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    §28 · 9 tips

    Don't wreck your body for looks

    If you want to lose weight, look better or straighten your teeth, which methods will damage your body?

    Tips from this section that apply in the United States. This section is about health and medicines. It is general information, not a substitute for a doctor’s diagnosis or prescription.

    Don't wreck your body for looks

    Don't use extreme dieting, fasting or induced vomiting to control your weight; if you want to lose weight, do it on the exercise side

    People with anorexia nervosa are about 5.9 times as likely to die as others their age. Out of every 1000 people followed for a year, 5.1 die. About one in five of those deaths is a suicide. Dieting makes an eating disorder more likely: in a three-year study of students at 44 secondary schools, girls who dieted severely were 18 times as likely to develop an eating disorder as girls who did not diet. If you want to control your weight, exercise more; don't eat so little that you go hungry.

    • Top value
    • Evidence A
    • Buys life
    Don't wreck your body for looks

    Before an injection, thread lift or surgery, check two things: that the facility's license lists “medical cosmetology” (医疗美容), and that the person doing it is the attending physician

    Anything that uses a needle or a knife, or a medical device that breaks the skin or goes into the body, counts as medical treatment. It may only be done at a facility whose license says “medical cosmetology,” and the person doing it must be a registered licensed physician. Beauty salons, studios and hotel rooms don't qualify. Someone without a physician qualification who does it is practicing medicine illegally; in cases of serious injury the sentence is 3 to 10 years, and if someone dies, 10 years or more.

    • Top value
    • Evidence A
    • Buys life
    Don't wreck your body for looks

    Avoid the bridge of the nose, the area between the eyebrows and the forehead for facial fillers, and above all don't go to an unlicensed injector to save money

    Among people who went blind after a filler injection, more than half had it in the nose, followed by between the eyebrows, the forehead and the nasolabial folds, and over 80% involved hyaluronic acid. Only about 20% of the people who lost sight recovered it fully, just over 10% partly, and nearly 20% also had brain injury. No rescue method works reliably at present, so these areas have to be avoided beforehand.

    • Top value
    • Evidence B
    • Buys life
    Don't wreck your body for looks

    Don't buy diet pills, slimming coffee, slimming candy or enzyme plums (酵素梅, plums said to be soaked in enzymes) that promise fast weight loss

    Sibutramine is often found secretly added to this kind of product. It was originally a diet drug and was taken off the market in China in 2010. In people 55 or older who were overweight and had heart disease or diabetes and took it for more than three years, nonfatal heart attacks were about 30% higher and strokes about 36% higher. They lost only 1.7 kg more. By the time a spot check finds it, you have already swallowed it.

    • High value
    • Evidence A
    • Buys life
    Don't wreck your body for looks

    Don't use anabolic steroids (“muscle-building injections,” “oral pills”) to build muscle

    Men who tested positive for doping at a gym were 3 times as likely to die as others their age, and made more than twice as many hospital visits a year. Acne, enlarged breasts in men and erectile dysfunction each hit at least 1 in every 10 users. These drugs are prescription-only in China, and any channel that will sell them to you is itself breaking the law.

    • High value
    • Evidence A
    • Buys life
    • Disputed
    Don't wreck your body for looks

    If you want a weight-loss drug or a weight-loss injection such as semaglutide, get a prescription at a hospital and follow the doctor's schedule for dose increases and follow-up checks; don't buy from online shops that ship without a prescription, and don't get injections at a beauty salon

    Prescription drugs must be sold with a prescription, and when sold online there must also be a real prescription and real-name registration. Online shops that ship without a consultation and beauty salons that give injections on the spot mostly have drugs of unknown origin, and no one is responsible for the dose or contraindications. A year after weight-loss injections are stopped, about two thirds of the weight lost comes back, so count the cost as long-term treatment.

    • Moderate value
    • Evidence B
    • Buys life
    Don't wreck your body for looks

    Use sex-hormone drugs only when a doctor has prescribed them and you have regular follow-up checks; don't buy them online or raise the dose yourself

    This item does not discuss whether to use them, only how. Transgender women taking estrogen have clearly more blood clots in their blood vessels than others their age: about 4 more per 1000 people at two years, and about 17 more at eight years. This kind of risk has to be watched through regular checks, and if you buy the drugs online and adjust the dose yourself, no one checks for you.

    • Moderate value
    • Evidence A
    • Buys life
    Don't wreck your body for looks

    If “feeling ugly” has reached the point of checking the mirror again and again and wanting to change it again and again, get a body-image assessment before talking about surgery

    About 15% of people who go to plastic surgery have body dysmorphic disorder (躯体变形障碍), which means blowing up a flaw that others can barely see until it affects your life. Among people who go to a dermatologist it is about 13%, and in both groups more than 70% are women. First register for one visit to see whether this is your situation, and then decide whether to have surgery.

    • Moderate value
    • Evidence B
    • Buys life
    Don't wreck your body for looks

    For teeth straightening, see a doctor with orthodontic qualifications for an in-person exam and keep your follow-up visits; don't buy aligners online and wear them at home on your own

    Clear aligners are Class II medical devices in China, and their instructions require that they be worn under the guidance of a doctor with orthodontic qualifications, with regular follow-up visits. The U.S. drug regulator says it has not authorized aligners sold directly to individuals without a dentist's prescription. Without an in-person exam, the bite may go crooked, teeth may move to the wrong place, and there may be pain or even tooth loss.

    • Moderate value
    • Evidence C
    • Buys life