As a child, I frequently observed a common pattern of behaviour in my Dad. We would go out for the day, perhaps to a theme park or to the shops. At a predictable time in the afternoon my Dad would become irritable and snappy. We soon associated this behaviour with Dad being hungry or ‘hangry’.

This behaviour is also applicable to the mental presentation of patients with Eating Disorders. A large part of the role as a dietitian is giving the patients education (we call it psychoeducation). Helping them understand their illness and providing justification to choose recovery. When discussing the cognitive impacts, we often rely on the foundational findings of the Minnesota study.

The Minnesota study

The Minnesota study (1) was conducted during the second world war. A group of 36 male conscientious objectors of war volunteered to participate in a twelve month experiment looking at the impact of starvation. In the context of the war, there was widespread starvation and the researchers were looking at how they could minimize the impact of starvation and help those recover from malnutrition. They found that the participants became depressed and irritable, had obsessive thoughts about food, lost much of their hair, had a much reduced metabolic rate, became sensitive to the cold and struggled sleeping. Many of the symptoms that we associate with restrictive eating disorders are actually symptoms of starvation.

The Minnesota study is an extreme example of the impacts of starvation. Newer evidence shows that even short-term food restriction in someone of a healthy weight can result in more rigid thinking (hence, ‘hangry’). This is likely explained by the drop in blood glucose when we have not eaten for a while (2). Psychology Professor, Prof Francesco Leri explains “Hypoglycemia is a strong physiological and psychological stressor”(3).

Looking at the 5:2 diet. Whereby a dieter eats normally for 5 days of the week and dramatically reduces their food intake/ fasts, on 2 days of the week. Found that those who are on the 5:2 diet, when fasting have a slower and less accurate cognitive performance.(5)  Looking at the long term impact on mental health there is evidence to indicate that skipping breakfast can result in increased risk of depression.(4)

When I talk to my patients about their cognitions and their symptoms of starvation syndrome I sometimes tell them it is like they are hangry, but on an extreme level. This is why regular eating for those in recovery (and for everyone) is so important for wellbeing.

(1)   https://eatingdisorders.dukehealth.org/education/resources/starvation-experiment

(2)   https://link.springer.com/article/10.1007/s00213-018-4998-1

(3)   https://www.sciencedaily.com/releases/2018/09/180925115218.htm#:~:text=University%20of%20Guelph%20researchers%20have,Francesco%20Leri%2C%20Department%20of%20Psychology.

(4)   https://www.cambridge.org/core/journals/psychological-medicine/article/abs/an-eating-pattern-characterised-by-skipped-or-delayed-breakfast-is-associated-with-mood-disorders-among-an-australian-adult-cohort/4E61BDCC89AD0E629770811231D72114

(5)   https://discovery.ucl.ac.uk/id/eprint/10083606/1/O%E2%80%99Leary_10083606_Thesis_sig-removed.pdf

Take the First Step

If you’re struggling with a disordered relationship with food and exercise, know that you don’t have to face it alone. Professional support is crucial for your journey towards recovery.
As a registered dietitian specialising in eating disorder recovery, I provide personalised guidance and support to help individuals like you establish a healthy relationship with food and exercise.

You can book a free call with me below or get in touch with me here.

Hugs,
Sophie x