肥胖属于疾病范畴的10大原因(下)

ity Impacts on the Proper Working of the Body

5.肥胖影响身体正常运转

Ask a child what happens when you are sick or have a disease and the likelihood is that they will say that the disease stops 'some body part' working properly. Heart disease impacts the heart, lung disease the lungs etc. Obesity also impacts on the proper working of the body.

当你问小孩子生病会有什么感觉时，他们很可能会说那种不适使“身体某些部位”不能正常工作了。心脏病会影响心脏，肺病会影响肺部，肥胖也会影响身体的正常运转。

This impact on the body comes in two separate but connected ways. Firstly the increase in body mass can cause mechanical problems such as osteoarthritis, sleep apnoea and mobility problems. These will often be alleviated if the sufferer loses weight. Secondly the increase in the number of fat cells within the body can be the cause of a range of medical problems such as Heart Disease, Fatty Liver Disease, Infertility, High Blood Pressure etc. Such medical problems may not be easily reversed by a loss of weight.

肥胖对身体的影响主要有两个方面，而它们既相互独立又相互联系。第一，体重增加会导致机体问题，如骨关节炎、睡眠呼吸暂停和移动障碍。如果体重下降，那么这些病症也常随之减轻。第二，身体脂肪细胞数量的增加会导致一系列的健康问题，如心脏病、脂肪肝、不孕和高血压等，而这类健康问题就不会随体重的下降而得到缓解。

ity Works like Type II Diabetes

4.肥胖症的作用机理与2型糖尿病类同

When a person becomes obese their body starts to produce more of a hormone called Leptin than the bodies of people who are not. Leptin is responsible for telling the body when it is full in the same way that Insulin controls the body's response to Glucose. When a person produces too much Leptin they become resistant to it in the same way that someone with type II diabetes is resistant to Insulin.

一个人变得过于肥胖后，身体相较于正常人而言会产生更多称之为瘦蛋白（Leptin)的激素。这是一种传达身体饱腹程度的激素，就像胰岛素传达体内葡萄糖含量一样。当瘦蛋白过多，人会对其产生免疫作用，就跟二型糖尿病患者对胰岛素产生抗体一样。

As a person puts on weight their body secretes more Leptin – they are then no longer able to tell when they have eaten enough and so their body allows them to over-eat. Type II Diabetes is treated as a disease whether or not a person develops it as a result of genetic predisposition or as a result of a particular lifestyle. If this is true for Type II Diabetes then why not for obesity?

随着人们体重上升，身体分泌出更多瘦蛋白，既而无法得知自己的饱腹水平，这样一来就会过度饮食。不论二型糖尿病的病因是先天而来或是生活方式所致，人们都将其视作一种疾病来对待。所以，既然二型糖尿病受到了这种待遇，肥胖症又有何不可呢？

Body Adapts To a Specific 'set Point'

3.肥胖影响“体重固定值”

Most people will have a stable 'set point weight' – the weight to which their body defaults. The scales may go up or down but they generally sit at or around this point. As a person puts on weight the body becomes used to a new normal – the set point changes and creeps up. When a person tries to lose weight the body will default back to its set point – it 'defends' the weight. This is why diets are often inefficient unless the person concerned is able to make a wholesale lifestyle change. Even then the body will often try to revert back if the person 'slips'. Not unlike an alcoholic who is never cured a person who does manage to lose weight is not able to give up on their new regime at any time.

大多数人都有一个稳定的“体重固定值”，这是身体默认的。平时的体重或高或低于这个数值，但通常都与其相差无几。人的体重上升后，身体会适应一个新常态，这个固定值会缓慢上升。而当人们试图减掉几斤时，身体就自动想要回到那个“固定值”，捍卫原来的体重量。这也就解释了为什么饮食调节对于减肥不太有效，除非减肥者可以颠覆原有的生活方式。不过即使是这样，一旦减肥者稍有懈怠，身体就试图故态复萌。恰恰就如一个不可治愈的酗酒者一样，认真想要减肥的人也无法随心所欲地抛弃自己的饮食起居习惯。

ity Meets the Definition of 'Disease'

2.肥胖符合疾病的定义

There is no single definition of disease but Webster's dictionary defines it as 'An alteration of the state of the body or some of its organs, interrupting or disturbing the performance of the vital functions and causing or threatening pain and weakness; malady; affection; illness; sickness; disorder…'

疾病的定义并不是单一的，其中《韦氏词典》是这样解释的：一种身体和某些器官的变化；有碍于身体重要功能的发挥；导致疼痛、虚弱；身体失调；心情烦躁；身体不适；呕吐；机能紊乱。

Obesity meets this definition in all respects. It alters the body– not only by increasing the size of the person suffering from the disease but by affecting the way in which the body produces or metabolises substances; by altering how efficiently some of the organs work or how well the person affected can move. It can cause the sufferer pain, discomfort, embarrassment. It exacerbates other underlying problems and is often, in its causes and effects beyond the control of the sufferer. Obesity has an effect on the physical and mental wellbeing of the sufferer and causes sickness or even death.

