“国家不让你胖”，也没让你瘦啊
双语君约 8 分钟“五月不减肥，六月徒伤悲。”气温回升，社交媒体上的“比瘦”风潮如约而至。“碳水脸”“躺瘦神针”等话题轮番登上热搜，一条条“7天瘦10斤”的对比图，牵动着不少人“以瘦为美”的心。
2024年6月，国家卫生健康委等16部门联合启动“体重管理年”三年行动，“国家不让你胖”“国家喊你来减肥”成为热梗。两年以来，“体重管理年”行动成效显著，但仍有不少人将体重管理简单等同为“减肥”，折射出当下一些健康误区。
While the "Weight Management" campaign launched by China's National Health Commission has gained traction online, many still mistake weight management for mere weight loss, revealing persistent misunderstandings.
图源：东方IC
体重管理路上
你踩过几个坑？
目前，全国多地公立综合医院已提供健康体重管理门诊服务。多位专家在接诊中发现，很多患者对减重存在认知误区。
Hospitals across China now offer healthy weight management clinics. Doctors say they frequently encounter patients who hold flawed beliefs about shedding kilos.
① 戒碳水瘦脸？
“断碳一周，脸肉眼可见地紧致了”……近期，不少网民声称告别主食就能换来“上镜小脸”，一度引发大量效仿。
但沈阳市第一人民医院内分泌与代谢性疾病科主任刘伟说，所谓“碳水脸”通常是面部脂肪堆积、水分滞留和肌肉松弛的综合表现，单纯靠戒碳水来瘦脸并不科学。
"One week without carbs, and my face is visibly tighter" — such posts have inspired many to ditch staples. But experts explain that what people call a "carb face" is usually a mix of facial fat, fluid retention, and muscle laxity. Going carb‑free is not a scientific solution.
图源：东方IC
网上流行的做法，大多走向生酮、液断饮食等极端模式。刘伟表示，生酮饮食的原理是通过极低碳水化合物摄入，让身体转向燃烧脂肪来供能，但长期坚持会导致营养素缺乏、电解质紊乱，加重肝肾负担。
液断饮食则是一种短期限制性饮食，通过摄入液体或流质食物代替固体食物，本质上是一种过度节食，且减掉的多数是水分和肌肉，易导致基础代谢率受损，引起脱发、月经紊乱等问题。此外，长期节食会使身体进入“节能模式”，后续易反弹，变成“易胖体质”。
Extreme diets are popular online, such as very low‑carb, high‑fat ketogenic diets that force the body into ketosis. Long‑term adherence to such diets can lead to nutrient deficiencies, electrolyte imbalances, and added strain on the liver and kidneys.
Liquid‑only diets, which replace solid food with fluids, are essentially severe calorie restriction; most weight lost is water and muscle, not fat. This can damage basal metabolic rate, cause hair loss and menstrual disorders, and often leads to rebound weight gain.
② 打针能“躺瘦”？
司美格鲁肽，自2024年成为我国首款获批的长效周制剂注射减重药品以来，便被不少人奉为“躺瘦神针”。
公开临床数据显示，持续使用约68周后，受试者平均体重下降约17%，腰围平均减少15.8厘米。不少人认为打了“神针”便能一劳永逸，却忽视了药物的使用边界与健康风险。
Since semaglutide became China's first approved weekly injectable weight‑loss drug in 2024, it has been hailed as a magic bullet. Clinical data show that after about 68 weeks, users lost 17 percent of body weight on average and reduced waist circumference by 15.8 cm. But many overlook its limits and risks.
刘伟说，这类药物原理是模拟人体自身的饱腹激素，通过延缓胃排空、抑制食欲来达到减重效果，在规范使用前提下有一定减重作用，但只适用于偏胖或轻度肥胖、且体内激素水平无明显异常的人群。
贵州医科大学附属医院肥胖代谢中心主任严芝强表示，“神针”的平均减重幅度有限，对中、重度肥胖人群来说治标不治本，难以纠正体内紊乱的激素和代谢水平。
Experts say the drug mimics the body's own satiety hormone, delaying gastric emptying and suppressing appetite. When used appropriately, it can help people who are mildly overweight or mildly obese with no significant hormonal abnormalities. But another expert notes that its average effect is modest — for moderate to severe obesity, it treats the symptom, not the root cause.
多位专家说，司美格鲁肽是处方药，必须在医生评估下使用，并有胰腺炎病史者、18岁以下青少年等明确禁用人群。刘伟提醒，常见副作用包括恶心、腹胀、便秘等，“应将其视为医生评估下的治疗工具，不是普通人的常规选择”。
Semaglutide is a prescription drug. It must be used under medical evaluation and is contraindicated for people with a history of pancreatitis and for those under 18.
