理性減肥：減肥應以健康為本

On May 4， 2015， the Interpol issued a global warning in an orange alert notice that， 2.4-dinitrophenol （DNP） may lead to death. This chemical is commonly used as an ingredient of weight loss drug， and it has claimed the life of a woman from UK in 2012. With the substantial bulge of obese population and the increasing popularity of \"diet wave\"， a variety of ways to lose weight crops up. Many obese people and those who value their appearances tend to try out some diet recipes which have not been tested， resulting untold tragedies and invoking people to reflect on their choice.

In the 20th century， women in Europe wore basquines to build an upright bodice figure and a slender waist with wood， whalebone and metal strip so as to keep a graceful bearing. They tightened the belt fast so hard till their ribs showed wounds cut deep into their skin. And some even died of this practice.

Over 100 years passed， some are still crazy about it. Till now， it's common to pick out a couple of our friends who are now or about to be on a diet. Diet is not only taken as a way to cure obesity， but as a way of \"slimming and getting prettier\". If Google the word \"diet\"， numerous methods of losing weight will crop up， including \"apple diet\"， \"seven-days weight loss soup\"， \"Slimnastics taught by Jung Da Yeon\" ， \"Enzymes from Japan\"， \"diet tea\"， \"liposuction surgery\" and so on. Crazy slogans like \"non-toxic and no side effect\"， \"dumping 10 kilograms in a week\" trick people into believing that losing weight is a piece of cake， but is it true？

2015年5月4日國際刑警組織發出全球性橙色警告，稱2.4-二硝基苯酚（簡稱DNP）可致人死亡。該化學成分常用于制作減肥藥物，曾在2012年致使一名英國女性服用死亡。隨著肥胖人群在全球范圍內的大幅增加和“瘦身風尚”的愈演愈烈，五花八門的減肥方式也相繼出現。肥胖人士和“愛美”一族往往盲目嘗試未經科學驗證的減肥方法，由此發生了無數悲劇，而這也使人們不得不重拾理性，反思減肥的前因后果。

十九世紀的歐洲女性為了優雅的姿態都會穿上束腰內衣，以木板、鯨骨和金屬條的壓迫來塑造挺直的上身曲線和纖瘦的細腰。為了苗條，女人們綁緊勒帶，緊緊箍扎，直到兩肋出現深入肌膚的傷口。許多人甚至因此喪命。

一個多世紀過去了，人們依然瘋狂。如今，幾乎每個人都可以在身邊找到三五個意欲減肥或正在減肥的朋友。減肥不僅作為一種應對肥胖癥的治療手段，更成為了一股瘦身愛美的風潮。在網頁中搜索“減肥”一詞，“蘋果減肥法”、“七日瘦身湯”、“鄭多燕減肥操”、“日本酵素”、“減肥茶”、“吸脂手術”……成千上萬的方法令人眼花繚亂。各種“無毒無副作用”“一周甩10斤”等瘋狂的標語使人恍惚以為減肥是如此輕松的一件事。然而，減肥真的那么簡單嗎？

Diet pill， also pesticide

既是減肥藥，也是殺蟲劑

Compared with losing weight by diet or exercise which requires great will power， losing weight only by taking several tablets makes the whole thing easy and convenient， which has become the top choice for those are busy or weak-willed but also want to lose several pounds. However， the result is unconceivable if the tablets which enter into our intestines and melt into our blood contains poisonous chemical ingredients.

On September 24， 2012， 23-year-old Sarah Huston， a student of Medical school of University of Leeds， UK， was found died in her own room. Huston had taken prescription antidepressant drug and several diet tablets which she bought from a retailer in Spain. The test result on April 22， 2013 proved that Huston was died of 2.4-dinitrophenol， DNP， an ingredient of the diet pill.

It's not the first death caused by DNP. Since 2008， five people are died of taking diet pills containing DNP only in UK and a French guy was seriously ill after ingesting it. A research by Medical Toxicology Journal showed that， worldwide 62 people are died of DNP. As a matter of fact， early in 1930s， DNP had been all the rage due to its effect of accelerating metabolism. However， its side effect， ranging from dizziness， nausea， rising temperature and disordered heart rate， which led to many deaths， had been noticed by US State Food and Drug Administration， and the latter had issued a ban on it. The shocking fact is that， there was never a legal clinical test report on DNP， that is to say， the pill which were taken by so many is hardly rated as a medicine.

