Can a morbidly obese person starve to death before they lose all their excess weight?

[Dave1001]

Can a morbidly obese person starve to death before they hit a normal weight?

1. If they were just provided with water and vitamins.
2. If they were just provided with water
3. If they were provided with nothing.

Why would they even dehydrate until they hit a normal weight? Isn't excess fat mostly water?

[ChristineR]

The world's heaviest known people. (http://www.dimensionsmagazine.com/dimtext/kjn/people/heaviest.htm)

Several of them starved to death on moderately low calorie diets, some weighing in at more than a ton.

[Hellbound]

Hmmm.

I looked through the first coupel dozen, and only one mentioned starvation. I would suspect, however, that malnutrition would be the more likely culprit rather than straight starvation (although I am, admittedly, no expert).

[Kaarjuus]

Isn't excess fat mostly water?

Jesus wept. Have you ever thought of consulting anything before posting?

Explain this one to me, please. Why did you think excess fat is mostly water?

[ChristineR]

2, 4, 16, 17 and 28 all apparently starved to death, which is five of twenty-eight. Of course this were people with numerous serious medical problems, so you could say "heart failure due to starvation and massive obesity" and argue that they didn't technically starve.

I'm not sure how one distinguishes between starvation and malnutrition, unless you are talking about people who eat quantities of junk food and get excess calories but still suffer from vitamin or protein deficient diseases. This also used to happen with people who were getting their calories from limited sources, notably corn (maize) and potatoes.

This may be out of date, but it used to be that the majority of the world's deaths had dehydration and diarrhea as the immediate cause, although the underlying cause was of course various infectious diseases. A little off topic, but it shows how this gets complicated.

[hgc]

Jesus wept. Have you ever thought of consulting anything before posting?

Explain this one to me, please. Why did you think excess fat is mostly water?
It is interetsing. Afterall, people are always confusing oil and water, right? I think the confusion stems from a) slight knowlege of a connection between fluctuating body weight and water (ie., "water weight") and b) slight knowledge of the notion that up to 70% of body weight is water. Yes, body fat is 50% water, but excess fat is a case of excess fat, not excess water. Or to put it another way, all body fat is about half water. Excess fat ain't significantly different from other fat in that regard.

[ChristineR]

I believe about 15% of the stuff on your hips is blood vessels and connective tissues, with about 85% being actual fat of the sort you can melt and put in a deep fat fryer to make french fries.

[Hellbound]

Good points.

But for me (note my definition is not definitive :D) starvation means death because you run out of energy (not enough calories). Malnutrition means death because you run out of a particular vitamin, mineral, or protein that you need.

I could see an obese person dying becuase they don't get enough protien (likely in #2...the body scavenges protein from muscle tissue), or enough vitamins and/or minerals. Seems though, that the body would convert as much fat as it needed for the raw calories.

[ChristineR]

When you eat, "sugar" ends up in the blood, and from there it's stored in the muscles, then the liver. When that runs out of space, you make fat. If you don't have enough sugar to run the body, your body will start burning fat and protein (muscles), converting them into sugar.

So starvation is usually failure of the heart muscle due to its being excessively digested.

The problem with the "burn fat" scenario is that your body won't necessarily burn the fat before it burns the protein. If anything, it prefers the protein, as muscle wastes a lot of calories and it's best not to exercise when you're unable to get food.

There's all sorts of hormones and enzymes and feedback loops involved, and in these people, for whatever reasons, their bodies are much more likely to make fat and burn muscle. Which is kind of a d'oh! moment, as these are obviously people with some sort of problem regulating fat production.

[Kaarjuus]

Or to put it another way, all body fat is about half water.

I'm curious as to where this "half water" comes from. To my knowledge, lipid molecules have a long chain of carbohydrates, and just a few oxygen atoms at the end.

[ponderingturtle]

I'm curious as to where this "half water" comes from. To my knowledge, lipid molecules have a long chain of carbohydrates, and just a few oxygen atoms at the end.

But fatty tissue is not just a collection of lipids.

