paper were able to contact and interview 19 of the 36 participants that completed the original study. The participants were asked about their personal experiences and any psychological, physical, cognitive, and behavioral changes during the experiment and inquired specifically about changes in eating behavior and weight which occurred during and after the experiment.

The participants all reported leading full and productive lives, without permanent consequences from starvation. Many participants reported maintaining a higher than normal weight and had abnormal eating habits (e.g. binge eating behaviors) for many months and even years before returning to “normal” state. Changes in weight were more drastic and lasted longer than predicted by the Keys study. The mean weight gain recalled by 16 follow-up participants was 22 pounds. Most took longer than 58 weeks to return to their baseline weight. Interestingly, although symptoms of depression were documented for most participants during the Keys study, at 57 year follow up, these men did not recall experiencing depressive symptoms and all but one described that they would repeat the experience if needed.

This work informs our understanding and treatment of eating disorders. All signs of physiological starvation described in the Keys study, with the exception of the markedly diminished energy levels and physical activity patterns, have also been described in anorexia nervosa. The description of these effects and participants’ recovery with adequate nutrition have formed the basis for eating disorder interventions which focus on nutritional restoration as a fundamental component of recovery.