The Curious Case of the Man Who Ate Nothing For Over a Year
Yes, he lost a lot of weight and yes, he survived. Here’s how he did it.
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In June 1965, a 27-year-old Scottish man weighing 456lb (207kg) decided to stop eating until he reached his desired weight of 180lb (82kg). Angus Barbieri ate nothing whatsoever for 382 days, achieved his goal, and lived to tell the tale.
Morbidly obese, Barbieri certainly needed to lose weight, but no, this is not one to try at home. His approach was potentially life threatening, which is why this superhuman feat was achieved under strict medical supervision. Before embarking on his fast, Angus checked into the Maryfield Hospital in Dundee, returning regularly for evaluation and occasionally staying overnight.
Quite wisely, under the circumstances, Angus also gave up working in his father’s fish and chip shop, which later closed down. He spent most of his time at home, taking regular blood and urine tests and drinking calorie-free beverages.
Thus, for well over a year, Angus lived on just tea, coffee and water. He was given appropriate vitamin and electrolyte supplements. Towards the end of his fast, he added a small amount of milk and/or sugar to his tea and coffee.
When this extraordinary undertaking came to an end on 11 July 1966, Angus had lost a total of 276lb. In 1971, he entered the Guinness Book of Records for the longest recorded fast.
Drastic action was not part of the original plan. Angus’s doctors had suggested a short fast for some immediate weight loss. They underestimated his willpower. Like Forrest Gump going out for a run one day, he just kept going. And going.
Despite the riskiness of the plan, the doctors must have been secretly thrilled to be given the chance to observe and be part of such a unique experiment. They were watching human metabolism at its rarest and most fascinating, a demonstration of how the body copes under extreme circumstances. In 1973, they published their report of Angus’s journey in Postgraduate Medical Journal.
How the body adapts to fasting mode is indeed fascinating, and this one-man experiment provides a view of cellular activity through a magnified lens.
It also raises many questions, so here’s a virtual Q&A session I’ve created in an attempt to answer those questions.
Question 1. How did Angus live without eating for so long?
This one is fairly straightforward. Angus lived off his own, abundant supply of energy. Stored body fat is called adipose tissue, and this is what he burned. That’s also what happens during the more popular and less risky strategy, intermittent fasting.
Ordinarily, glucose provides the body’s first source of energy. Glucose comes from the carbohydrates you eat. You also store glucose in the form of glycogen in muscles and in the liver. However, you only have around 2,000 calories’ worth of stored glycogen, and when that runs out you switch to burning fatty acids from adipose tissue and ketones, made from those fatty acids.
That, in a nutshell, is how a low carbohydrate diet works — it induces ketosis. A low carb diet produces a shift to ketone metabolism and is indicated by the presence of ketones in urine, and later in blood. That’s what happens on the ketogenic diet.
If you fast for a whole day, glucose remains in the low to normal range, but ketones rise progressively until food is eaten.
In Angus’s case, tests revealed that ketones were detected throughout, confirming that he was in a state of ketosis for the duration.
Question 2. What were the risks involved?
Starvation is not normally considered an effective weight loss strategy as it regularly ends in death. In their paper, the researchers state that they were aware of five reported fatalities from extreme starvation diets, due to heart failure, lactic acidosis, and small bowel obstruction. Monitoring and supplements were essential to make sure this didn’t happen to Angus.
Angus had plenty of fat to burn for energy, but the body needs a constant and regular supply of vitamins and electrolytes. Electrolytes are electrically-charged, circulating minerals that keep everything going, including heart function.
Question 3. How did Angus live without glucose, which is essential to life? Doesn’t the brain run on glucose?
Yes, some glucose is essential, as certain cells are entirely glucose dependent. These cells are the erythrocytes (red blood cells), and the tissues of the cornea, lens, retina, testis, and kidney medulla.
However, in the absence of dietary carbohydrate, the body is able to manufacture glucose from fat and/or protein. The protein in meat, for example, is readily and efficiently converted to glucose — 100g of meat protein can produce around 50g of glucose. This metabolic alchemy is called gluconeogenesis.
