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His stomach growled; he was hungry again. Dean remembered Purgatory, not eating the year he was there and being unable to bring himself to start once topside. About the third day back the hunger pains stopped. He'd had to stay bedridden the day after that, too weak to move, his heart pounding slow and heavy anytime he did.
Then, nothing.
He woke up without hunger and, while not 100%, strong enough to continue his journey to Louisiana. Once Dean reunited with Sam, he hoped to feel safe enough to eat, but whenever he went to get food goose bumps pricked the back of his neck and all his hair stood on end. He felt the monsters in the shadows, waiting for him to let his guard down. Dean didn't bother hiding it. Sam had his own issues to work through; why would he notice whether or not Dean white-knuckled the steering wheel while driving passed that taco joint? Why would Sam care if Dean excused himself to the restroom when he glimpsed the waitress coming over?
Sam noticed. Sam cared. Sam bought Dean food - watching like a fussy grandmother - until Dean was eating normally (normal for them anyway). The feeling of hunger returned with the first bite of greasy burger and Dean wolfed it down. He never told Sam how that first meal shot out one end or the other at the gas stations and motel they stopped at that night. Or how the next morning's coffee and donuts made his heart strum like a hummingbird's, so fast Dean was convinced it would give out. Dean felt every ounce of food he consumed, fighting the panic that he wouldn't be fast enough when they were attacked.
It took longer to get back into eating than it had to stop (even now he sometimes felt the increased heart rate and the nervous swallow, not quite shaking the feeling that this time something bad would happen because he was eating). The nausea and burning stomach cramps after every meal was enough to convince him to give it up again, but he ate what Sammy gave him without complaint, and Sam made the effort to provide food three times a day - more consistently than Dean had eaten since Mom was alive - only stopping when Dean brought lunch back without prompting.
Dean never learned if he would've starved himself to death because Sammy saved him.