The latest heavy fighting in the Damascus suburbs over the weekend left more than 160 fighters dead, according to activists cited by USA Today.

Aiming to crush the rebel resistance, forces aligned with Syrian President Bashar Assad have laid siege for months to rebel strongholds in the Ghouta area east of Damascus, preventing food, clean water, medicine and other supplies from entering.

The tactic reportedly has led to famine, helping government troops capture several rebel-held areas over the past month outside the Syrian capital, according to USA Today.