比起需要強大意志力的節食或運動減肥法，只需按時服用幾粒小小的藥片即可瘦身的減肥藥顯得如此輕松便利，它也因此成為了許多工作繁忙或意志薄弱的減肥人士的首選。但如果含有危害性的化學成分，小小的藥片直接進入腸胃，融于血液后，帶來的后果卻是無法挽回的。

2012年9月24日，英國利茲大學醫學院一名23歲的女學生薩拉·休斯頓死于自己房間。臨死前，休斯頓曾服用了處方抗抑郁藥及幾粒通過網絡從西班牙賣家那里買的減肥藥。2013年4月22日檢驗報告證實休斯頓的死因正是減肥藥中的2，4-二硝基苯酚成分（2.4-dinitrophenol，DNP）。

這并不是DNP造成的第一起死亡事故。自2008年起，僅英國就先后有五人因服食含DNP的減肥藥身亡，一名法國男子服食后也仍在重病。《醫學毒理學雜志》刊登的一份研究顯示，DNP已在全球造成62人死亡。實際上，早在上世紀30年代，DNP作為可以加速新陳代謝的減肥藥就曾風靡一時。但輕則頭暈作嘔，重則體溫急升、心率紊亂的副作用和大量的死亡病例使美國藥監局在1938年將其禁止。令人震驚的是，DNP從來沒有過合法的臨床試驗報告，也就是說，被眾人當作減肥藥服用的它甚至不能算藥品。

So what is DNP？ To put it simply， it's a kind of depressor which can be directly used in energy metabolism. The energy organism needed to be transformed into ATP in the plastosome to be directly used in vital activities after taking food， a process which DNP could interdict and lower the generation efficiency of ATP， so as to make the body decompose fat and lose weight. Nevertheless， this process which blocks energy transfer can produce a huge quantity of extra heat to sharply increase people's temperature. And a high temperature could lead to convulsion， coma， cataract and other symptoms， which is very dangerous. Meanwhile， DNP is also applied into manufacturing of pesticide due to its effect of depressing， and it was even used as an ingredient of detonator during World War I.

Now although governments has stipulated that DNP can only be used in the chemical industries or research area and is forbidden to register as goods and sold as diet pills， many loopholes still exist. Firstly， as insectide， DNP is still easy to come by； moreover， DNP is still sold in the internet as \"the best product to lose weight\". According to The Independent Newspaper of UK， such a bottle containing 50 diet pills is sold in the internet at 85 euros， with 79 euros at discount. After the incident， UK Food Standards Agency shuffled the responsibility of ineffective management to drug administrative agency， which said however， DNP is not a medicine and no legal measures can be taken on its producers or retailers.

There are loopholes in government monitoring， and the phenomenon that people blindly taking DNP diet pills is also worth our reflection. Over recent years， many young people died of taking DNP diet pills. For example， the 18-year-old girl， Samad Aladdin， opted to use DNP for her addiction of \"slim bodybuilding\". Once allured by the outside nature of diet pills which is easy to buy and take， people tend to ignore the latent risks within.

那DNP到底是什么呢？簡單地說，它是一種抑制劑，能夠直接作用于能量代謝。人攝入食物后，有機物的能量需要在細胞的線粒體中轉化為三磷酸腺苷（ATP）的形式才能直接用于生命活動，而DNP會阻斷這一轉化活動，降低ATP的生成效率，從而促使身體分解脂肪供能，達到減肥的目的。但是，這種阻斷能量轉化的過程會產生大量的額外熱量，導致人的體溫急升，而高體溫又可能引起抽搐、昏迷、白內障等癥狀，十分危險。同時，利用這種抑制作用，DNP也常用于殺蟲劑的制作，它甚至在一戰期間還是炸藥的原料之一。

現在，雖然各國政府規定DNP只能用于化工產業和科研領域，禁止進行商品注冊以及作為減肥藥發售，但監管卻漏洞重重。一方面，作為殺蟲劑，DNP仍然能輕易買到，另一方面，通過網絡，DNP仍然作為“最佳減肥產品”得以販售。據英國《獨立報》稱，這樣的減肥藥在網絡上一瓶50粒，售價85歐元，打折后僅79歐元。而事發之后，英國食品標準局將監管不力的責任推給了藥監機構，藥監機構又表示，由于DNP不屬于藥品，因此無法對生產者與銷售商采取法律措施。

