Deadly hunger: How extreme starvation ravaged the hostages' bodies

The hostages who emerged from Hamas’s brutal stage of humiliation have set off alarms in Israel’s healthcare system, which is now preparing for intensive treatment.

By DR. ITAY GAL FEBRUARY 8, 2025 14:03 Updated: FEBRUARY 8, 2025 14:04

Ohad Ben Ami, a hostage held in Gaza since the deadly October 7, 2023 attack, is released by Hamas terrorists as part of a ceasefire and a hostages-prisoners swap deal between Hamas and Israel in Deir Al-Balah in the central Gaza Strip, February 8, 2025. (photo credit: REUTERS/Ramadan Abed)

The gaunt appearance of the released hostages—who have lost significant weight due to extreme starvation, surviving on minimal carbohydrates with no protein, vitamins, or minerals—was immediately visible. But beyond the outward signs, they likely suffer from severe multi-system damage, requiring urgent medical care in Israel.

The human body relies on a continuous supply of energy and nutrients to function properly. When deprived of food for extended periods, it enters a metabolic emergency mode, breaking down fat and muscle to sustain itself. This leads to dramatic physical changes, offering clear evidence of severe malnutrition.

One key indicator of nutritional status is Body Mass Index (BMI). A BMI below 18 is classified as severe malnutrition, while a BMI below 13 is considered life-threatening, indicating the body has lost critical amounts of fat and muscle.

The extreme starvation the hostages endured is evident in their physical condition:

1. Pronounced cheekbones

Under normal conditions, cheeks are supported by a layer of fat and muscle. In cases of prolonged starvation, these fat reserves deplete, and the muscles weaken, resulting in sharp, hollow facial features.

(L-R) Ohad Ben Ami, Or Levy, and Eli Sharabi, released from Hamas captivty, February 8, 2025. (credit: Canva, REUTERS/Ramadan Abed)

2. Sunken facial skin and eyes

Loss of subcutaneous fat causes the skin to sag, losing its elasticity and support. This gives the face a hollow, dehydrated look. Around the eyes—where the skin is particularly delicate—deep hollows form, creating a fatigued and sickly appearance.

3. Prominent Adam’s apple

Severe malnutrition leads to significant muscle loss around the neck, making the Adam’s apple highly visible. This causes the neck to appear frail and thin, sometimes exposing the underlying bones.

4. Protruding collarbones

In healthy individuals, the clavicle (collarbone) is cushioned by a layer of fat and muscle. In cases of extreme starvation, these layers deplete, making the bones stand out sharply.

5. Widespread muscle wasting

A severe lack of protein and calories forces the body to break down its own muscle mass for energy. This leads to significant muscle shrinkage throughout the body, including in the arms, legs, face, and chest, giving an emaciated appearance.

Beyond appearance: The hidden dangers of starvation

Extreme starvation doesn’t just affect physical appearance—it wreaks havoc on overall health. The immune system weakens, body temperature drops, and individuals experience extreme fatigue and deep depression. In the most severe cases, the damage may be irreversible, leading to long-term complications in the cardiovascular system, bones, and nervous system.

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Muscle wasting also affects the heart, reducing its ability to function properly. The weakening of respiratory muscles between the ribs can cause breathing difficulties, and the digestive system muscles may atrophy, further complicating recovery.

Rehabilitation from such conditions requires intensive medical supervision, including gradual refeeding and close monitoring of organ function to prevent life-threatening complications such as refeeding syndrome and mitigate the damage caused by prolonged starvation.