Symptoms for an obese person going without food? (fictional)
November 2, 2014 3:56 PM   Subscribe

Imagine a 50-year-old, 5'4", 300-pound woman with no diabetes or other medical condition. She suddenly has no access to food, but plenty of water. What symptoms might she have after one day, two days, a week, etc.?

Please understand that there is no real person at risk here--just a character in a screenplay I'm writing. Nobody in real life is embarking on a dangerous diet or sneakily seeking medical advice. And I am not seeking to portray this condition as something positive or parlay it into giving nutrition advice.

I've read a bit about malnutrition and undernourishment on places like Wikipedia. But I haven't found much for this particular case where the person begins with excess fat and suddenly goes from ample food to none. I imagine they would suffer from low energy, hunger pangs, and dizziness pretty quick. What about kwashiorkor symptoms like edema or swollen feet? Is there a second wind of energy that kicks in when the body starts burning fat? I'm trying to figure out a realistic timetable of when symptoms would start. For example, will my character have enough energy to fight somebody after 24 hours of not eating?

And finally, if you have any interesting related facts that may play well in fiction, I am all ears.
posted by ErikH2000 to Health & Fitness (24 answers total) 5 users marked this as a favorite
Fast for 24 hours yourself and try it out. It's not that hard. Yes, your character would be able to fight someone.
posted by judith at 4:06 PM on November 2, 2014 [7 favorites]

posted by the Real Dan at 4:11 PM on November 2, 2014 [3 favorites]

Under doctor supervision, an obese man did go a full year without eating. It'd be worth getting the full case report, here's the abstract, and here's a random article about said case report.

I don't know if the case report outlines the progressive impacts, but it is definitely interesting.
posted by jpeacock at 4:12 PM on November 2, 2014 [18 favorites]

Try a little research on ketoacidosis. One interesting side effect of ketosis is that one's breath smells like acetone, which might be something you can use in your screenplay.
posted by joebakes at 4:18 PM on November 2, 2014 [2 favorites]

Everybody I've ever known who has done a big fast has started off with a huge headache the first few days.
posted by BlahLaLa at 4:34 PM on November 2, 2014 [4 favorites]

You also tend to have trouble staying warm when fasting (I know this from firsthand experience). Guides that advocate fasting often suggest you make sure to dress warm enough because you tend to not only feel too cold but actually have trouble maintaining your body temperature.

I don't know names or dates or places or how to source this, but some plump man slowly starved to death over the course of 6 weeks (iirc) when his vehicle broke down or got stuck in some mountainous area. He had plenty of snow to melt, so he had access to water. He kept a diary of the ordeal. If you can somehow find something about that, it might give you some details that might otherwise be rather hard to find. (If I were googling it, I would start with an assumption that it was in Colorado, which may or may not imply that I vaguely recall where this happened from having watched some show about it, possibly that show about disasters that the weather channel used to do.)
posted by Michele in California at 4:44 PM on November 2, 2014

Michele in California may be talking about this man in Oregon, but it sounds like his diary was sparse with the details.
posted by lizzicide at 5:12 PM on November 2, 2014 [2 favorites]

Not your direct question, but this may play well in fiction. People can die from eating regular amounts of food after a long period of starvation. Check out "refeeding syndrome".
posted by kandinski at 5:23 PM on November 2, 2014 [1 favorite]

Reminds me of the Straight Dope: Can Man Live on Bread Alone?
posted by Nevin at 6:03 PM on November 2, 2014

Headaches and extremely short temper. I KNOW this.
posted by srboisvert at 7:44 PM on November 2, 2014

From experience with a multi-day fast: headache, feeling of weakness, lethargy. It's not THAT bad for a few days, but I imagine it gets progressively more difficult, at least for a while.
posted by zug at 7:49 PM on November 2, 2014

I'm 5'3" and my weight fluctuates around ~260 lbs. I think you'd be surprised how long it takes for hunger to hit me. If I've had a high fiber/protein dinner the night before, I can easily go until 4PM the next day without anything to eat. Granted, this usually happens in a period of high stress/during a crazy work day but I'll also just get lost in some task on the weekends and forget to eat. Main issue I get is caffeine withdrawals which a 12 oz diet coke solves nearly instantly.

Once I hit about 6PM, I get a bit light headed and nauseated which devolves into me getting sluggish/grumpy. If I power through this stage, I'm pretty much okay. I could absolutely fight someone at this point. I have come home on one of these days and lifted weights before I made dinner.

As for more than 24 or 36 hours, I haven't fasted for that long! Good luck!

Additional tidbits:
I do find my thirst is vastly reduced if I'm not eating.
My focus peaks at about 2 or 3PM.
I don't get a rumbling stomach if I haven't had breakfast.
I've found that I can go MUCH longer without food than my thinner friends. They get "hangry" after a few hours while it takes me nearly 24 to reach that stage.
Not sure if this matters but alcohol/pills of any sort affect me really intensely if I haven't eaten. I will get a solid buzz off one beer. This also kills any appetite I might have.
posted by Aunt Maude at 10:59 PM on November 2, 2014 [3 favorites]

IME after 24 hours, your person would still have plenty of physical energy. Until the ketones kick in (after about 48 hours iirc), mental faculties would suffer - not in a delirious way but if this person had an intellectual job, their performance would suffer.