除了政府監管的漏洞以外，人們盲目選擇DNP減肥藥的現象也值得反思。近幾年服用DNP減肥藥身亡的大多是年輕人，大部分人甚至不屬于肥胖人群，比如2013年一名18歲姑娘薩瑪德·阿拉丁服用DNP減肥的理由就是“癡迷瘦身”。人們一旦被減肥藥輕松便捷的特點所吸引，往往就會忽視它蘊含的危險。

DNP is just the tip of the iceberg among the risky factors in diet pills. \"Sibutramine\" diet pill which is more familiar with Chinese people once was recalled due to its ingredient Sibutramine， which can increase the risks of catching cardiovascular and cerebrovascular diseases. Sibutramine acts on the neural center and helps lose people's weight through inhibiting appetite. Since it was approved by FDA in US， it was once popular all over the world， but its side-effects like causing endocrine dyscrasia， and heart attack， and so on killed dozens of people. In 2002， the EU launched a six-year-long control experiment SCOUT （Sibutramine Cardiovascular Outcome Trial）. There are 9，800 obese people aged above 55 and had the history of heart attack and diabetes to participate in it. The experiment showed that， those who took Sibutramine lose at most 2 to 4 kilos， but the risk of catching cardiovascular disease increased largely. The result made all governments stop the practice of producing and selling of Sibutramine. But due to its low cost and real effect on losing weight， some illegal producers still add Sibutramine in its products and make their customers more prone to health risks.

Besides， there is also fenfluramine which can cause drowsiness， depression and even heart valve disease； ephedrine which is although extracted from natural ingredients can still cause arrhythmia； diuretic which can cause kidney failure if taking for a long time…it seemed that we never try to learn these names until tragedies occur. Weight reduction with drugs is workable， but it only works on obese groups with detailed treatment plan. If your weight does not exceed the standard， and you just want to look \"thinner\"， the cost will be unimaginable. As the saying goes like， \"all drugs have some degree of toxic\"， not to mention the diet pills which has not gone through clinical trial. Losing weight with drugs should be considered rationally， the risks should be taken into consideration for the sake of healthiness and one better take it after gaining the approval of doctors or pharmacist.

DNP只是減肥藥危險成分中的冰山一角。更為中國百姓熟知的“曲美”減肥藥，也一度因其含有增大心腦血管疾病患病風險的化學成分西布曲明（Sibutramine）而被撤回。西布曲明作用于神經中樞，通過抑制食欲來達到減肥的目的。1997年經美國FDA批準上市風靡全球，隨后內分泌失調、引起心臟病發作等副作用逐漸暴露，數十人因此身亡。2002年歐盟展開了長達六年的對照實驗SCOUT（Sibutramine Cardiovascular Outcome Trial）。該實驗共有9800名55歲以上，有過心臟病和糖尿病史的肥胖病人參與。實驗證明，服用西布曲明者平均只多減掉2公斤到4公斤，但心血管疾病風險大幅增加。這項研究使各國紛紛叫停西布曲明的生產與發售。但由于成本低廉且確有一定減肥效果，許多不法商家仍然在減肥產品中偷偷摻入西布曲明，造成嚴重的健康隱患。

除此之外還有會引起嗜睡、抑郁，甚至心臟瓣膜疾病的芬氟拉明；雖然從天然成分中提取，但仍然會導致心律不齊的麻黃素；長期服用導致腎功能衰竭的利尿劑……人們總是在悲劇發生之后才試圖了解并記住這些名字。藥物減肥的方法本身是可取的，但它是醫學上針對肥胖癥或超重者，配合詳細的治療計劃采用的治療手段。體重并未超標，僅僅只是想“更瘦”的人服用減肥藥可能會付出未曾料想過的代價。古人云：“是藥三分毒”，何況是未經臨床實驗認證的減肥藥。本著對自己的健康負責的態度，采用藥物減肥需要理性思考，慎重考慮既有風險，最好經過醫生或藥劑師的認可再服用。

