理性减肥:减肥应以健康为本
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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日国际刑警组织发出全球性橙色警告，称2.4-二硝基苯酚（简称DNP）可致人死亡。该化学成分常用于制作减肥药物，曾在2012年致使一名英国女性服用死亡。随着肥胖人群在全球范围内的大幅增加和“瘦身风尚”的愈演愈烈，五花八门的减肥方式也相继出现。肥胖人士和“爱美”一族往往盲目尝试未经科学验证的减肥方法，由此发生了无数悲剧，而这也使人们不得不重拾理性，反思减肥的前因后果。
十九世纪的欧洲女性为了优雅的姿态都会穿上束腰内衣，以木板、鲸骨和金属条的压迫来塑造挺直的上身曲线和纤瘦的细腰。为了苗条，女人们绑紧勒带，紧紧箍扎，直到两肋出现深入肌肤的伤口。许多人甚至因此丧命。
一个多世纪过去了，人们依然疯狂。如今，几乎每个人都可以在身边找到三五个意欲减肥或正在减肥的朋友。减肥不仅作为一种应对肥胖症的治疗手段，更成为了一股瘦身爱美的风潮。在网页中搜索“减肥”一词，“苹果减肥法”、“七日瘦身汤”、“郑多燕减肥操”、“日本酵素”、“减肥茶”、“吸脂手术”……成千上万的方法令人眼花缭乱。各种“无毒无副作用”“一周甩10斤”等疯狂的标语使人恍惚以为减肥是如此轻松的一件事。然而，减肥真的那么简单吗？
Diet pill， also pesticide
既是减肥药，也是杀虫剂
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.
比起需要强大意志力的节食或运动减肥法，只需按时服用几粒小小的药片即可瘦身的减肥药显得如此轻松便利，它也因此成为了许多工作繁忙或意志薄弱的减肥人士的首选。但如果含有危害性的化学成分，小小的药片直接进入肠胃，融于血液后，带来的后果却是无法挽回的。
2012年9月24日，英国利兹大学医学院一名23岁的女学生萨拉・休斯顿死于自己房间。临死前，休斯顿曾服用了处方抗抑郁药及几粒通过网络从西班牙卖家那里买的减肥药。2013年4月22日检验报告证实休斯顿的死因正是减肥药中的2，4-二硝基苯酚成分（2.4-dinitrophenol，DNP）。
这并不是DNP造成的第一起死亡事故。自2008年起，仅英国就先后有五人因服食含DNP的减肥药身亡，一名法国男子服食后也仍在重病。《医学毒理学杂志》刊登的一份研究显示，DNP已在全球造成62人死亡。实际上，早在上世纪30年代，DNP作为可以加速新陈代谢的减肥药就曾风靡一时。但轻则头晕作呕，重则体温急升、心率紊乱的副作用和大量的死亡病例使美国药监局在1938年将其禁止。令人震惊的是，DNP从来没有过合法的临床试验报告，也就是说，被众人当作减肥药服用的它甚至不能算药品。
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？简单地说，它是一种抑制剂，能够直接作用于能量代谢。人摄入食物后，有机物的能量需要在细胞的线粒体中转化为三磷酸腺苷（ATP）的形式才能直接用于生命活动，而DNP会阻断这一转化活动，降低ATP的生成效率，从而促使身体分解脂肪供能，达到减肥的目的。但是，这种阻断能量转化的过程会产生大量的额外热量，导致人的体温急升，而高体温又可能引起抽搐、昏迷、白内障等症状，十分危险。同时，利用这种抑制作用，DNP也常用于杀虫剂的制作，它甚至在一战期间还是炸药的原料之一。
现在，虽然各国政府规定DNP只能用于化工产业和科研领域，禁止进行商品注册以及作为减肥药发售，但监管却漏洞重重。一方面，作为杀虫剂，DNP仍然能轻易买到，另一方面，通过网络，DNP仍然作为“最佳减肥产品”得以贩售。据英国《独立报》称，这样的减肥药在网络上一瓶50粒，售价85欧元，打折后仅79欧元。而事发之后，英国食品标准局将监管不力的责任推给了药监机构，药监机构又表示，由于DNP不属于药品，因此无法对生产者与销售商采取法律措施。