[casebro]

From having my body fat checked electronically several times, at different fat percentages, I believe that the body needs X much water. More fat adds more fat, not more water. Plus some protein to hold it together. Permanent weight loss is about 80% fat, most of the rest is protein. A slim person might be 60% water, while a fatty is only 50%. Most water is in muscles, bones, organs, and fluids.

[Dave1001]

The world's heaviest known people. (http://www.dimensionsmagazine.com/dimtext/kjn/people/heaviest.htm)

Several of them starved to death on moderately low calorie diets, some weighing in at more than a ton.

How could Michael Edelman "starve to death" at 600 pounds? I'm curious for more details.

ETA: I see the theories in this thread seem to be that his body cannibalized necessary muscles such as the heart for protein, or that he died from lack of necessary nutrients rather than lack of calories.

[Dave1001]

Jesus wept. Have you ever thought of consulting anything before posting?


The OP sparked a decent discussion thus far. Feel free to ignore this thread and its interested participants. :)

[skeptifem]

Yes, definatley. The body needs protein to survive.

[casebro]

Read up on CRAN, Calorie Restricted, Adequite Nutrition. I think that somebody my size needs 1/2 pound of protein per day. It's figured on X grams of protein per pound of lean mass. One gram per pound? So I need 220 grams per day, about 3 pounds of extra lean meat. That's 1,500 calories.Then add some vitamins and minerals to get the very minimum amount. So, less than 1,500 calories per day would be starvation, not weight loss. My current activity level requires 3,000 cal/day, so trying to lose more than 3 pounds per week would be counter productive. But then, not trying to lose weight (reality) is also counter productive...

[Katana]

How could Michael Edelman "starve to death" at 600 pounds? I'm curious for more details.

ETA: I see the theories in this thread seem to be that his body cannibalized necessary muscles such as the heart for protein, or that he died from lack of necessary nutrients rather than lack of calories.

From the link:
After the sudden death of Walter Hudson (below), with whom he had formed a long-distance friendship, Michael developed a pathological fear of eating. He rapidly lost several hundred pounds, taking nourishment only when spoon fed. At about 600 lbs, he literally starved to death.
Sounds like he "literally" starved to death.

[Katana]

How could Michael Edelman "starve to death" at 600 pounds? I'm curious for more details.

ETA: I see the theories in this thread seem to be that his body cannibalized necessary muscles such as the heart for protein, or that he died from lack of necessary nutrients rather than lack of calories.

From the link:
After the sudden death of Walter Hudson (below), with whom he had formed a long-distance friendship, Michael developed a pathological fear of eating. He rapidly lost several hundred pounds, taking nourishment only when spoon fed. At about 600 lbs, he literally starved to death.
Sounds like he "literally" starved to death.

[Katana]

How could Michael Edelman "starve to death" at 600 pounds? I'm curious for more details.

ETA: I see the theories in this thread seem to be that his body cannibalized necessary muscles such as the heart for protein, or that he died from lack of necessary nutrients rather than lack of calories.

From the link:
After the sudden death of Walter Hudson (below), with whom he had formed a long-distance friendship, Michael developed a pathological fear of eating. He rapidly lost several hundred pounds, taking nourishment only when spoon fed. At about 600 lbs, he literally starved to death.
Sounds like he "literally" starved to death.

[andyandy]

a point so good, it's worth making, twi...no thrice!

:D

[El Greco]

There's also the famous case of Angus Barbieri who has reportedly survived in a hospital for 382 days only on vitamins, coffee and tea. At the start of this period he weighed about 200kg, when he died he was about 80kg.

IIRC, the longest recorded survival without any water or food is 17-18 days.

[Dave1001]

Right Katana, as I wrote in post #13, I'm curious if it happened via lack of protein intake, like of other nutrients, or if could happen simply from insufficient calorie intake, even if he had 600 pounds worth of calories (and hence probably about 400+ excess calories) stored in his body. In general I'm curious about what might be physical limitations on the body to process existing stored calories in their various forms. beyond that one line in the link -and JREFforum members' takes on them.