From diet to anorexia

從節食到厭食

\"Two glasses of water， 200 ml vegetable juice for breakfast， 500g buttermilk for lunch， 200ml vegetable juice for supper， and 1-2 glass of water before going to bed\" is the one of the popular diet recipes in the internet， and named as \"the Diet Therapy by Eating Buttermilk\". There are also other recipes， like \"Apple Diet\" which requires people to eat apples for three successive days， and \"Honey Diet\" which requires people only to drink honey water. They are all well received by the internet users. If to say the tragedy of diet pills is caused by the hazardous ingredient which in indiscernible for common people， then disease caused by blindly diet eating is due to the lack of reason and the wrong notion of healthiness.

A majority of diet recipes directly block the intake of staple food and meats. But The Dietary Guideline for Chinese Citizens released by Chinese Nutrition Society in 2007 stressed that， our daily food must contain the three food which provides energy including carbonhydrate， protein and fat， especially staple food of grain and potatoes which provides carbonhydrate make up for a large portion in the Balance Diet Pagoda and should be taken 250g to 400g per capita per day. 70% of the heat energy required by the vital activity of our body is provided by carbonhydrate. If we do not eat carbonhrydate for a long time， we may show haziness， drooping spirit and other symptoms of hypoglycemia. And since our brain can only be supplied by glucose for energy， insufficient of staple food will lead to memory deterioration， feebleness and other symptoms. Extreme diet recipes may help us lose weight in a very short time， it may also cause malnutrition， and stomach disease， which are chronic health problems.

When one practicing diet so hard that it become an obsession in body and mentality， it may be deteriorated into anorexia nervosa. According to a report of Daily Mail in UK on May 21， the 37-year-old actress Rachael Farrokh was caught with Anorexia nervosa because of practicing diet， and losing her weight from 113 kilos to 36 kilos， becoming \"only skin and bone\". She now suffers from difficulty in breathing and walking. The hospital did not want to take risk and she can only asked for help via videos in the internet. Yangzi Evening Paper ran a story in 2014 about a post-90 girl from Suzhou who is 169 centimeters high but with only 79 kilos. She was caught with anorexia in high school when followed the diet trend， which led her to constipation， amenorrhea， degeneration of functions and other symptoms， the medical cost as high as 400，000RMB.

“起床后兩杯水；早餐200毫升蔬菜汁；中餐500克優酪乳；晚餐200毫升蔬菜汁；就寢前1至2杯水。”這是網絡上流行的減肥食譜之一，被稱為“優酪乳減肥瘦身食療法”。還有連續三天只吃蘋果的“蘋果減肥法”，只喝蜂蜜水的“蜂蜜減肥法”，都紛紛受到網友追捧。如果說減肥藥的悲劇是普通人難以識別其中危險的化學成分造成的，那么盲目節食導致的疾病就是人們缺乏理性，健康觀念錯位的表現。

大多數的減肥食譜都直接杜絕了主食和肉類的攝入，但中國營養學會發布的《中國居民膳食指南》（2007年）強調，每日膳食必須合理搭配碳水化合物、蛋白質和脂肪三大供能物質，尤其是提供碳水化合物的谷薯類主食，在平衡膳食寶塔中占最大比重，每人每天應攝入250克至400克。人體生命活動所需的熱能有70%是由碳水化合物提供的，長期不吃主食會出現心慌，頭暈，精神萎靡等低血糖癥狀。由于大腦能量只能由葡萄糖供能，因而主食攝入不足還會導致記憶力下降，明顯乏力等癥狀。極端的減肥食譜或許可以讓人在短時間內體重下降，但其造成的營養不良、腸胃疾病則是長久的健康問題。

當節食變本加厲，成為一種生理和心理的強迫，就有可能發展成神經性厭食癥。據英國《每日郵報》5月21日報道，美國加利福尼亞的37歲女星蕾切爾·弗萊迪（Rachael Farrokh）因減肥患厭食癥，從113斤銳減至36斤，整個人瘦得只剩“皮包骨頭”，呼吸困難，現已無法下地行走，醫院也無法承擔風險，致使她只能發視頻向網友們求助。中國《揚子晚報》曾在2014年報道過一名身高169厘米，體重卻只有79斤的90后蘇州女孩，高中時因跟風減肥而患厭食癥，結果導致便秘，閉經，身體各項機能退化等癥狀，家里已花費近40萬的醫療費。

Apart from a series of physiological symptoms， anorexia is also a mental illness. According to the statistic of American Psychiatric Association， overall the weight of the patients of anorexia is 15% less of the standard weight. The patients tend to connect body images with self values， regard fasting and diet as the proof of their efforts. Once they eat something， they feel guilty and will \"remedy\" by emetic or taking laxative. The mentality that always thinking self is too fat despite being emaciated in reality becomes a wrong spiritual disorder for self judgment.