除了政府监管的漏洞以外，人们盲目选择DNP减肥药的现象也值得反思。近几年服用DNP减肥药身亡的大多是年轻人，大部分人甚至不属于肥胖人群，比如2013年一名18岁姑娘萨玛德・阿拉丁服用DNP减肥的理由就是“痴迷瘦身”。人们一旦被减肥药轻松便捷的特点所吸引，往往就会忽视它蕴含的危险。
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只是减肥药危险成分中的冰山一角。更为中国百姓熟知的“曲美”减肥药，也一度因其含有增大心脑血管疾病患病风险的化学成分西布曲明（Sibutramine）而被撤回。西布曲明作用于神经中枢，通过抑制食欲来达到减肥的目的。1997年经美国FDA批准上市风靡全球，随后内分泌失调、引起心脏病发作等副作用逐渐暴露，数十人因此身亡。2002年欧盟展开了长达六年的对照实验SCOUT（Sibutramine Cardiovascular Outcome Trial）。该实验共有9800名55岁以上，有过心脏病和糖尿病史的肥胖病人参与。实验证明，服用西布曲明者平均只多减掉2公斤到4公斤，但心血管疾病风险大幅增加。这项研究使各国纷纷叫停西布曲明的生产与发售。但由于成本低廉且确有一定减肥效果，许多不法商家仍然在减肥产品中偷偷掺入西布曲明，造成严重的健康隐患。
除此之外还有会引起嗜睡、抑郁，甚至心脏瓣膜疾病的芬氟拉明；虽然从天然成分中提取，但仍然会导致心律不齐的麻黄素；长期服用导致肾功能衰竭的利尿剂……人们总是在悲剧发生之后才试图了解并记住这些名字。药物减肥的方法本身是可取的，但它是医学上针对肥胖症或超重者，配合详细的治疗计划采用的治疗手段。体重并未超标，仅仅只是想“更瘦”的人服用减肥药可能会付出未曾料想过的代价。古人云：“是药三分毒”，何况是未经临床实验认证的减肥药。本着对自己的健康负责的态度，采用药物减肥需要理性思考，慎重考虑既有风险，最好经过医生或药剂师的认可再服用。
From diet to anorexia
从节食到厌食
"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.
“起床后两杯水；早餐200毫升蔬菜汁；中餐500克优酪乳；晚餐200毫升蔬菜汁；就寝前1至2杯水。”这是网络上流行的减肥食谱之一，被称为“优酪乳减肥瘦身食疗法”。还有连续三天只吃苹果的“苹果减肥法”，只喝蜂蜜水的“蜂蜜减肥法”，都纷纷受到网友追捧。如果说减肥药的悲剧是普通人难以识别其中危险的化学成分造成的，那么盲目节食导致的疾病就是人们缺乏理性，健康观念错位的表现。
大多数的减肥食谱都直接杜绝了主食和肉类的摄入，但中国营养学会的《中国居民膳食指南》（2007年）强调，每日膳食必须合理搭配碳水化合物、蛋白质和脂肪三大供能物质，尤其是提供碳水化合物的谷薯类主食，在平衡膳食宝塔中占最大比重，每人每天应摄入250克至400克。人体生命活动所需的热能有70%是由碳水化合物提供的，长期不吃主食会出现心慌，头晕，精神萎靡等低血糖症状。由于大脑能量只能由葡萄糖供能，因而主食摄入不足还会导致记忆力下降，明显乏力等症状。极端的减肥食谱或许可以让人在短时间内体重下降，但其造成的营养不良、肠胃疾病则是长久的健康问题。
当节食变本加厉，成为一种生理和心理的强迫，就有可能发展成神经性厌食症。据英国《每日邮报》5月21日报道，美国加利福尼亚的37岁女星蕾切尔・弗莱迪（Rachael Farrokh）因减肥患厌食症，从113斤锐减至36斤，整个人瘦得只剩“皮包骨头”，呼吸困难，现已无法下地行走，医院也无法承担风险，致使她只能发视频向网友们求助。中国《扬子晚报》曾在2014年报道过一名身高169厘米，体重却只有79斤的90后苏州女孩，高中时因跟风减肥而患厌食症，结果导致便秘，闭经，身体各项机能退化等症状，家里已花费近40万的医疗费。
