Famine, plague, and slaughters: The fleeing famine hypothesis of anorexia nervosa reconsidered.

The fleeing famine hypothesis (FFH) posits that a genetically and evolutionarily based predisposition for food restriction and hyperactivity is activated among susceptible humans and nonhumans upon experiencing a prolonged energy deficit. Such circumstances manifest in the counterintuitive responses to starvation that are characteristic of anorexia nervosa: continued dietary restriction, denial of declining physical state, and, in at least a subset of those with anorexia nervosa, increased motor activity. We consider the nine predictions derived by Guisinger (2003) in her original formulation of the FFH and evaluate the evidence regarding each, including, of course, evidence that has accumulated subsequent to the 2003 statement of the model. We further expand upon Guisinger's original hypothesis by addressing apparent contradictions, outlining important directions for future research, and discussing the clinical implications of the FFH. We conclude that the relevant literature is unsurprisingly imperfect but that, with a number of reconsiderations, the FFH has substantial explanatory scope. (PsycInfo Database Record (c) 2026 APA, all rights reserved).