Alternatively, if he said "I'm so hungry I feel like I'm starving to death", and then keeled over and died from the hunger pangs, that would be interesting too. :)

[Solus]

Guess Katana needs to cut down on the coffee. :p

Interesting infomation though. I always thought those grossly obsese people could just stop eating but a family member enabled them to get so fat. I never knew a heavy person could die from not eating.

[andyandy]

IIRC, the longest recorded survival without any water or food is 17-18 days.

tut tut

someone's not been reading their bible.....:D

[Dave1001]

There's also the famous case of Angus Barbieri who has reportedly survived in a hospital for 382 days only on vitamins, coffee and tea. At the start of this period he weighed about 200kg, when he died he was about 80kg.

IIRC, the longest recorded survival without any water or food is 17-18 days.

17 days without water seems pretty exceptional to me. Do you know if there we any distinguishing charactersitics about them alowing such a long survival time?

As for Barbeiri, I think that translates from about 400 pounds to about 175 pounds, pretty similar to the scenario in the OP. I'm assuming he wouldn't get any usable amounts of protein from the vitamins, coffee and tea (is that incorrect?) so it does sound like one can live off of excess calories alone at the least until one reaches about a normal body weight (175 pounds is normal for average build men).

So perhaps it wasn't lack of protein that did in Edelman but lack of vitamins? Also, I wonder if the coffee and tea played a substantive role in Barbeiri's persistance.

Any thoughts on it?

[joobz]

But fatty tissue is not just a collection of lipids.
simple way to see that fat isn't mostly water:
Fat floats in water. the lipid chains in fat are less dense than water, therefore they float.

[Soapy Sam]

Ice also floats in water.
As do ducks and witches.

[joobz]

Ice also floats in water.
As do ducks and witches.
But fat will burn like a witch, water won't.

BTW, if the water in your body is in solid form, I'm guessing you're currently bunk mates with Disney.

[Dogdoctor]

If I recall correctly when you don't eat carbohydrates you produce more ketones which causes ketosis and may result in ketoacidosis and death. Starvation would do the same thing.

[ChristineR]

Protein is a source of calories. Although it's true that you will lose muscle if your diet has inadequate protein, that's not why the starving body burns muscle. The muscle is a source of calories, that is blood sugar, which is necessary for brain function and one thing you cannot do without.

Very low calorie diets are usually all or almost all protein, and this is supposed to minimize the amount of protein used by the body to create calories. It is possible that these super-fat people were not eating enough protein, but I suspect that it was the calories, not the protein, that killed them. You simply can't wave a wand and prevent the body from burning protein.

For example, #28 ate a "prescribed diet of 420 calories." That's a very suspicious number--70 g of protein, a number frequently recommended for normal people. No proof, but I suspect her body couldn't or wouldn't burn those hundreds of pounds of fat fast enough to protect her heart.

[skeptifem]

Protein is a source of calories. Although it's true that you will lose muscle if your diet has inadequate protein, that's not why the starving body burns muscle. The muscle is a source of calories, that is blood sugar, which is necessary for brain function and one thing you cannot do without.

protein is the most inefficient fuel source calorie wise, and a morbidly obese person's fat is there specifically to see them through a famine. The protien in the body serves many more purposes than just being muscle and extra calories. I was under the impression that muscle decreases in a poor diet due to the fact that muscle mass increases metabolism and that the protein can go to other processes that are more essential. or perhaps i am misunderstanding you?

[Iamme]

This is a very interesting question. We know that animals fatten themselves up for the winter so they can live off their fat. Some of these animals hibernate. Maybe animals that hibernate can get by on just their own fat being consumed and don't need as many nutrients as normal.

[Alkatran]

As has already been said, keep in mind these people may be fat for genetic/physical reasons. We're not dealing with the standard human body here.

[ChristineR]

protein is the most inefficient fuel source calorie wise, and a morbidly obese person's fat is there specifically to see them through a famine. The protien in the body serves many more purposes than just being muscle and extra calories. I was under the impression that muscle decreases in a poor diet due to the fact that muscle mass increases metabolism and that the protein can go to other processes that are more essential. or perhaps i am misunderstanding you?

