If a character was starved for a long period of time but was able to recover, what would the permanent side effects be?

Question

In my book series, there is a small planet called Eaglypt. On this planet, there is a huge famine because an evil space overlord named Tate magically summoned a sandstorm that choked up the oasis (and thus the rivers fed by it) that Eaglypt uses to irrigate its crops in the harsh global desert. Anyway, the entire population eventually starves and dies. However, the royal family possesses a one-man escape pod (the only spaceship on Eaglypt that Tate didn't have his army destroy). Using this escape pod, Taftenkhamun (the heir to the Eaglyptian throne) escapes to live a life on a faraway planet as the last of his kind. However, Taftenkhamun was absolutely starving by the time he arrived (due to both Eaglypt's famine and the fact that his pod had no food on it).

What side effects would Taftenkhamun be likely to suffer from for the rest of his life as a result of being starved to near-death?

Answer 1

Probably none, but with some caveats.

Actually no-food-at-all starvation is a pretty cut and dried affair: either it's for a short period (I've heard three weeks to a month) and you can recover with no long-term effects, or it's for a longer period and you die. If the heir is a child, he might be at some risk of developmental disabilities, but probably not that great of a risk, all things considered. (If the heir is an infant, I wouldn't like to put money on how long he could survive without food, but it should still be without long-term effects.)

On the other hand, malnutrition over a prolonged period - say because you're on your last box of emergency rations and they really need to last the rest of the year - can have profound impacts, especially on children. We're talking stunted growth, developmental and learning disabilities, the works. Luckily for the heir, sitting around on an escape pod waiting to land isn't very physically taxing, so his calorie needs are minimal, but various nutrient deficiencies are a very real risk on a longer journey. Even if he survives, he's likely to be suffering at least one acute deficiency by the end, which can (depending on what exactly he's missing) easily lead to impaired judgment and death. Prompt treatment by some kind of experienced - and well-meaning - locals on landing would be vital.

On the gripping hand, why not launch the heir before all the food gets eaten? Sure, some of the peasants might object that he gets it and they don't, but why wouldn't they raise the same objection about the escape pod? You're probably going to have at least one angry mob trying to storm the palace before you can launch anyway, you might as well steal their bread too.

Answer 2

Physical Effects are Poorly Studied

There actually hasn't really been any in depth studies as to long term physical effects in starvation survivors. We do, however, have anecdotal evidence from many holocaust survivors. Statistics taken from the medical records of holocaust survivors later in life show that they had increased risk of cancer, osteoporosis, diabetes, and dental issues. Additionally fertility was affected and survivors of the holocaust gave birth to less healthy babies, and those babies grew up to suffer a slightly lower level of health as adults than that of people descended from individuals who did not nearly starve.

Additionally, evidence has been discovered and is beginning to be explored that starvation may trigger genetic changes in survivors which they pass down to children and even grand children. Descendants of starvation survivors trend towards less fertile, smaller builds, and more males are born. Additionally, holocaust survivors have shown altered hormone levels that make them more susceptible to stress and more prone to PTSD. These altered hormone levels have been observed in both the children and grand children of holocaust survivors as well. The field of epigenetics is a relatively new field and much of it's findings are still hypothetical but it is theorized that physiological stress can trigger genetic changes to try to adapt offspring to the environment of the parents. In effect, long term starvation can end up not just effecting the individual, but the following generations as well.

Psychological Effects

The psychological effects are a lot more heavily studied, and a lot more noticeable. Survivors of starvation are documented hoarding food, and have exhibited great anxiety in throwing food away, even when food is great abundance and easily accessed. Eating disorders, food obsession, and food hoarding are all well documented long term psychological effects seen in starvation survivors. Keep in mind that psychological effects are never 100% predictable. PTSD is also likely though whether it is due to the effects of starvation, or to the traumatic events that caused the starvation is often difficult to determine.

Answer 3

Depends

How long? 2 weeks? 6 months? Years?

What kind of starvation? Eating a literal nothing is different from eating hardly anything. Is water a plenty? What about essential vitamins and fatty acids?

Does the person have any problems to begin with? Weak heart, diabetes, overweight, etc.. How well people can handle starvation depend largely on their body.

Under what conditions? If you're forced into hard labor you're gonna have different requirements than if you're imprisoned in a cell. Again different from being stuck in the wilderness.

Taftenkhamun

Being a royal in an escape pod, it's fair to assume he's neither doing any hard labor, nor has he done a lot of manual labor in the past. I'm gonna assume water is no problem, as otherwise he'd kick the bucket before starvation was even an issue. For simplicity's sake I'll assume he's without health issues and in his 20s.

Since there wasn't any food in his pod, his hunger would vanish after about 3 days. He won't even feel lethargic as his body switches to burning his fat stores.

If he have access to supplements, he can last as long as his body have fat stores. Which is a lot for the average person, and if he was bordering on obesity, quite a lot. The world record fast lasted over a year without issues.

Without supplements, he'd start to face issues as his body run low on various vitamins and minerals. Have a pick.

After running out of fat stores, he'd feel hungry, lethargic and then his body would start to break down muscle mass in order to sustain energy, not before. Then shortly afterwards, he'd die.