It’s essential that characters eat and drink enough to survive, but in the wasteland it isn’t always easy to find the necessary supplies.

Sources of food and liquids are abstracted into meals, drinks, solid snacks, and liquid snacks. Players should either keep track of their own food and drink supplies or the group may designate a volunteer as their quartermaster.

Starvation and Dehydration

A character needs at least two meals worth of sustenance and two bottles worth of water (or equivalent hydration) each in-game day.

Every day that a character goes without one or both of their meals, they gain that many points of Starvation. Similarly, going without one or both bottles of water gains that many points of Dehydration.

When a character has points in Starvation or Dehydration, they must make a Constitution saving throw at the beginning of the following day (usually after their next long rest). The DC is 8 + their starvation points + their dehydration points. Failure reduces the character’s Exhaustion track by one step. This Exhaustion is permanent until the character properly feeds and hydrates themselves for at least one day (see below). Success means that the character is ignoring the effects of their hunger and/or thirst, for now.

Returning to an Adequate Diet

Every day that a character eats at least two meals, they reduce their starvation by 2. Provided they aren’t also dehydrated, they also regain access to one step on their Exhaustion track. A character may eat three meals per day, if they have enough food, to reduce their starvation by 3 instead of 2.

Returning to an Adequate Level of Hydration

Every day that a character hydrates themselves with at least two canteens of water (or equivalent), they reduce their dehydration by 2. Provided they aren’t also starving, they also regain access to one step on their Exhaustion track. A survivor may drink three canteens worth of water per day, if they have enough, to reduce their dehydration by 3 instead of 2.


Snacks are sugary or caffeinated foodstuffs and beverages. One snack of either type can be consumed to temporarily recover a step of Exhaustion. Since this recovery is from the effects of a sugar or caffeine rush it doesn’t last, and the character moves one step along the Exhaustion track again at the end of the current encounter. A character may only gain the effects of imbibing an energy snack once per encounter.

Other than this, three edible snacks can also be consumed in place of a meal if the character doesn’t have anything healthier and more substantial available to them. Three liquid snacks can count as a single bottle worth of water.

Irradiated Food and Drink

Whether canned or bottled goods from before the Great War, or grown or sourced in the post-nuclear wastes, almost all sources of food and drink available are irradiated. All meals and bottles are assumed to be radioactive unless the GM specifies otherwise.

When a character consumes radioactive food or liquid on any given day, at the beginning of the next day (usually after their next long rest) they make a DC 10 Constitution saving throw. On a failed saving throw, the character gains a level of radiation poisoning.

If a character is fortunate enough to partake of fresh food or purified drink for some but not all of their daily rations, reduce the DC by 1 per non-radioactive meal or drink consumed that day. Naturally, if all meals and drinks consumed are non-radioactive, no saving throw is required.

Skipping a meal or drink also reduces the DC by 1. Eating and drinking nothing avoids the saving throw altogether. Abstaining from irradiated food and drink can work for avoiding the risks of radiation poisoning in the short term, though it means the character may instead face the consequences of starvation and dehydration (see above).


One way to track a character’s growing or decreasing dehydration and starvation is through the use of physical counters.

Counters for Dehydration and Starvation are included in the Fifth Edition Fallout Counters Pack. You can download the pack from the Fifth Edition Fallout page on the Spilled Ale Studios blog.

Instead of tallying Starvation and Dehydration scores on paper, the Game Master give a player between 0-2 Starvation counters and 0-2 Dehydration counters when they take a long rest, depending on how many meals and drinks they were able to consume that day.

  • If the character consumes 2 meals they receive 0 starvation counters, and if they consume 2 drinks they receive 0 dehydration counters.
  • If the character consumes 1 meal they receive 1 starvation counter, and if they consume 1 drink they receive 1 dehydration counters.
  • If the character consumes 0 meals they receive 2 starvation counters, and if they consume 0 drinks they receive 2 dehydration counters.

The number of Dehydration counters in a player’s possession is known as their character’s Dehydration Pool. Similarly, the number of Starvation counters they have is their Starvation Pool. The growing or shrinking collection of both types of counter on the table in front of the player is a physical reminder of their character’s current Dehydration and Starvation score.

As the PC manages to reduce their Starvation and Dehydration scores, they give the appropriate amount of counters from each pool back to the Game Master.

Fallout is the sole intellectual property of Bethesda Softworks. This is purely a fan work. Rules presented work with D&D 5e. Text and game mechanics presented in this wiki are not Open Game Content and should not be reproduced or repackaged in any way.