Wendigo, a high-level Z-class monster which normally hits using cold damage, but if the target is resistant to cold damage, it instead hits with Famine’s hunger-inducing damage type. If you commit cannibalism, you may polymorph into one (permanently?) as a side effect.

Attacking Famine with food should produce some slight effect, like minimal damage, the food disintegrating, or possibly no more than a YAFM about Famine looking offended.

Famine’s attack gives you some amount of temporary intrinsic hunger in addition to the direct damage to your nutrition it already does.

If you get hit with multiple illness attacks in the same turn, the second one functions like Famine’s attack, draining your nutrition, rather than speeding up your delayed instadeath.

Famine’s hungering attack takes the maximum of his current 40-80 nutrition and a large fraction (1/2 to 3/4) of your current nutrition.