Climate activist Sonam Wangchuk is still observing a fast after being hospitalised following 20 days of hunger strike. He has been seeking reform in the education system, and the resignation of Education Minister Dharmendra Pradesh over alleged irregularities in the NEET exam.
Wangchuk was taken from the Jantar Mantar protest spot to Safdarjung Hospital in the early hours on Saturday. The Cockroach Janata Party alleged Wangchuk was taken away “forcibly” by the Delhi Police.
Medical Superintendent Dr Charu Bamba of Safdarjung Hospital, where Wangchuk was admitted on Saturday, said he continues to refuse oral and intravenous fluid therapy despite repeated counselling by doctors. She told ANI that the activist remains conscious and clinically stable but is showing signs of dehydration.
Quick answers to key questions
Health risks of prolonged fasting include dehydration, electrolyte imbalances, and dangerously elevated ketone levels, which can lead to serious organ complications such as kidney dysfunction.
Sonam Wangchuk is refusing intravenous fluids despite being advised by doctors, as he continues his fast and is only consuming water with salt.
Fasting can become harmful when ketone levels in the blood exceed a certain threshold, leading to fatigue, organ damage, or worse, metabolic acidosis if the condition progresses unchecked.
Medical teams recommend interventions such as forced nutrition or forced feeding, including the administration of glucose intravenously, particularly if the individual refuses oral nourishment.
Yes, individuals on hunger strikes should consider medical advice seriously, as neglecting treatment can lead to critical health issues, including irreversible organ damage.
“He is definitely showing signs of dehydration. He needs treatment. But despite our counselling, he is refusing treatment. He is accepting neither oral rehydration fluid, electrolyte solution, nor IV therapy,” Bamba told ANI news agency on Saturday.
Wangchuk’s wife Gitanjali J Angmo also said Wangchuk is still fasting. “The fast is continuing because he isn’t consuming any sugar,” she said on Saturday.
“He is only taking the water with salt that he was consuming earlier… I am grateful that the government cared enough to bring him here, but we will handle the next steps ourselves; there is no need for government interference in this matter. He is definitely weak and losing muscle mass—which happens during any fast — but he is alert and very strong,” Wangchuk’s wife said.
When does fasting become harmful?
While commenting on activist Sonam Wangchuk’s hunger strike, General physician Dr M Wali explained the medical risks of extended fasting and said intervention may be required if ketone levels in the blood rise dangerously.
In an interview with ANI, Dr Wali said the formation of ketone bodies is a natural process during fasting. However, he cautioned that the benefits reverse once ketone levels cross a certain threshold.
He said, “Ketone bodies in the blood develop after fasting. We do fasting monthly or in some religions for 40 days and we do ‘vrat’ routinely. The practice of ‘vrat’ is very important, it stimulates healthy metabolism which includes ketone body formation. This ketone body formation is neutralised once we start taking food.”
“If the ketone level is around 0.3 mmol/L then it is not harmful. You can get fatigue, exhaustion and you may feel hungry. But if it reaches between this amount and up to 3, then this becomes very harmful to the body and various organs,” Dr M Wali said.
The physician noted that while ketones serve as nutrition for the brain, high levels in the blood can be dangerous.
Dr Wali said that in cases of prolonged hunger strikes, medical teams advise the individual to eat. If they refuse, “We are advising them forced nutrition or forced feeding.”
“Although ketone is the nutrition for brain, it is bad for blood. If it circulates in blood, it is called ketonemia. In diabetics, it is called ketoacidosis. So, these ketone levels, if they cross 3 are very harmful and in such cases, we ask such people who do hunger strike to eat and if they don’t follow the command, we are advising them forced nutrition or forced feeding,” he said.
The physician added, “Even if they don’t feel like taking orally, glucose can be given intravenously. Their vitals, blood pressure, hydration, pulse, oxygenation – everything has to be monitored and this can be done in hospital setup,” Dr. Wali added.
‘IV fluids becomes essential when…’
Another health expert, Dr. Suranjit Chatterjee, a senior consultant in Internal Medicine at Indraprastha Apollo Hospitals, emphasised how a “decompensated” state could become extremely harmful for an individual.
Explaining Wangchuk’s condition, Chatterjee said the issued report indicates “compensated metabolic acidosis.”
“Although ketone is the nutrition for brain, it is bad for blood. If it circulates in blood, it is called ketonemia. In diabetics, it is called ketoacidosis. So, these ketone levels, if they cross 3 are very harmful and in such cases, we ask such people who do hunger strike to eat and if they don’t follow the command, we are advising them forced nutrition or forced feeding,” he said.
The physician added, “Even if they don’t feel like taking orally, glucose can be given intravenously. Their vitals, blood pressure, hydration, pulse, oxygenation – everything has to be monitored and this can be done in hospital setup,” Dr. Wali added.
‘IV fluids becomes essential when…’
Another health expert, Dr. Suranjit Chatterjee, a senior consultant in Internal Medicine at Indraprastha Apollo Hospitals, emphasised how a “decompensated” state could become extremely harmful for an individual.
Explaining Wangchuk’s condition, Chatterjee said the issued report indicates “compensated metabolic acidosis.”
“This clearly means that the body is being affected and is suffering from dehydration. Dehydration leads to increased lactic acid production and acidosis, which can impact kidney function. However, the use of the term ‘compensated’ implies that the body is still fighting the condition,” he told ANI.
Chatterjee added that “compensation” occurs only when the body is actively trying to restore the imbalance.
“If the condition progresses to a ‘decompensated’ state, it could become extremely harmful. Once decompensation sets in, complications such as electrolyte imbalances, loss of consciousness (which could potentially lead to a coma), and injury or dysfunction of the liver and kidneys may occur,” Chatterjee said.
“Therefore, it is crucial to address issues such as electrolyte imbalances, particularly involving potassium and other substances vital for organ function at this stage. If left untreated, the damage could become irreversible and seriously detrimental,” Chatterjee added.
He said that at present, “we are at a stage where the body is still fighting the condition. Therefore, administering IV fluids and initiating nutritional support are essential. Beyond a certain point, the situation could become critical for the patient.”