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症，厌食症更是一种心理障碍。据美国精神协会的诊断统计，就总体水平而言，厌食症患者的体重低于标准人体体重的15%。厌食症患者往往将身材形象和自我价值绑定，将减肥绝食当作自己奋斗的证明，一旦进食便有极深的罪恶感，接着就采取催吐或服用泻药的方式“挽回”。虽然已经消瘦，但仍然觉得自己在发胖的心理已经变成一种自我体像判断错误的精神障碍。
厌食症的死亡率高达20%，各国政府逐渐依照相关法律法规从时尚界入手进行整治。在欧洲，西班牙已经立法禁止体重指数过低的模特参加马德里时装走秀；意大利则要求参加时装表演的女性提供健康证明；法国国会议员4月3日通过法案，将时尚机构聘用过瘦的模特定为犯罪。聘用者将可能面临6个月的监禁和75000欧元的罚款，同时规定所有宣传厌食的行为均属违法。值得注意的是，厌食症多见于青少年，发病年龄多在13至25岁期间，主要罹及女性，男性与女性患病比例约为1：9.5。因此，关注青春期女性的身心发展，正确引导其建立以自然健康为美的审美标准就显得尤为重要。另外，合理的节食的确是安全有效减肥的手段之一，但这并不意味着“吃得越少越好”，而是要杜绝暴饮暴食，在保证营养充足的情况下调整肉多糖多蔬果少的饮食结构。科学的饮食习惯不仅对肥胖人士来说至关重要，对于每个人来说都是健康身体与美丽身材的基石。
Returnng to health
减肥应回归健康
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.
除了减肥药和厌食症以外，青春期减肥导致发育不良；吸脂手术产生并发症；为了快速减肥进行高强度运动导致膝盖与脚踝的运动伤害等等，人们一直在与肥胖斗智斗勇，结果却常常是以健康为代价，得不偿失。但这似乎并没有阻止人们前赴后继加入减肥大军的脚步。一些人为了减肥所展现出的“勇敢”和“坚毅”令人瞠目结舌，也让人不禁要问，在如火的减肥热情下，人们是否真的思考过减肥的目的和意义。
据2014年美国华盛顿大学的数据，全球如今有三分之一的人超重或肥胖。过去30年里，中国的肥胖率急剧上升，导致4600万成人肥胖，3亿人超重，儿童肥胖率更加严重。肥胖往往是糖尿病、高血压、睡眠呼吸暂停等疾病的源头，美国每年因肥胖症而增加的死亡人数在111999到365000之间。毫无疑问，肥胖是一个全球性的问题，威胁着人的生命。减肥也因此迫在眉睫，成为用科学方法分析肥胖者饮食与运动类型，以此为基础，合理修正其生活方式的行为。由此可以知道，减肥最本质的意义在于使肥胖者回归健康的生命状态，免受肥胖疾病的困扰。
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 false 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.
事实上，随着21世纪“以瘦为美”的审美标准深入人心，许多正常体重范围内的人反而构成了减肥的主力军。重要的原因之一是各类媒体、商家都在着力塑造过于夸张的理想性别形象：女人们细腰平腹，高挑纤瘦；男人们八块腹肌，强壮健硕。原本，身体形象是极其私人化的事情，因为全社会统一的，铺天盖地的纤瘦健美的形象宣传，人们潜移默化地将这些大都经过了美工处理的形象作为了真实的美的标准。这样的后果就是身材不再只是身体形态本身，而和人格价值、社会交际、职业发展等等领域联系在一起，减肥的目的已经从健康偏置到“更受欢迎”“获得更多机会”上。
当然，“环肥燕瘦”，每个时代都有独特的审美标准，人人皆有爱美之心。适当的身材管理有助于增加自信，但将自我价值全部投射在身材与样貌上，为了减肥不惜牺牲健康，毫无疑问是扭曲而畸形的行为。因此，人们应在时代潮流中保持清醒的自我意识，明确自我的审美标准和价值认知，不要盲目跟风减肥。即便决定减肥，也要首先树立正确的减肥观念：减肥应以健康为本。选择科学合理的减肥方法，将平衡膳食与固定运动的习惯融于日常生活，向着匀称、自然的身材和饱满、健康的精神状态不断努力。