The death rate of anorexia reaches 20%， and all governments have taken measures to rectify this trend by starting from the fashion circle. In Europe， Spain has legislation to ban models below the body mass index to walk on the Madrid Catwalks； Italy asks females walking in fashion show to provide health certificate； and the Congress of French passed a bill on April 3， ruling that the act of hiring the too skinny models by fashion companies as crimes. Noticeably， anorexia is more found among youth and teenagers， and the onset age mostly ranging from 13-25. And it's more common found among females than males， with a illness ratio of 1： 9.5. Hence， it's rather important to pay close attention to the physical and mental development of female in puberty， and scientifically guide them to build an aesthetical standard which regards natural health as beauty. Besides， scientific diet is one of the safe and effective ways to lose weight， but it does not equal to \"eating less， the better\". It means putting an end to gluttony， and adjusting the dietary structure of more meat， more sugar， but less vegetables and fruits while maintaining the nutritional balance. A scientific dietary habit is not only essential for obese people， but also constitutes a cornerstone for everybody to have a healthy and beautiful body.

除了一系列的生理病癥，厭食癥更是一種心理障礙。據美國精神協會的診斷統計，就總體水平而言，厭食癥患者的體重低于標準人體體重的15%。厭食癥患者往往將身材形象和自我價值綁定，將減肥絕食當作自己奮斗的證明，一旦進食便有極深的罪惡感，接著就采取催吐或服用瀉藥的方式“挽回”。雖然已經消瘦，但仍然覺得自己在發胖的心理已經變成一種自我體像判斷錯誤的精神障礙。

厭食癥的死亡率高達20%，各國政府逐漸依照相關法律法規從時尚界入手進行整治。在歐洲，西班牙已經立法禁止體重指數過低的模特參加馬德里時裝走秀；意大利則要求參加時裝表演的女性提供健康證明；法國國會議員4月3日通過法案，將時尚機構聘用過瘦的模特定為犯罪。聘用者將可能面臨6個月的監禁和75000歐元的罰款，同時規定所有宣傳厭食的行為均屬違法。值得注意的是，厭食癥多見于青少年，發病年齡多在13至25歲期間，主要罹及女性，男性與女性患病比例約為1：9.5。因此，關注青春期女性的身心發展，正確引導其建立以自然健康為美的審美標準就顯得尤為重要。另外，合理的節食的確是安全有效減肥的手段之一，但這并不意味著“吃得越少越好”，而是要杜絕暴飲暴食，在保證營養充足的情況下調整肉多糖多蔬果少的飲食結構。科學的飲食習慣不僅對肥胖人士來說至關重要，對于每個人來說都是健康身體與美麗身材的基石。

Returnng to health

減肥應回歸健康

Losing weight in puberty can also cause mal-development besides anoxeria； liposuction surgery can have complication； high strength exercise to lose weight fast can cause sport injury in knees and ankles， etc.. People have always fought obesity with courage and wit， but the result is always at the cost of health， not worth the candle. But this seems do not halt people's steps to join into the bandwagon of losing weight. It's shocking for the \"courage\" and \"stamina\" displayed by some people's efforts in losing weight. And one cannot help but ask that， do we really consider the goal and meaning of losing weight， amid all the heat of losing weight.

According to the data from University of Washington in 2014， about one third of the people in the world are overweight or obese. In the past 30 years， obesity in China rose sharply， with 46million obese adults and 300million overweight people. Children obesity is even worse. Obesity becomes the culprits for diabetes， high blood pressure， sleep apnea-hypopnea syndrome and other diseases. The casualty resulting from obesity in US reached 111，999 to 365，000. Undoubtedly， obesity is a global issue， threatening people's life. Losing weight becomes more urgent and an act of analyzing the diet and exercise type of obese group and taking the result as the basis to scientifically rectify one's lifestyle. So， the ultimate meaning of losing weight is make obese group returning to a healthy life state so as to be free from obesity diseases.

