Since Israel launched its war on Gaza in October 2023, dozens have died from starvation and malnutrition-related conditions.
The majority of these deaths have been recorded in recent months, as the already fragile humanitarian situation collapsed further.
In March this year, Israel tightened its blockade into what aid workers describe as a “total siege,” halting nearly all food and medical supplies.
This decision has left trucks full of emergency aid stalled at land crossings, unable to enter despite the urgent need.
The consequences have been catastrophic.
Gaza’s 2.1 million residents have endured relentless bombardment and mass displacement — many forced to flee multiple times, with some uprooted as many as ten times since the conflict began.
This instability, coupled with blocked aid, has created conditions of extreme hunger. Images emerging in recent weeks show visibly emaciated children.
The United Nations World Food Programme has reported that more than one-third of the population has gone for days at a time without food. At least a quarter of Gaza’s people are now experiencing
what experts describe as “famine-like conditions.”
Local doctors report scenes in hospitals where many Palestinians too weak to donate blood and mothers physically unable to produce breast milk for their babies.
The World Health Organisation warns that the “worst-case scenario of famine” is no longer a prediction — it has arrived.
In July alone, the WHO documented 63 deaths from malnutrition in Gaza.
UNICEF estimates that 100,000 women and children are currently suffering from severe malnutrition, while other UN agencies warn that disease is spreading rapidly and health infrastructure has almost completely collapsed.
What happens to the human body without food
While hunger is a universal sensation, prolonged deprivation sets off a series of profound changes inside the human body — changes that can ultimately end in death.
“If you’re not eating enough, we have evolved mechanisms for how to stay alive,” Dr. Kevin Stephenson, a malnutrition expert at Washington University in St Louis, US, explained, while speaking to National Public Radio (NPR).
“We basically eat our own body for nutrition.”
This self-consumption unfolds in five overlapping metabolic stages, as the body adapts to survive without external energy sources.
Phase one
In the earliest stage of food deprivation, the body turns to its most accessible energy source — stored carbohydrates, mostly in the liver.
“The carbohydrate stores in our liver are like protein bars that our body has evolved to be able to tap into,” Stephenson explains. During a normal overnight fast, or even the gap between meals, the body already taps these reserves.
If no food is consumed beyond this initial period, the carbohydrate stores run out — typically within 24 to 48 hours — and the first weight loss begins.
Hunger pangs and stomach “growling” may occur as the digestive tract contracts to clear out remnants of food.
Phase two
By the second day, the body switches fuel sources, relying on fat.
As fat is broken down for energy, blood sugar levels drop.
This can lead to fatigue, dizziness and lightheadedness.
Phase three
Around the third day, the liver ramps up production of ketones — compounds derived from fat that serve as an alternative fuel for the brain.
This ketone production allows the body to keep functioning without the severe symptoms of low blood sugar.
Paradoxically, some people report a fleeting sense of mental sharpness during this stage, along with a reduced desire to eat.
Phase four
As hunger stretches into days and weeks, the body enters a conservation state, slowing its metabolism to preserve energy.
Heart rate and blood pressure drop, and the body reduces production of certain hormones.
“Hormones that are important but not critical to survival are dialed down,” Stephenson notes. Thyroid hormones decline, causing lethargy; reproductive hormones also dip, often halting menstrual cycles.
People instinctively reduce their physical activity, not just out of weakness but because their bodies are essentially telling them to conserve every bit of energy.
Phase five
Eventually, fat stores run out. This can take weeks or even months, depending on the person’s initial fat reserves.
At that point, the body begins to consume muscle protein — including muscles essential for life, such as the heart.
“The body tries to preserve muscle as best it can because muscle is very metabolically demanding to build,” Stephenson tells NPR.
“But ultimately, though, it gives up and says, ‘I’m gonna die if I don’t get protein here.’”
This phase causes the most visible signs of starvation: severe muscle wasting, weakness, swollen legs and abdomen (due to loss of the protein albumin), brittle hair, thin and dry skin, and deeply sunken eyes.
If starvation continues, organ systems fail.
The immune system collapses, leaving the body vulnerable to infections it can no longer fight. The weakening of the heart muscle can cause dangerous irregular rhythms, which can trigger sudden cardiac arrest.
Adults with water access can survive up to two months without food. But ultimately, in this fifth stage, unless food is reintroduced carefully, starvation becomes fatal.
Why children are the most vulnerable
Children deteriorate much faster under starvation. Their bodies need a steady stream of nutrients for growth, but their energy reserves are small.
UNICEF estimates that 12.2 million children worldwide faced severe malnutrition last year, with South Asia being the hardest-hit region. Gaza is
now adding dramatically to those figures.
Stephenson warns that the danger for children is acute and fast-moving: “It’s so, so common to hear this story from a mom: ‘My kid was irritable and felt hot. I took them to a local doctor, and within two hours, they were dead.’”
Children with even minor infections — pneumonia, diarrhoea — spiral downward rapidly. Illness drains energy stores further, and their already fragile systems can’t recover.
In severe cases, children stop feeling hunger entirely. Their digestive systems weaken, and they lose the ability to swallow.
Muscle wasting affects the jaw and the coordination needed to eat.
“Swallowing is so fundamental to survival, and so I think that speaks to how severe this condition is,” Stephenson says.
“Eventually, you can just get sick enough that the parts of your brain that stimulate you to eat stop working.”
The treatment for malnutrition in children is straightforward in theory: food and water.
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Emergency responders often provide peanut-based pastes, rich in calories and nutrients. Children too weak to swallow are given feeding tubes.
But treating children with prolonged starvation comes with its own risks. They can develop refeeding syndrome — a dangerous shift in electrolytes that can disrupt heart rhythms and cause death if not managed carefully.
If left untreated, severe malnutrition kills between
10 per cent and 40 per cent of affected children. Survivors often suffer long-term damage: stunted growth, developmental delays, and lifelong vulnerability to illness.
Studies also show that severe malnutrition in childhood correlates with poorer academic performance and reduced economic prospects later in life.
Still, Stephenson offers hope: “It is possible, if you get them through that one bad, worst period of their childhood, that they could be OK. All hope is not lost.”
Starvation: A preventable tragedy
Severe malnutrition is one of the simplest medical crises to treat — yet one of the deadliest if left unaddressed.
“There are lots of complicated things that we can’t fix in the world, but severe malnutrition is not one of them,” Stephenson says.
The Gaza Humanitarian Foundation (GHF), backed by the US and Israel, began operating aid distribution points in May.
But instead of being a lifeline, many human rights organisations
accuse these sites of being deadly traps.
According to multiple rights groups, more than 1,000 Palestinians have died at or near GHF distribution centres.
Security forces managing the aid points have allegedly fired live ammunition into crowds and used tear gas in tight, densely packed areas, causing fatal suffocation incidents.
The GHF has also been criticised for operating in a militarised environment, where chaotic crowd control and insufficient safeguards leave the weak and vulnerable behind.
Only those physically strong enough to reach and withstand conditions at these sites — often younger, healthier individuals — can collect rations.
People who are elderly, disabled, or too frail are effectively excluded, deepening the inequality in access to desperately needed food.
More than 100 humanitarian organisations have called on Israel and international authorities to ensure unimpeded access for aid deliveries, insisting that starvation on this scale is both preventable and reversible if assistance reaches those in need.
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With inputs from agencies
