Sonam Wangchuk Hangs On to Hunger Strike: What Happens to Your Body During a 19-Day Fast

Activist Sonam Wangchuk has entered the 19th day of his indefinite hunger strike, with doctors warning that he could soon enter a stage involving organ damage. Wangchuk, who began his fast on June 28, has lost more than 9 kg and now weighs 56.9 kg, The Times of India reported.

Dr Satish Lamba, who examined Wangchuk, said his condition remained stable but required close monitoring. "Today, on the 19th day of hunger strike, his total weight loss exceeds 9 kilograms," he said.

According to The Hindu, Wangchuk's latest medical examination recorded a blood sugar level of 80 mg/dL, a pulse rate of 72 beats per minute and blood pressure of 105/61 mmHg. Dr Lamba said his hydration levels were satisfactory and that he remained mentally alert.

How The Body Responds To Prolonged Fasting

Fasting is practised for religious, cultural and health reasons, and is also used as a therapeutic measure in some traditional Indian systems of medicine. However, prolonged fasting, particularly among older people, can lead to significant physiological changes.

As the body exhausts its immediate energy reserves, it begins drawing on stored fat. A study published in Nutrition Reviews found that fasting for five to 20 days can result in a 2 to 10% reduction in body weight while increasing circulating ketone levels. Around two-thirds of the weight lost is lean body mass, while the remaining one-third comes from fat stores. Continued fasting eventually leads to the breakdown of muscle protein.

Blood sugar and blood pressure also tend to decline during prolonged fasting. The risks become greater for people with diabetes, low blood pressure, eating disorders, pregnancy or other underlying medical conditions.

A seven-day water-only fasting study published in Nature Metabolism found changes in blood proteins, including an increase in coagulation factor XI, which may raise the risk of thrombosis.

Another study from China, published in Nature, examined a 21-day complete fast. It reported a marked fall in body weight and blood glucose, along with higher ketone and uric acid levels, indicating a shift towards fat metabolism.

Potential Health Risks

As muscle protein is broken down for energy, fasting can lead to headaches, hunger, insomnia and metabolic acidosis, a condition in which excess acid builds up in the body. The severity of these effects depends on the duration of fasting, hydration and an individual's health before the fast began.

The body also loses sodium and potassium through urine, particularly during the early stages of fasting. Prolonged calorie restriction reduces magnesium and bicarbonate levels as well. These minerals play a role in maintaining blood pressure, muscle and nerve function, cellular activity and the body's acid-base balance.

Milder deficiencies can result in dizziness, fatigue, cramps, constipation and palpitations. More severe electrolyte imbalance may cause confusion, fainting, seizures, cardiac rhythm disturbances and, in extreme cases, death.

Doctors also point to the long-term effects of sustained muscle loss. Prolonged fasting creates a negative nitrogen balance, reflecting continuous protein breakdown. This weakens muscles, reduces mobility and physical strength, impairs recovery and increases the risk of illness.

Extended periods in this catabolic state can also weaken immunity, slow healing and affect bone health, hormonal balance and the body's ability to recover from illness. Protein-calorie malnutrition has been linked to impaired immune function, increasing the likelihood of infections.

Why Refeeding Must Be Gradual ?

Doctors caution that resuming food after prolonged fasting must be done carefully. The principal concern is refeeding syndrome, a condition that can trigger sudden falls in phosphate, potassium, magnesium and thiamine levels, leading to serious heart, nerve and breathing complications.

During fasting, the body relies mainly on fat and ketones for energy. Once food is reintroduced, insulin levels rise rapidly, causing cells to absorb glucose and electrolytes.

If feeding begins too quickly, these sudden shifts can overwhelm an already depleted system. Medical supervision during refeeding helps maintain electrolyte balance and reduces the risk of complications.