除了減肥藥和厭食癥以外，青春期減肥導致發育不良；吸脂手術產生并發癥；為了快速減肥進行高強度運動導致膝蓋與腳踝的運動傷害等等，人們一直在與肥胖斗智斗勇，結果卻常常是以健康為代價，得不償失。但這似乎并沒有阻止人們前赴后繼加入減肥大軍的腳步。一些人為了減肥所展現出的“勇敢”和“堅毅”令人瞠目結舌，也讓人不禁要問，在如火的減肥熱情下，人們是否真的思考過減肥的目的和意義。

據2014年美國華盛頓大學的數據，全球如今有三分之一的人超重或肥胖。過去30年里，中國的肥胖率急劇上升，導致4600萬成人肥胖，3億人超重，兒童肥胖率更加嚴重。肥胖往往是糖尿病、高血壓、睡眠呼吸暫停等疾病的源頭，美國每年因肥胖癥而增加的死亡人數在111999到365000之間。毫無疑問，肥胖是一個全球性的問題，威脅著人的生命。減肥也因此迫在眉睫，成為用科學方法分析肥胖者飲食與運動類型，以此為基礎，合理修正其生活方式的行為。由此可以知道，減肥最本質的意義在于使肥胖者回歸健康的生命狀態，免受肥胖疾病的困擾。

In fact， with the aesthetics notion of \"skinniness is beauty\" popular around the world in the 21st century， many people with normal weight become the main force of losing weight. One of the reasons is that media and many companies try to build an exaggerated ideal gender image with women of slender waist and flat abdomen and men of abdominal muscle. The body image is originally regarded as a private matter， but thanks to the universality and the hype of advertisement on slim and muscular figure， people tend to take these 1 images beautified by Photoshop as the true beauty standard unwittingly. The result is the figure does not only represent figure， but one which is tied with the personality， values， social intercourse， professional development and other things， and the aim of losing weight is deviated to \"becoming more popular\" and \"gaining more opportunities\".

Of course， \"each woman is beautiful in her own way\"， every era has its unique standard for beauty and every one have a \"love for beauty\". Reasonable body management can build up confidence， but projecting one's self value totally on figure and appearances， and scarifying health for losing weight are without doubt a distorting and abnormal act. Hence， we should keep calm against the wave of the era， have a defined standard for beauty and value recognition， instead of following the bandwagon of losing weight blindly. Once we decided to lose weight， we first need to set up a correct notion of losing weight， which should be based on healthiness. We need to opt for a scientific method， integrate the habit of balanced diet and routine exercise into our daily life， and strive for a symmetrical and natural figure and a vigorous and healthy spirit.

事實上，隨著21世紀“以瘦為美”的審美標準深入人心，許多正常體重范圍內的人反而構成了減肥的主力軍。重要的原因之一是各類媒體、商家都在著力塑造過于夸張的理想性別形象：女人們細腰平腹，高挑纖瘦；男人們八塊腹肌，強壯健碩。原本，身體形象是極其私人化的事情，因為全社會統一的，鋪天蓋地的纖瘦健美的形象宣傳，人們潛移默化地將這些大都經過了美工處理的形象作為了真實的美的標準。這樣的后果就是身材不再只是身體形態本身，而和人格價值、社會交際、職業發展等等領域聯系在一起，減肥的目的已經從健康偏置到“更受歡迎”“獲得更多機會”上。

當然，“環肥燕瘦”，每個時代都有獨特的審美標準，人人皆有愛美之心。適當的身材管理有助于增加自信，但將自我價值全部投射在身材與樣貌上，為了減肥不惜犧牲健康，毫無疑問是扭曲而畸形的行為。因此，人們應在時代潮流中保持清醒的自我意識，明確自我的審美標準和價值認知，不要盲目跟風減肥。即便決定減肥，也要首先樹立正確的減肥觀念：減肥應以健康為本。選擇科學合理的減肥方法，將平衡膳食與固定運動的習慣融于日常生活，向著勻稱、自然的身材和飽滿、健康的精神狀態不斷努力。