Fasting is the willful refrainment from eating for a period of time. In a physiological context, fasting may refer to the metabolic status of a person who has not eaten overnight, or to the metabolic state achieved after complete digestion and absorption of a meal. Several metabolic adjustments occur during fasting. Some diagnostic tests are used to determine a fasting state. For example, a person is assumed to be fasting once 8–12 hours have elapsed since the last meal. Metabolic changes of the fasting state begin after absorption of a meal (typically 3–5 hours after eating). A diagnostic fast refers to prolonged fasting from 1 to 100 hours (depending on age) conducted under observation to facilitate the investigation of a health complication, usually hypoglycemia. Many people may also fast as part of a medical procedure or a check-up, such as preceding a colonoscopy or surgery. Fasting may also be part of a religious ritual.