③ 瘦就是好？
将体重秤上的数字视为衡量减肥成效的唯一标准，是较为普遍的认知误区。江苏省人民医院营养科主任蒋琳注意到，不少减重者一味追求体重的下降，却很少分辨减去的究竟是水分、肌肉，还是真正需要减少的多余内脏脂肪。
Many people track only the number on the scale, rarely distinguishing between lost water, muscle, or excess visceral fat. Healthy weight loss should mean reducing fat while preserving or gaining muscle.
“健康的减重应该是减脂增肌。”刘伟说，采取过度节食等方式快速减重，其不良后果也不容忽视。她回忆，一个年轻女孩长期节食并服用减重药物，半年内体重骤降40斤，但随之而来的是脱发、闭经、焦虑。检查发现，她的基础代谢率非常低，脂代谢紊乱，还伴随代谢相关性肝损伤。
Rapid weight loss through extreme dieting can backfire. There is a young woman who lost 20 kg in six months by chronic dieting and taking weight‑loss pills — but she also suffered hair loss, stopped menstruating, and developed anxiety. Tests showed extremely low basal metabolic rate, lipid disorders, and metabolic‑related liver damage.
图源：东方IC
专家表示，健康是“体重管理”的根本目的，如因减重致病，则背道而驰、得不偿失。
Health is the real goal of weight management. If losing weight makes you sick, it's a complete reversal of purpose.
国家没让你瘦
国家喊你“存肌肉”
“国家是不让你胖，但也没让你瘦啊。”刘伟表示，体重管理管的不只是“胖”，同样也包括不健康的“瘦”和肌肉衰减带来的风险。
Weight management covers both unhealthy thinness and the risks of muscle loss.
体重管理，管的是什么？国家卫生健康委发布的《体重管理指导原则（2024年版）》提到，成人体重指数（BMI）宜控制在18.5至24之间，高龄老人适当放宽到22至26.9。
对于肌肉发达人群，BMI超标不能简单算作肥胖，体脂率更为关键。刘伟说，男性体脂率健康范围为10%至20%，女性为15%至25%，男性大于25%、女性大于30%才视为肥胖。
According to the Weight Management Guidelines (2024 Edition) issued by the National Health Commission, adults should aim for a BMI between 18.5 and 24 (slightly higher for seniors, 22–26.9). For muscular individuals, body fat percentage matters more: healthy ranges are 10–20 percent for men and 15–25 percent for women; obesity is defined as over 25 percent for men and over 30 percent for women.
相比于全身性肥胖，中心性肥胖与代谢紊乱、心血管疾病的相关性更强，危险程度更高。刘伟提醒，成年男性腰围一般控制在90厘米以内，女性一般控制在85厘米以内。腰臀比方面，男性0.85至0.9、女性0.75至0.8一般为正常范围。
Central (abdominal) obesity is even more strongly linked to metabolic disorders and heart disease. Recommended waist circumference is under 90 cm for men and under 85 cm for women; healthy waist‑to‑hip ratios are 0.85–0.9 for men and 0.75–0.8 for women (though global definitions may vary slightly).
图源：东方IC
可见，体重管理需要综合评估各项指标。
贵州航天医院全科医学科主任陈琪介绍，在接诊的患者中，真正达到肥胖标准的患者只占不到三分之一，超重患者约占六成，另外有近一成的患者体重正常，但仍要求减重，甚至希望通过药物强行降低体重。“这类患者，我们会明确拒绝。”
在“国家喊你减肥了”引起热议之后，“国家喊你存肌肉”近日又刷屏全网。4月，国家卫生健康委发布的2026年版《成人肌少症食养指南》提到，人体肌肉量30岁左右达到峰值，之后随年龄增长肌肉流失逐渐加速。因此，要尽早“储蓄”肌肉。
After the phrase "The state calls on you to lose weight" went viral, a new meme has taken over: "The state calls on you to bank muscle." In April 2026, the National Health Commission released the Dietary Guidelines for Adult Sarcopenia, noting that muscle mass peaks around age 30 and then gradually declines. Early muscle "savings" are crucial.
专家提醒，“老来瘦”不能“老来寿”，“有肌肉”才能“老来寿”。当老年人肌肉“余额不足”，出现肌少症，跌倒、骨折乃至失能的风险都会大大增加。只有增加肌肉量，才能安全、持久地提高基础代谢率，让身体更有活力。
Experts warn that being thin in old age does not mean being healthy — maintaining muscle does. Sarcopenia dramatically increases the risk of falls, fractures, and disability. Building muscle safely and sustainably raises basal metabolic rate and keeps the body vigorous.
“管理体重不是追求瘦身，而是科学养身。”刘伟说，这要因人而异、精准施策。
来源：人民日报微信公众号综合新华社
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