This is all true, but the problem is that any sort of calorie restriction results in both fat and protein (muscle) loss. From a dieter's point of view, the muscle loss is completely undesirable, but from an evolutionary standpoint it makes sense. Less muscle means lower calorie needs. The less food available, the more important it is to reduce muscle and conserve fat.

I'm not sure if I have any quantitative references around or not. Here's one link (http://patrifriedman.com/writing/journal/expat/954atkinsmuscles.html)I found that cites a bunch of studies, but it's hard to say what's going on. The net result appears to be that you need a certain number of calories and a certain amount of protein or you will lose muscle, above those thresholds, it's less clear.

To put it another way, if you are on a very low calorie diet, it should be pretty much all protein, and you should never go below your protein requirements. Practically, we are talking about something 420 kCal / 105 g a day, like that #28 on the fattest ever list. But she died on that diet, so either she wasn't actually getting enough protein, or her body still burned muscle tissue to make up the calorie deficit, despite all that excess fat.

One of the pages linked to on that page cites a study that had as much as one-third of the weight loss being due to lean body mass.

[casebro]

17 days without water seems pretty exceptional to me. Do you know if there we any distinguishing charactersitics about them alowing such a long survival time?

As for Barbeiri, I think that translates from about 400 pounds to about 175 pounds, pretty similar to the scenario in the OP. I'm assuming he wouldn't get any usable amounts of protein from the vitamins, coffee and tea (is that incorrect?) so it does sound like one can live off of excess calories alone at the least until one reaches about a normal body weight (175 pounds is normal for average build men).

So perhaps it wasn't lack of protein that did in Edelman but lack of vitamins? Also, I wonder if the coffee and tea played a substantive role in Barbeiri's persistance.

Any thoughts on it?

Many vitamins are "fat soluble". You need to get some fat into your digestive tract in order to soak up the vitamins. A,D,E are fat soluble, B's and C are water borne. I don't know whether the oil in a vitamin E pill would be enough. But then, bodies do store the fat solubles- in fatty tissue, like liver? Plus they seem to learn more all the time about the synergys required for absorption. The chance mix of a broad diet works, restricted intake is hazardous to your health.

[clarsct]

The enzyme responsible for turning glycogen, stored in your fat cells;) , back to blood glucose requires glucose as a co-binding ligand. In other words, if your blood sugar is low, you won't burn fat. (Or you'll burn it slowly, I ought to say. Even at low concentration, there is an equilibrium.)

You'll burn more muscle than fat on a starvation diet. Your liver will take whatever protein it can to make sugar out of. It does produce what is known as alpha ketones in this process, which is the 'high' that anorexics get when they don't eat. Alpha-ketones tend to have a euphoric effect on the brain, at least in some people. Basically, they don't eat, and they feel better.

Basically, it is possible to starve to death when overweight. If you blood sugar level crashes, your body simply does not have the extra blood glucose to spare for a co-binder. You'll start digesting your own proteins. It is also very possible that on a very low-calorie diet that you could die of malnutrition, of not getting something essential. Potassium is a good example, because many low-sodium diets also cut out foods that are potassium rich, so eating broccoli and bananas tends to be a part of them, as well as something like Morton Light Salt, that uses potassium as a substitute.

So, if you want to lose wieght, EAT, but eat in a healthy and sensible fashion. and EXERCISE!!!!! You must eat a certain amount of calories each day, but you can also control the rate at which you burn them!

[ponderingturtle]

Guess Katana needs to cut down on the coffee. :p

Interesting infomation though. I always thought those grossly obsese people could just stop eating but a family member enabled them to get so fat. I never knew a heavy person could die from not eating.

Sue why should the body be able to metabolize fat into energy fast enough to supply all its needs?

[ponderingturtle]

simple way to see that fat isn't mostly water:
Fat floats in water. the lipid chains in fat are less dense than water, therefore they float.

