Hunger Disease

by Misha Holleb

Printer-frienldy version of the text

In the parsha Miketz, hunger is moralized. Paroy has prophetic dreams of seven healthy “handsome” cows and seven emaciated “ugly” cows. Yosef correctly predicts that after seven years of abundance, the world will be ravaged with seven years of famine. The text makes an aesthetic judgement on health and implies that famine is a tool to create desirable character outcomes.

Hunger is an ironic punishment for Yaakov, who withheld food from his brother Eyso as a young man and coerced him to sell his birthright (Toldos). The ordeal of securing food is vengeance too for Yosef’s brothers for putting him in the pit and selling him into servitude (Vayeshev).

וַיֹּאמְר֞וּ אִ֣ישׁ אֶל־אָחִ֗יו אֲבָל֮ אֲשֵׁמִ֣ים ׀ אֲנַ֘חְנוּ֮ עַל־אָחִ֒ינוּ֒ אֲשֶׁ֨ר רָאִ֜ינוּ צָרַ֥ת נַפְשׁ֛וֹ בְּהִתְחַֽנְנ֥וֹ אֵלֵ֖ינוּ וְלֹ֣א שָׁמָ֑עְנוּ עַל־כֵּן֙ בָּ֣אָה אֵלֵ֔ינוּ הַצָּרָ֖ה הַזֹּֽאת׃

They said to one another, “Alas, we are being punished on account of our brother, because we looked on at his anguish, yet paid no heed as he pleaded with us. That is why this distress has come upon us.” (Bereshis 42:21)

It’s a tidy narrative: hunger is punishment. Hunger also functions as proof that Yosef is a man of G-d and an accurate dream interpreter, making him a more formidable character. This is no consolation to the unnamed masses of starving people across the famished ancient world, nor a comfort to hungry readers who turn to Torah for spiritual guidance. The lesson of hunger in the text is Hashem creates famine because someone—maybe you, maybe not—needs to learn a lesson from it.

Hungry people are not ugly, but hunger is. To let people go hungry is an insult to life and a stain on our souls.

The effects of hunger are disabling before they are fatal: diabetes, high blood pressure, heart disease, weakened immune system, stunted growth in children, infertility, decreased cognitive function, slow heartbeat, high temperature, shallow and slow breathing, low bone density, fat loss, and finally muscle loss. Even if people recover from starvation, they face chronic health and mental health problems as a result: issues with their immune and circulatory system, disordered eating, and PTSD. The stress of hunger also contributes to psycho-physical problems like anxiety and depression. Food scarcity causes and reinforces social isolation. Hungry people must make difficult choices about feeding themselves at the expense of their other basic needs like heat and medicine, and feeding their dependents. Of course, this is what hunger does to otherwise healthy people—comorbidity with other medical issues only compounds the devastating effects.

We are challenged by Torah to engage with the text as both parable and literal—we must imagine that the famine across Yosef’s world was a metaphor and a historical event. The narrative provides some details about the emotional effects of hunger and desperation on our ancestors, but not the physical consequences. For that we can turn to more recent history.

The Warsaw Ghetto Hunger Study remains the largest medical study of starvation. The ghetto held more than 400,000 prisoners. Faced with the impossibility of treating hunger with food due to the Nazi blockade, the ghetto’s doctors (led by Dr. Israel Milejkowski) decided to study starvation in an act of optimism that their work might provide humanitarian benefit. They began preparing in November 1941 and started studying in earnest in February 1942.

”It was found that the adaptation to starvation did not reverse evenly when abundant food became available. The metabolic changes reversed quickly, yet the circulatory changes took much longer. This situation put an extra strain on an already weak heart, and the person went into heart failure. Repeated observations were made, checked and rechecked, and the findings summarized in charts and tables on a scale never before done in a study of this nature.

