Eating Disorders

Implications for the Treatment of Anorexia Nervosa Brought Minnesota



Betty Gorham's image for:
"Implications for the Treatment of Anorexia Nervosa Brought Minnesota"
Caption: 
Location: 
Image by: 
©  

The Minnesota Starvation Study was an experimental study conducted over 50 years ago by Ancel Keys and his colleagues at the University of Minnesota. It turned into a whopping 1,385 page publication entitled "Biology of Human Starvation" that was published in 1950. This article will briefly describe the experiment and then discuss the implications of the study for the treatment of eating disorders, especially anorexia nervosa.

The Minnesota Starvation Study involved studying 36 men on a 6-month semi-starvation diet. These men were in their prime: young and healthy, both physically and psychologically. In fact, out of the pool of over 100 men who volunteered for the study as an alternative to military service, the 36 men who were ultimately chosen had the highest levels of physical and psychological health. They were also the most committed to the objective of the experiment, which was to learn the best way to refeed the thousands of starving Europeans when World War II came to a close.

During the first 3 months of the semi-starvation experiment, the volunteers ate normally while numerous variables were studied, not just their physiological changes. The beauty of the experiment is that, in addition to tracking the men's physiological changes, the researchers meticulously tracked the men's behavior, personality, and eating patterns. Tracking of these variables continued throughout the study. Following the 3-month baseline period, the men entered the 6-month semi-starvation period, in which they were restricted to approximately half of their former food intake. Over this period, they lost an average of approximately 25% of their former weight. The final phase of the study was a 3-month rehabilitation/refeeding period.

The Minnesota Starvation Study highlights the effects of caloric restriction and weight loss on behavior and mood. It enables eating disorder professionals to realize that many of the symptoms once thought to be primary features of anorexia are actually symptoms of starvation. The effects of starvation are not limited to food and weight. Starvation leaves almost no aspect of life untouched; it impacts psychological and social functioning in addition to physical functioning.

What are the implications of the Minnesota Starvation Study for the treatment of eating disorders, especially anorexia?

Providing eating disorder patients with information about the Minnesota Starvation Study can be very useful in giving them an "explanation" for many of the emotional, cognitive, and behavioral symptoms that they experience. The Minnesota Starvation Study also sheds light onto why recovering from anorexia is so hard: During the 3-month refeeding phase of the experiment, most of the abnormal attitudes and behaviors in regard to food persisted. In a newspaper article commemorating Ancel Keys' life, journalists interviewed several surviving Minnesota Starvation Study participants. The journalists concluded that, "For some, the rehabilitation period proved the most difficult part of the experiment." The article quotes one participant as saying, "I had troubles because I didn't feel that I was coming back at all" (2005, p. 1351).

Think about it. Some of the Minnesota Starvation Study men found the 3-month refeeding phase more difficult than the actual 6-month semistarvation period, and these men weren't ambivalent about recovering and gaining their weight back, whereas anorexics are very ambivalent about weight gain. Imagine that a girl with anorexia decides she is going to try to recover. For three months, she eats well and endures the anxiety that accompanies eating and weight gain. At the end of the three months, she still feels depressed, she still feels tired and weak, and she still obsesses about food. Everything is the same except she weighs more. It is very likely she'll conclude that nothing is going to make her feel better and that at the very least, she wants to be thin, to return to her previous safe and predictable world of anorexia.

It is important for eating disorder therapists to be intimately familiar with the details of the Minnesota Starvation Study. The study gives therapists a tool to disentangle the symptoms of starvation from psychopathology and helps them guide patients through the difficult process of recovery.

References:

Garner, D.M. (1997). Psychoeducational principles in the treatment of eating disorders. In: Handbook for Treatment of Eating Disorders. (145-177). D.M. Garner & P.E. Garfinkel (Eds).
New York, NY: Guilford Press.

Guetzkow, H. G., & Bowman, P. H. (1946). Men and hunger: A psychological manual for relief workers. Brethren Publishing House, Elgin, IL.

Kalm, L. M., & Semba, R. D. (2005). They starved so that others be better fed: Remembering Ancel Keys and the Minnesota Experiment. American Society of Nutritional Sciences, 1347-1352.

 

More about this author: Betty Gorham

ARTICLE SOURCES AND CITATIONS