Honestly, having "fasted" a lot, its really not that bad after the first couple of days. I imagine it gets a lot harder when you're running low on fat stores but even people who aren't obese can fast for quite a while before there is a problem, once they've got passed the hangry stage and the hunger headaches
posted by missmagenta at 12:47 AM on November 3, 2014

I also think you should try it out. I am about 20-30 pounds overweight, so not actually obese, but for a week or two I tried the "eat every other day" diet. I literally skipped eating from 8pm of day 1 to 8am of day 3. Drank only water. I dropped 4 or 5 pounds during the fast, which of course, I gained all back right afterward.

It wasn't comfortable and my energy level definitely dropped, but I didn't die or even get sick. I actually stopped because my skin started breaking out, which for me, is almost always a diet related issue.
posted by ethidda at 1:11 AM on November 3, 2014

Headaches are only a problem for me if I've been drinking coffee recently. If your character drinks coffee she'll have horrible headaches. Otherwise - not necessarily. I tend to feel fine, but a bit "floaty" and unfocused. And cold, as someone said above. This doesn't change much for the first couple of days, but the longest I went was three.
posted by Joe in Australia at 2:22 AM on November 3, 2014

After 3 days, the headache, lethargy etc. usually go away. Many people report feeling that they have more energy and feel less hungry once the body is in a state of ketosis. There are several diet programmes that work by using this effect to achieve weight loss (although they usually involve consuming some food, just not carbs, which will tend to take the body out of ketosis).

Bad breath and changes in sleep patterns are very common side-effects.
posted by pipeski at 3:06 AM on November 3, 2014

It's not THAT bad for a few days, but I imagine it gets progressively more difficult, at least for a while.

Longest I've done at a stretch is 23 days (male, 52yo, BMI > 30).

Typical pattern for a >2 week fast goes like this:

End day 1: slight headache.
Day 2: grumpy, headache.
Days 3..9: plain sailing. Occasional hunger pang quickly and easily mitigated with a glass of water. No energy deficit.
No bowel movements until day 10, at about which point there is usually one episode of astonishingly brook-no-delay diarrhoea.
After day 10, most of the difficulty is psychological - food is a considerable pleasure, and missing out on it altogether makes for sadness.

Typical weight loss rates for me: 5kg by start day 3; another 5kg by start day 7; roughly 300g/day thereafter.

Warmth-seeking becomes very noticeable by about day 4, at which point Postural hypotension also kicks in (personally I'm lucky enough to get the euphoric kind, which I've had to learn not to let persist long enough to drop me on my arse).

Brushing the tongue as well as the teeth, and doing a twice-daily salt water rinse and gargle, avoids a foul-tasting fuzzy white overgrowth on the tongue arriving by about day 7. This is much easier to prevent than to get rid of afterward, though it disappears completely within two days of breakfast.
posted by flabdablet at 4:11 AM on November 3, 2014 [3 favorites]

On the typical day 1-2 headaches: if I allow myself black coffee during the fast, they don't happen until the day after I stop the coffee. So I suspect they're mostly down to caffeine withdrawal.
posted by flabdablet at 4:14 AM on November 3, 2014

One thing I notice after about 24 hours of fasting: I feel that I have more energy, that I can run like the wind. I don't know whether I really do have more energy or whether my time perception is skewed. I haven't tested it out, because I also get fatigued easily while fasting.
posted by Joe in Australia at 4:51 AM on November 3, 2014

Tom Hank's character in Cast Away wasn't exactly rotund, but if you rent that movie they did a fairly good job of showing what happens to a person whose lifestyle and food access suddenly changes.

The bonus commentary has a survival expert talking about what happens to your body on day one, two, etc. On day five supposedly the hunger pangs abate.

I go without food for a day on a regular basis. Sometimes I am just too busy, and then when I can eat I don't feel like it. I actually have to watch how I eat or I'd do one giant meal once a day. When I force myself to have breakfast I eat a sensible lunch, but if I skip both I either eat like a monster or I forgo at dinner.

You will have various health problems and problems with skin if the weight is dropped too rapidly.
posted by cjorgensen at 6:33 AM on November 3, 2014 [1 favorite]

In Stephen King's The Stand Mother Abagail (Abigail? I'm seeing multiple spellings) goes on a 40 day and 40 nights type quest/fasting thing in the desert. She starts off as a very old (108) and, from my memory, obese woman and she comes out skinny but near death. I seem to remember discussion of what the period of starvation had done to her body, and what the other characters needed to do to help treat her to help her survive.

Not sure how medically accurate it was, but if you're looking for other examples of starvation in fiction, that is one.
posted by sparklemotion at 9:18 AM on November 3, 2014

Said someone who I am close to: After several days you notice that doors get heavier and stairs get longer.
posted by Midnight Skulker at 9:20 AM on November 3, 2014 [1 favorite]

The classic hunger research experiment was the Minnesota Starvation Experiment. There's a book and 269,000 Google hits for it. The participants weren't obese and they were given small amounts of food, so it doesn't match your scenario, but it should be useful. This seems to be a decent summary.
posted by Mr.Know-it-some at 10:08 AM on November 3, 2014 [1 favorite]

This is an absolute goldmine of information, and I would like to thank everyone. Last night I wrote in the following bits...

* she has the fight after 24 hours
* she's grumpy
* bad headaches
* bad breath (ketosis)
* drinking water to get hunger pangs to go away

I also plan to give her a second wind, and a gradual sense of weakening. (Doors get heavier.)

Again, much thanks to everyone.
posted by ErikH2000 at 9:40 PM on November 4, 2014

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