We were all moved to tears watching the hostages return home to their families after two long and harrowing years in captivity. At first glance, some may appear unharmed or not visibly malnourished – but this is merely an illusion.
Two years of deprivation inevitably result in malnutrition, even if body weight suggests otherwise. Beneath the clothes, the loss of muscle mass and the depletion of essential vitamins and minerals are often hidden, yet they are critical for the proper functioning of the body’s systems.
The extreme conditions described by hostages who were previously released point to severe nutritional deficiency. Such circumstances can lead to damage to the nervous and immune systems, anemia, gastrointestinal disruptions, and body pain.
Therefore, in the initial acute phase, close medical and nutritional supervision is essential to prevent refeeding syndrome – a potentially life-threatening condition.
Refeeding syndrome occurs when an individual who has been fasting or consuming minimal food begins to eat again. The longer the period of deprivation, the more the body shifts into a breakdown state.
When feeding resumes, vital electrolytes such as potassium, magnesium, and phosphorus move back into the cells, leaving dangerously low levels in the bloodstream.
This can cause cardiac and respiratory complications. A gradual, carefully monitored return to normal eating is therefore vital, allowing the body to rebuild itself safely and restore essential mineral balance.
Naturally, families want to shower their loved ones with favorite foods upon their return.
As clinicians, we often see this instinct among families caring for patients after prolonged hospitalization. However, overfeeding – especially with carbohydrates – can be harmful.
The diet of returning hostages must be carefully managed. Families can be guided toward alternative, safe ways to express their love and support without endangering their loved one’s recovery.
Rebuilding the body, step by step
From our extensive clinical experience in rehabilitation, the goal is to rebuild the body gradually and gently, with close monitoring of blood tests and physical indicators.
The initial phase includes small portions and soft textures, based on the individual’s tolerance and condition. Gradually, the diet becomes more varied and substantial, tailored to each patient’s unique needs.
It is important to remember that the mouth also contains muscles, and proper chewing and swallowing require adequate muscle function. Significant muscle loss may initially make even these basic actions difficult.
The primary goals are to replenish nutritional deficiencies, rebuild muscle mass, and promote controlled weight gain – without overburdening the heart and other systems.
Nutrition should be based on all food groups, emphasizing proteins, complex carbohydrates, and essential fats. Foods rich in vitamins and minerals and with high nutritional value are key.
Muscle recovery does not depend on nutrition alone. Once the body is strong enough and medical clearance is given, physiotherapy and physical activity should be integrated.
These are essential for regaining strength, stability, and mobility that were lost due to prolonged immobility and confinement.
The hostages face a long rehabilitation journey in which nutritional rehabilitation is a vital component. Treatment must be holistic, multidisciplinary, and individualized, addressing both the physical and emotional state.
As a society, we must give the returnees the time and space they need to reintegrate into daily life in the best possible way.
The writer is head of the Nutrition and Dietetics Unit at Reuth Rehabilitation Hospital in Tel Aviv.