碳烤羊腿价格:肥胖使你逃离了什么？

疾病防控中心最近的统计数据表明，大约三分之一（33.8%）的美国成人都过度肥胖。而且，这个数据每天都在上涨，速度可以跟股票相媲美。我和美国最好的肥胖整形医生一起工作，他们致力于帮助病人减肥，以此来防止疾病，或减缓疾病的进程。我在休斯顿也成立了好几个12步法食物成瘾治疗小组，在许多城市也有网上服务。1

I talk to morbidly obese patients everyday. I teach them, counsel them, eat with them, and spend endless hours reading their journals. These patients have a story to tell, but we aren’t listening and we continue asking the wrong questions.

我每天都跟肥胖症的病人谈话。我给他们授课，给他们提建议，并和他们一起吃饭，还要没完没了地花时间阅读他们的日记。这些病人们都有故事要讲，但是我们却不听，只是一味地问他们错误的问题。

To be sure, obesity is genetic and many times the social milieu of obese patients I work with is chaotic with issues of abuse, abandonment, shame, ridicule, and anger. The genetic role helps explain the body type; the way food may be processed, stored, and proportioned. It cannot explain what keeps the person from changing the behavior that contributes to obesity. In my work, during step 4 of the 12-step addiction group, the group members begin making amends. They look at how their behavior got them where they are. They quit thinking about how they were abused, and begin to consider how they hurt/abused others. The step is painful, gut wrenching and overwhelming for all of these patients.

可以肯定的是，肥胖是遗传的，而且很多时候，我工作中遇到的肥胖病人的社会环境是一片混乱，充斥着虐待、遗弃、羞辱、奚落和愤怒。遗传可以解释体型；食物是被如何加工、存储和分配的。但它不能解释是什么原因使肥胖病人一再回到使他肥胖的习惯。在我的工作中，在12步法食物成瘾治疗小组的第4步中，小组成员开始忏悔。他们会思考，自己的行为如何使自己成了现在的模样。他们停止去想他们过去曾被怎样地虐待过，转而思考他们如何伤害/虐待了别人。这一步十分痛苦，压倒一切地令所有病人都痛彻心扉。2

It is also the step I ask them, ”How do you benefit from being obese?”

也是在这一步，我会问他们：“肥胖给你们带来了什么好处？”

At first they look at me as if I am crazy. After all, they are weight loss surgery patients, and have gone to extremes to lose weight. They laugh, shake their head, and then the room gets quiet.

起初，他们会看一看我，看我是不是疯了。但毕竟，他们是减肥手术病人，为了减肥已用尽了一切办法。他们笑起来，摇摇头，之后房间里就静下来。

One of the bravest patients will say, “My obesity gives me an excuse. I am not held to the same standards as others; they don’t expect it, because I am morbidly obese.” Another will chime in, “My obesity keeps men away; I was sexually abused by my dad for 4 years of my life.” 

有勇气的病人会说：“我的肥胖给了我借口。别人不会拿对其他人的标准来要求我；他们不会期待我做到的，因为我是一个肥胖病人。”另一个会插嘴说：“我的肥胖使没有男人敢接近我，而以前我曾经遭受过父亲的性虐待整整四年。”1

A statistic that no one likes to talk about was once mentioned in Bariatric Times in 2007. As many as 20 to 40% of obese women have been sexually molested, harassed and/or perpetrated (they know it’s higher than that but can’t ascertain the exact amount). Yet another will talk about how her/his marriage is so distant that food has become their lover/best friend. They are lonely, and they eat to comfort that incredible sense of loss.