There was plenty of autopsy material. From January 1, 1940, to July 22, 1942, 3,658 autopsies were performed. Of these, 492 were cases of “pure” starvation, proved by the absence of any complicating disease. On the basis of their findings, the Warsaw doctors came to the conclusion that prolonged starvation in human beings leads to a specific disease entity, which they called “starvation disease.” They regarded this disease as one of adaptation to a peculiar, prolonged and ungovernable stress-calorie deficiency.” (Erwin W. Rugendorff, MD, 2020)

More than 100,000 people died of starvation in the Warsaw Ghetto before the remaining 254,000 were deported to Treblinka. The manuscript of the study was smuggled out before liquidation in 1943, and has proved extremely valuable: it’s from the doctors in Warsaw that we know that we need to re-feed starving people slowly.

Today, there is an ongoing starvation crisis in Gaza. In August of this year (2025), the WHO confirmed that there is famine—“extreme food deprivation, acute malnutrition and starvation-related deaths”—in Gaza City affecting over 500,000 people. In September, UNICEF reported that 1 in 5 children in Gaza are malnourished. Even after the so-called ceasefire in October, food and aid remain blockaded at some Israeli checkpoints and the IDF’s military offensive continues to kill. Palestinian Journalist-cum-aid-worker Mohamed al-Astal writes:

”Prices of many food items have significantly dropped since the ceasefire. But essentials we need – like baby formula, food supplements for pregnant and breastfeeding women, poultry, meats, and milk – are still not reaching us. On top of that, Gaza’s economy has been destroyed. Many people simply have no source of income, and even those with savings have long since exhausted them. As a result, many families cannot afford to buy food even at reduced prices. The need is also too large for UN agencies and NGOs to meet. Many people are falling through the gaps. Starvation and poverty have become entrenched in this society. … The truce has created some space to breathe and to distribute items to people more safely. But every effort is stalked by fear of renewed bombing.”

An estimated 10,000 people in Gaza have died of hunger since October 7, 2023. The scale of violence and death in Palestine will not be known until years after the conflict is truly over.

Famine includes indignity on a scale that’s difficult to comprehend. In my research on hunger, I’ve read harrowing stories of the lengths people will go to survive—abandoning each other and, in doing so, their own humanity. Families fracture not just through death but when healthier members forsake their more vulnerable relatives in order to save themselves. Lying and cheating are common. Children roam the streets alone, howling and coughing at night. Rent is extorted from people who have less than nothing, for the privilege of living in a dilapidated house or a leaky tent. People sift through feces for undigested grains. The conditions of famine also cause medical and sanitation crises, breeding diseases like typhoid (Warsaw) and polio (Gaza). The disposal of corpses is difficult due to scale and lack of resources—indignity doesn’t end even in death.

Famine is a policy choice, not an inevitability. As economist Amartya Sen wrote in his 1981 book Poverty and Famines, “Starvation is the characteristic of some people not having enough food to eat. It is not the characteristic of there being not enough food to eat.” The famines in Nazi-occupied Europe and Gaza were caused entirely by blockades and a deliberate starvation strategy. Across the world, hunger is the policy choice of governments which prefer capitalism to humanity. In Torah, famine is the policy choice of Hashem.

We should not accept such hostile conditions, from Hashem or the government. There is no room for fatalism or necro-fetishistic deference to “the market” in our tradition. Judaism is not a death cult. We are responsible for each other. 

Yosef’s visionary policy of storing grain during the years of abundance prevents needless deaths during the years of scarcity. When his brothers travel to Mitsrayim to retrieve food, they bring money with the expectation that they will pay for it. Yosef returns their money in an act which I choose to read as generosity rather than manipulation.

As long as food costs any money at all, there will be unnecessary hunger. Where governments fail us, there are many community interventions: friends and neighbors overcooking and sharing; free fridges and pantries. Food Not Bombs chapters all over the world; crowdfunders for internally displaced people like my friends Kamal and Farid in Gaza.

Yosef decides that he will feed his brothers despite their betrayal. No one, no matter their flaws, is undeserving of food. It’s our collective responsibility to feed people.

Misha Holleb is an orthodox transsexual anarchist and writer and khazn in Brooklyn. He runs Rōsh Pinoh (a minyon) and the pink peacock (a queer Yiddish anarchist pay-what-you-can free food café).