肥 胖 症
1.Patients who are naturally very fat are apt to die earlier than those who are slender.
—— Hippocrates，460——377 BC
【译文】天生过胖的人比苗条的人容易早死。
2.Severe obesity restricts the movements and maneuvers of the body.It compresses blood vessels causing their narrowness.Breathing passages are obstructed and the flow of air is hindered leading to nasty temperament ...on the whole these people are at risk of sudden death ...they are vulnerable to stroke,hemiplegia, palpitation, diarrhea, fainting ...any physical effort they make will weaken them.
—— Avicenna，980——1037
【译文】严重的肥胖会限制身体的活动和动作。压迫血管导致血管狭窄。呼吸道受阻，气流不畅导致性情暴躁……总体而言这些人有猝死的风险……他们容易中风、偏瘫、心悸、腹泻、昏厥…… 他们做任何体力活动都让他们感到虚弱。
【点评】这话在今天并无惊人之处。但在1000年前还是难能可贵的。
3.Obesity is a mental state, a disease brought on by boredom and disappointment.
—— Cyril Connolly, 1903——1974
【译文】肥胖是一种由无聊和失望所导致的精神状态性疾病。
4.In the eleventh century obese English king William the Conqueror took to bed and consumed nothing but alcohol to shed pounds, a practice many of his countrymen seem to continue to this day.
—— David Sax
【译文】在11世纪，肥胖的英国国王威廉一世（William the Conqueror）为了减肥卧床不起，除了喝酒以外什么都不吃，他的许多同胞似乎一直坚持这种做法到了今天。
【点评】由此看来，减肥是人类的千年难题。
5.When women are excited about a date, they go immediately on a diet，because all women know they are hideously obese.
—— Cynthia Heimel
【译文】当女人对约会感到兴奋时，她们会立即节食，因为所有女人都知道自己胖得可怕。
6.Let's face it, in America today we don't have a health care system, we have a sick care system.We wait until people become obese, develop chronic diseases, or become disabled——and then we spend untold hundreds of billions annually to try to make them better.
—— Torm Harkin(https://www.daowen.com)
【译文】让我们面对现实，在今天的美国，我们没有“健保系统”，我们只有“病保系统”。我们一直等到人们变得肥胖、患上慢性病或残疾——然后我们每年再花数千亿美元试图让他们变好。
7.We need a new definition of malnutrition.Malnutrition means under- and over-nutrition.Malnutrition means emaciated and obese.
—— Catherine Bertini
【译文】我们需要一个新的营养不良定义。营养不良意味着营养不足和营养过剩。消瘦和肥胖都属营养不良。
【点评】世界卫生组织有关营养不良的新定义正逐渐得到广泛认同。
8.According to the surgeon general, obesity today is officially an epidemic；it is arguably the most pressing public health problem we face, costing the health care system an estimated $90 billion a year.Three of every five Americans are overweight; one of every five is obese.The disease formerly known as adult-onset diabetes has had to be renamed Type II diabetes since it now occurs so frequently in children.A recent study in the Journal of the American Medical Association predicts that a child born in 2000 has a one-in-three chance of developing diabetes.(An African American child's chances are two in five.) Because of diabetes and all the other health problems that accompany obesity, today's children may turn out to be the first generation of Americans whose life expectancy will actually be shorter than that of their parents.The problem is not limited to America: The United Nations reported that in 2000 the number of people suffering from over-nutrition——a billion——had officially surpassed the number suffering from malnutrition——800 million.
—— Michael Pollan
【译文】根据外科医生的说法，肥胖正在成为一种流行病；可以说这是我们面临的最紧迫的公共卫生问题，每年卫生保健系统为此花费大约900亿美元。3/5的美国人超重，1/5的人肥胖。以前被称为成人糖尿病的疾病已经被重新命名为2型糖尿病，因为儿童糖尿病（1型糖尿病）也频繁发生。《美国医学会杂志》最近的一项研究预测，2000年出生的孩子患糖尿病的概率为1/3，（非洲裔美国儿童的患病概率则高达2/5）。由于糖尿病和所有其他伴随肥胖而来的健康问题，今天的孩子们可能会成为第一代预期寿命比他们父母还短的美国人。这个问题不仅局限于美国：联合国报道称，2000年营养过剩的人数（10亿）已经正式超过了营养不良的人数（8亿）。
9.Do not treat supratentorial conditions with infratentorial procedures.
【译文】不要用幕下手术治疗幕上疾病。
【点评】这可能是“减重外科”应改称为“肥胖与代谢病外科”的原因。肥胖的病因是代谢出了问题，如果只在胃肠道做手术则难以解决根本问题，难以持久，必须从整个代谢环节着手。代谢的调节在颅内的高级中枢，而不是在小脑幕以下的胃肠道下功夫。
10.It is a certain surgical personality which adopts bariatric surgery as its sole career.
—— Moshe Schein
【译文】专攻减重手术的外科一定会成为外科的一个特色分支。
【点评】这一天正在向我们走来。“肥胖与代谢病外科”2018年已正式被写入全国医学生教材——人民卫生出版社《外科学》第九版，从而成为我国所有医学生的必修课。
11.Bariatric surgery is a major event in a patient’s weight-loss journey, but the event is best seen as a new beginning.Obesity is a lifelong disease and there is no operation, diet or medication that can by itself offer a permanent cure.Surgery with good aftercare and moderate lifestyle changes can give wonderful long-term results for health and weight.
—— asmbs.org
【译文】减重手术是患者减肥过程中的一件大事，但应该将这件大事视作一个新的起点。肥胖症是一种终生疾病，没有任何手术、饮食或药物能够为其带来永久的治愈。术后良好的调理和适度的生活方式改变才可以带来一个既健康又兼顾体重的理想的长期效果。