肥胖完全符合疾病的定义。它不但能改变人们的身体，使患者的体型变大，还能影响体内物质的新陈代谢，影响器官的高效运作和患者的行动能力。肥胖会使人难受，局促不安和尴尬。它也会引发潜在的疾病。通常情况下，患者无法控制其因果，影响患者身心健康，甚至造成疾病或是死亡等后果。

ity Is Like Alcoholism or Depression – Once Seen As Lifestyle Conditions but Now Accepted As a Disease

1.肥胖就像酒瘾和忧郁——过去被认为是生活方式，现在被列入疾病范畴

One hundred years ago alcoholics were given very little support. Not much was known about the psychology, physiology and mechanics of addiction and it was seen as a lifestyle problem – an addiction gone wrong. In years gone by people suffering from mental health problems were stigmatised, marginalised and told to sort themselves out. In these, more enlightened times, we look back at such attitudes with horror and compassion. People suffering from alcoholism or mental health problems have access to a wide range of support networks and treatments to assist them in dealing with their disease.

一百年前，酒鬼是得不到任何帮助的。当时，人们对心理学、生理学以及酒瘾都不太了解，都认为酒瘾属于生活方式问题——形成了错误嗜好。过去，患有精神疾病是可耻的、被排斥的。在如今开明的时代，人们回想曾针对那些精神疾病患者的态度时，难免感到恐惧，并为患者感到十分同情。现在，无论是精神病患者还是醉汉都能获得广泛的支持和治疗以摆脱困扰。

There is no reason to view obesity in a different light. Even if obesity in a particular person is connected to lifestyle instead of genetic issues there is no reason not to treat it as a disease. Alcohol or cigarettes are optional – we do not need them to survive. All people need to eat; even those who are obese. It is difficult to change a relationship with something that is a fundamental constant in life. You can say no to a glass of wine or beer every day for the rest of your life – you cannot say no to breakfast, lunch and supper. Obesity, as opposed to just being a little overweight, is a condition that is often beyond the means of the sufferer to fix without assistance. It is a disease that has been with us as long as people have been on the planet. Obesity can be inherited from family – if your parents are obese the strong likelihood is that you will be too. While obesity can cause or exacerbate many other health conditions such as heart disease or diabetes it can also be caused by underlying health problems. Once an obese person's body gets used to the weight it will work against attempts to lose it – our bodies are designed to 'defend' the highest weight we reach. Obese bodies become resistant to the hormone that tells us when we are full, in much the same way that a person can become resistant to insulin. Obesity limits life and the sufferer will most likely need medical assistance to deal with the problem. If Alcoholism, Lung Cancer, Cirrhosis, Depression are all diseases then so is Obesity. Obesity is a growing problem worldwide it is a complex issue with many underlying causes that require complex, multi-party solutions. If obesity is considered a lifestyle choice, it can be palmed off as the personal responsibility of the sufferer. If it is a disease with a social and economic impact it becomes a wider problem. The medical establishment can legitimately look for new and innovative ways to treat this disease. Governments will have to make conditions favorable for investment in treatment and ensure that it is accessible and affordable for all. They will promote healthy living; make sure that the urban environment is exercise friendly. Society needs to stop victim blaming and stigmatizing sufferers. Categorizing obesity as a disease is the first step in making these solutions possible and available to all.

所以，我们没有理由特殊对待肥胖。即使某些人的肥胖是因为生活方式问题而不是遗传问题，但我们没有理由把肥胖排除在疾病之外。人们可以自由选择是否抽烟喝酒，但所有人都需要吃饭，肥胖的人也不例外。改变我们和基本生活需求的关系是非常困难的。你可以在你的余生每天少喝一杯酒，但是你却没法不吃早饭、中饭或者是晚饭。肥胖跟略微超重不一样，如果没有人帮助，将会是患者无法解决的问题。只要人们还居住在星球上，这个疾病就会一直存在。肥胖也可能从家族遗传——如果你的父母肥胖，极有可能你也会肥胖。在肥胖会导致心脏病、糖尿病之类的疾病的同时，潜在的健康问题也会引发肥胖。一旦一个人长期处于肥胖状态，他便会习惯这种状态，他的身体会自动阻碍他减肥——因为人们的身体天生就有“偏袒高体重”的倾向。肥胖的人对传达腹饱程度的荷尔蒙已形成了抵抗性，就跟糖尿病患者对胰岛素的反应一样。肥胖限制了我们的生活，肥胖的人也需要医疗帮助才能解决这个问题。如果酒瘾、肺癌、肝硬化和抑郁症都属于疾病，那么肥胖也应该是一种病。在全球，肥胖已经是一个日益严重的问题。肥胖是一个复杂的问题，由很多潜在因素引发，解决方法复杂多样。如果肥胖被认为是一种生活方式上的选择，那么这就是患者个人的责任。而如果肥胖是一种影响经济社会发展的疾病，那么它涉及的范围就更广泛了。如此一来，医疗机构就可以研究各种新颖方法来治疗肥胖了。政府必须为治疗肥胖创造一个良好的投资环境，以确保所有人都能接受治疗并负担得起治疗费用。政府还要倡导健康生活，保证城市环境有利于人们做运动以锻炼身体。同时社会也要开始停止对患者的责怪和耻笑。为了让这些解决方案行之有效，首要任务就是把肥胖归到疾病这一类。

审校：哈利 来源：前十网