Starvation: not a cool way to lose weight

By Dr. Daniel Tumwine

I usually envy my Muslim friends every after Ramadhan. This is because some of them come out of the holy month weighing up to 10kg lighter and others come out without their potbellies.

However, although fasting may appear like an easy way to lose weight, it is not recommended by doctors. More so, many people love going on dieting fads, but they are also not healthy.

I was recently asked to comment about a pill that purportedly reduces appetite and subsequently reduce someone’s calorie intake. As it follows, reducing calorie intake will cause one to lose weight.


Starving causes health problems

Starving oneself can cause a number of health problems, including muscle loss. It is also important to note that the initial weight lost while fasting is primarily fluid or ‘water weight’,  not fat. And when one goes back to eating as usual, they will regain any weight they would have lost.

Not only do most people regain the weight they lose from starving, they also tend to add a few extra kilos. This is because when people starve themselves, their metabolism slows down.

Therefore, the slower metabolism caused by starvation makes it easier for such people to gain more weight.

Worse still, the weight that is usually regained is likely to all be made up of fat. More so, if someone lost any muscle through starvation, it can only be regained by doing physical exercise.

The risks get more complicated and severe the longer someone stays on a starvation fast, or if they repeatedly go on starvation fasts.

Starvation can be divided into stages. The first stage happens right after you have had your meal. The gastrointestinal system converts the food that you have eaten into simple fats and sugars. Glucose is the main sugar used as a fuel and it is stored in the liver and muscle. It generally acts as the body’s fast access energy.

Although all tissues are capable of using glucose as their energy, some tissues, such as the brain and red blood cells, are more dependent on glucose than other tissues because they cannot use other forms of energy.

Glucose is stored in the form of glycogen. The first thing that happens in starvation is that the body breaks down this stored glycogen into glucose which is then used by the body.

Glycogen is a precious commodity and after eight to 16 hours of starvation, the body will decide to break down fat in an effort to preserve glycogen.

Unfortunately, fat cannot be converted into glucose, but is converted into what is called ketone bodies. Though the heart prefers to use ketone bodies as their source of energy, organs such as the brain and red blood cells only use glucose. So, maintaining a high enough level of glucose in the blood is still vital.

After about two days of starvation, the body’s glycogen stores are exhausted and the body starts breaking down proteins to get glucose from them. As a result, there is a more rapid breakdown of protein, the bulk being in the muscles. This means that someone will lose muscle bulk and become progressively weaker.

Therefore, after a couple of days of starvation the majority of the body’s energy requirements are met by the stored fat and the glucose requirement is provided by the breakdown of muscle.

Once the majority of fat is broken down, the energy requirements are met by muscle breakdown, but this will rapidly lead to death as vital muscles stop working.

It is possible to go without food for up to two months, but after that, death can occur as vital muscles stop working.
Away from the science, the more common problem resulting from starvation-type diets is the resultant weight regain.

Weight is typically regained because there has not been a change in the lifestyle that led to the original weight gain.

As mentioned above, when weight is regained, it is in form of fat. When fat replaces the muscle mass that was lost during starvation, the metabolic rate (the number of calories needed to maintain the current weight) is decreased.

During Ramadhan, Muslims first ensure that their body’s glucose levels remain within functioning range by having a meal at night.

Although I envy my friends’ weight loss during the holy month, I still encourage them to take up aerobics to build muscles.
 

The writer is the director of The Children’s Clinic, Kansanga and excutive dierector of the Uganda Paediatric Association