Fat too is readily converted to glucose. The form of fat that circulates in the blood is called a triglyceride. It has a “backbone” of glycerol, to which are attached three fatty acids. When triglycerides are broken down to make fatty acids, the glycerol component can be converted to glucose, and may account for nearly 20% of gluconeogenesis.
This glucose provides important fuel for the body. The brain, however, is quite happy to run on ketones instead. Ketones provide an important, non-glucose source of energy to the brain. The liver can produce enough ketones, per day, to meet the brain’s needs.
In addition to ketosis, Angus’s body was clearly performing gluconeogenesis in an efficient manner. His blood sugar steadily decreased to 30mg/100ml, which is low but not drastically so. It remained at that level from the fourth month onwards. (Which is also how the doctors knew he hadn’t been eating surreptitiously.) His responses to glucose tolerance tests were normal and he “remained symptom-free, felt well and walked about normally”.
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Question 4. Protein can’t be stored in the body, so if you don’t eat it, how can you use it to make glucose and protein structures?
That’s a great question, and I’m glad you asked it. The body has got that one covered too. You’re right, the body cannot store this macronutrient and needs a regular supply. The amino acids in protein are used to make body tissues, and ordinarily protein must be obtained at each meal. Amino acids are used almost immediately, either to make protein or for other functions that require amino acids.
However, when you stop eating, for example when you practice intermittent fasting, a process called autophagy is triggered. Autophagy deals with protein requirements.
Autophagy is a quality control process whereby each cell of the body is able to clear out or recycle worn-out components. Old proteins are broken down into their amino acid constituents, which are then recycled into new protein structures. Voilà! Through autophagy you create a new protein without actually eating any.
The other great thing that autophagy does is protect muscle mass. If you’re making new protein, you don’t need to break down muscle. Unfortunately, we do not know if the doctors measured Angus for muscle loss. All we know is that he remained healthy.
“Autophagy, a process of cellular catabolism, is emerging as a key regulator of muscle regeneration”
Question 5. If Angus ate nothing for so long, does that mean he never “went”?
Angus still had bowel movements, though rather infrequently — only every 37–48 days. It makes you wonder what exactly was evacuated, but I can’t answer that.
Question 6. How can anyone stay so hungry for so long without going mad?
It appears that Angus lost his appetite, but not his mind. When he broke his fast, that July morning, he ate a boiled egg and a slice of bread and butter, and drank a cup of black coffee.
(As an aside: I went on a five-day fast when I was a nutrition student, for experimental purposes. I was starving, miserable and cold for the first three days, but then the misery passed. I broke my fast on day six with just a few spoonfuls of natural yogurt and it was quite sufficient. Even so, I can confirm quite categorically that I’ll never do that again.)
Here’s the thing about appetite. The hormone ghrelin is produced in the stomach and is called the appetite hormone because it tells the brain you are hungry. But instead of increasing steadily over a prolonged fast, as you might expect, the opposite happens. Once you are burning your fat stores, ghrelin decreases.
When Angus finally sat down to his first meal, he didn’t fall upon it like a pack of hyenas, as you might expect. He told the local press, who’d turned out to witness this momentous occasion, that: “It went down OK. I feel a bit full, but I thoroughly enjoyed it.”
Question 7. Did Angus keep the weight off?
Post fast, Angus put on a few pounds, but his weight remained stable at 196lb (88kg) for at least five years. Unfortunately, no further follow-up is recorded.
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Question 8. What became of Angus?
I am delighted to report that there was a happy ending, though the information available is short on detail. All we know of Angus’s life, post starvation, is that he “continued to live a fulfilling life, raising two sons”. He died in September 1990.
Question 9. How can I benefit from all this knowledge without risking my life?
Easy. See the article Why “Eat Less, Move More” Doesn’t Work for Weight Loss.
Weight loss really doesn’t have to be that drastic or that difficult. You can try a safer, more measured approach and still lose weight steadily, without endangering your life.
This article first appeared on Medium in September 2020