But what does that have to do with the relative propotions of lipids to other things in fatty tissue?

[ponderingturtle]

protein is the most inefficient fuel source calorie wise, and a morbidly obese person's fat is there specifically to see them through a famine. The protien in the body serves many more purposes than just being muscle and extra calories. I was under the impression that muscle decreases in a poor diet due to the fact that muscle mass increases metabolism and that the protein can go to other processes that are more essential. or perhaps i am misunderstanding you?

And it would work for famine where they have some food intake, but people living for prolonged periods with out eating is not something that was much of an evolutionary advantage. And when you add in things like all the energy requirements of a big brain, compareing humans to other animals who don't have the metabolic requirement of a big brain is silly.

[Katana]

What the hell?

Sorry, everyone. What's weird is that I didn't even mean to post that once much less three times. Big oops! :o

My intention was to expand on my comment and include information about starvation ketosis and why it might have factored into his death (a prolonged ketotic state can damage the kidneys). I didn't have the time to provide a source, though, so I was going to come back to it later. This is from a link with information about the Atkins Diet, but I think it applies:

Body protein provides most of the energy needed during the first few days of a low caloric diet, but after that the body will adapt to using fat for energy in an attempt to preserve muscle. Without this adaptation, death would eventually result, regardless of the quantity of fat a person stores. This places a significant on strain on the heart muscle and kidneys, especially significant in patients with a heart condition or with high blood pressure.

Fat is then metabolized to ketones, which can be used by the brain for energy. However, prolonged inadequate carbohydrate intake results in the build-up of ketones, which become toxic, resulting in a condition called ketosis.

Consequences: The kidneys and liver become burdened with toxic waste from the breakdown of fat and muscle tissue and the body’s normal functions are disrupted. Ketosis can cause fatigue, constipation, nausea and vomiting. The potential long-term side effects of ketosis include heart disease, bone loss, and kidney damage.

In addition, the lack of calories will deprive your body of essential vitamins and minerals so hair, nails and skin will show signs of deterioration. Ironically, if you’re using fasting as a means of detoxifying or cleansing the body, you will actually be achieving the opposite effect.
Link (http://www.imakenews.com/bioanalogics/e_article000163950.cfm)

I hadn't considered vitamin or other nutritional deficiencies, which could have played a role in the man's death, as well.

By the way, if you Google "morbid obese starve to death", this thread tops the list. That was an amusing discovery.

[El Greco]

17 days without water seems pretty exceptional to me. Do you know if there we any distinguishing charactersitics about them alowing such a long survival time?

IIRC it was not in the bible :D It was some German guy who somehow was forgotten in a prison cell. I guess if you google it you'll find the details.

[Yuri Nalyssus]

If I recall correctly when you don't eat carbohydrates you produce more ketones which causes ketosis and may result in ketoacidosis and death. Starvation would do the same thing.
Also the body has fat stores in the liver which, since fat is non-water-soluble, can only be transported in the blood is in the form of lipoprotein complexes - if you have no proteins you can't make lipoproteins and your liver turns into foie gras and kills you.

The fat made up of water thing I believe originated when it was discovered that fat metabolism produces water as a by-product, hence it was claimed that camels' humps were a way of storing not just fat for energy but also metabolic water. Then this neat and sensible theory was blown apart when it was discovered that fat metabolism also required water and that actually the net effect was less water, not more. To this day though you still come across people who believe that camels' humps contain water!

Yuri

[blutoski]

Ice also floats in water.
As do ducks and witches.

And tiny rocks.



But fatty tissue is not just a collection of lipids.

Yes, people forget that fat is stored inside cells. The cells are alive, and have a busy metabolism, so a good portion of fat mass is just ordinary cell stuff. Which is to say, a lot of water.

[Iamme]

You can make a needle float in a shallow pan of water. I remember that one from my school days. Water tension holds it there.

[Polaris]

I believe about 15% of the stuff on your hips is blood vessels and connective tissues, with about 85% being actual fat of the sort you can melt and put in a deep fat fryer to make french fries.

If they're waffle fries I'm in.