2007年《肥胖症治疗时报》曾刊载过一个统计数据，但是这个数据没有人愿意多谈。多达20%—40%的肥胖女性曾有过被猥亵、性骚扰或性侵犯的经历（他们知道实际数据会更高，但是不能确定具体的数据是多少）。而另一个则会谈到自己和丈夫或妻子是多么地疏远，食物于是就成了自己的情人或最好的朋友。他们很孤独，以吃东西来减缓那种无法想象的失落感。1

Another part of my job focuses on the group that failed the weight loss surgery. If you have never been morbidly obese, or gone through a weight loss surgery only to have the weight come back, you cannot understand the depth of failing these patients feel. They are cursed by their unresolved reasons for going back to food. They don’t understand it, and often those who love them most don’t either. A Gastric Bypass, Gastric Sleeve, Lap Band, or Duodenal Shift is never going to successfully keep weight off if the patient has no idea why they are eating, and experience a fear of stopping.

我工作的另一部分是关注减肥手术失败的那些人。如果你从来没有得过肥胖症，或者做过减肥手术来使体重正常，你就不会理解这些病人的失败感有多么深刻。他们似乎被上了魔咒一样，总是莫名其妙地忍不住吃食物。他们自己不知道为什么，爱他们的人们也不明白。如果他们不知道自己是因为什么总是要吃东西，而且一停下来就害怕，单单靠胃旁路手术，胃套管手术，腹腔带，切割十二指肠等，绝不会使他们成功减肥。

Many of the cravings patients feel are emotional; totally unrelated to real hunger. How can a weight loss surgery of any kind manage emotional hunger? It cannot. 

病人们的许多渴求都是感情上的，与真正的饥饿没有丝毫联系。减肥手术怎么能控制感情上的饥饿呢？当然不能。

When we evaluate patients who struggle with obesity we talk frequently about denial. I am beginning to think they are no more in denial than we, the health care professionals. We can talk food all we want, but most of my patients know what healthy food is; they could write a cookbook with the calorie count included! They know food like most of us know our lover. What they need help with are the tough questions. One of those questions is, “What are the benefits you are experiencing from your obesity?” 

当我们评估与肥胖症做斗争的病人时，我们时常会谈起拒绝。我觉得，他们也想拒绝，而且丝毫不比我们这些健康护理专家们少。我们可以谈论所有想谈论的食物，但是，我的大部分病人们知道什么是健康的食物；他们甚至有能力写出一本烹饪书，而且包含食物的卡路里含量！他们对食物就像我们大部分人对自己的爱人一样了解。他们需要帮助的，是来问他们一些难以回答的问题。其中国一个就是：“你从自己的肥胖之中得到了什么好处？”1

We have to ask this, and we should ask it prior to weight loss surgery so we can begin the process of helping them understand this part. People drop old behaviors when they are no longer benefiting from them. You don’t need to be a weight loss surgery patient to begin the yo-yo dieting process. If weight protects you from receiving attention, and you have been sexually abused in your childhood, then when you begin losing weight you are going to turn to food to manage the anxiety you feel when a man gives you eye contact. When patients begin to understand what they are protecting or avoiding with their weight, they can effectively work a weight loss program and keep the weight off.

我们不得不问这个问题，我们应该在减肥手术开始之前就先问这个问题，这样我们才能帮助他们理解这个部分。只有在旧的习惯不会给人带来好处的时候，人们才会改掉它。这样，病人才不会像其他减肥手术病人一样，不断地经历减肥—反弹的循环。如果肥胖使你免受别人的关注，而你在童年时遭受过性虐待，那么为了控制某个男人和你有目光接触时你所产生的焦虑感，你就会转向食物。当病人们知道他们用自己的体重来保护什么或者避免什么，他们就能够非常有效地参与减肥项目，并顺利减肥。

It is also important to look at obese children’s homes especially if there is a substantial weight gain. Many times, something is going on at home that is causing this child to medicate their anxiety with food. Society continues to be judgmental and negative with obese people. One thing is clear: shaming or ignoring obesity is not helping curb or decrease the numbers.

看一看肥胖儿童的家庭也很重要，尤其是当他们体重大幅度增加的时候。很多时候，家里正在发生一些事情，使孩子只有不断地吃食物，才能克服自己的焦虑。社会对肥胖的人向来持苛刻和否定的态度。但有一件事情很清楚：羞辱或是忽视肥胖，丝毫不会帮助控制或减少肥胖人群的数量。