Don’t harm your body just to change its appearance✳
This section covers several methods people use to alter their appearance: fasting, taking pills, getting injections, and undergoing surgery. They all share one thing in common: the decision to use them is usually driven by comparisons with others. Yet the costs are borne entirely by the individual, and many of those costs are irreversible. We make no judgment about anyone’s personal choice regarding how they want to look — that is a matter of personal preference. What we do address is this: for the same end result, how much greater is the risk when people follow unregulated paths — buying products online, using services at beauty clinics, or increasing dosages on their own — compared to following medically supervised routes that involve prescriptions, qualified professionals, and follow‑up care? Our assessment focuses on actual physical consequences such as blindness, hospitalization, and death. In addition, illegal cosmetic procedures can lead to serious criminal liability.
English text comes from the independent translation maintained by dlgrv. New entries without a translation appear in Chinese. The author's Chinese original is authoritative for the latest content. Translation snapshot: dlgrv/HowToLiveBetter · cc91bd6
Choose a platform and share a small step toward a better life.
01Evidence A
Do not use extreme dieting, fasting, or self-induced vomiting to control weight; if you want to lose weight, focus on exercise instead.
People with anorexia nervosa have a mortality rate roughly 5.9 times higher than their peers. Across 1,000 people followed for one year, about 5.1 die. One out of every five of those deceased individuals died by suicide. The root cause often starts with dieting: a three-year study of students at 44 secondary schools found that girls who dieted severely were 18 times more likely to develop eating disorders than those who did not diet. To control weight, prioritize exercise rather than cutting food intake to the point of hunger.
Cost
No cost at all. In fact, it saves money compared to buying…
Benefit
This conclusion is backed by 36 separate studies involving a total of 166,642 person-years of follow-up on ind…
02Evidence A
Two things to check before getting injections, thread lifts, or surgery: does the facility’s license list “medical aesthetics,” and is the practitioner a licensed attending physician?
Any procedure that involves needles, surgery, or medical devices — meaning anything that breaks the skin or enters the body — is considered medical treatment. Such procedures may only be performed at facilities whose licenses explicitly list “medical aesthetics,” and only by registered attending physicians. Performing them in beauty salons, private studios, or hotel rooms is illegal medical practice: in serious cases, offenders face up to three years in prison; if they cause injury, three to ten years; if they result in death, more than ten years.
Cost
There is no cost involved. Checking these two documents ta…
Benefit
Article 2 of the “Administrative Measures for Medical Aesthetic Services” defines medical aesthetics as “the u…
03Evidence B
Facial fillers should avoid the bridge of the nose, glabellar area, and forehead — and never opt for unregulated clinics just to save money.
Between 2015 and 2018, 48 new cases of partial or total vision loss following filler injections were reported worldwide. The nose was the most common site of complications, accounting for 56.3% of cases; followed by the glabellar area at 27.1%, the forehead at 18.8%, and the nasolabial fold at 14.6%. Hyaluronic acid was used in over 80% of these cases. Only 20.8% of patients regained full vision, while 16.7% saw partial recovery; the rest remained visually impaired. Nearly 20% also developed complications affecting the central nervous system. Currently, no single treatment has been proven consistently effective for reversing these effects, so prevention remains the only reliable option.
Cost
No cost at all. You simply choose a different injection si…
Benefit
Data compiled from all published case reports worldwide show that from January 2015 through September 2018, 48…
04Evidence A
Don’t buy weight‑loss pills, coffee, candies, or “enzymatic plums” that promise rapid results
The illegal ingredient most often found in these products is sibutramine. Originally a legitimate weight‑loss medication, it was banned in China in 2010. One large trial enrolled nearly 10,000 participants who took the drug for an average of over three years. Compared with placebo, users had a roughly 30% higher risk of non‑fatal heart attacks and a 36% higher risk of non‑fatal strokes; the overall adverse‑event rate was 11.4% versus 10.0%. Over three years, the drug only produced an extra 1.7 kg of weight loss. By the time tests detect the substance, you’ve already consumed it.
Cost
Zero. In fact, you’ll save the money you’d otherwise spend…
Benefit
The SCOUT trial involved 9,804 participants aged 55 or older who were overweight or obese and had cardiovascul…
05Evidence A
Do not use anabolic steroids (“muscle‑building injections” or “oral pills”) to build muscle
A Danish study followed 545 men who tested positive for anabolic steroids and compared them with 5,450 age‑matched controls. Users had a three‑fold higher risk of death, and the median number of hospital visits per year was 0.81 versus 0.36 for controls. More than 10 % of steroid users developed acne, gynecomastia, or erectile dysfunction. In China these drugs are prescription‑only, and any source selling them illegally is breaking the law.
Cost
There is no cost involved;
Benefit
The Danish researchers matched each steroid user with a control of the same age. The original cohort comprised…
06Evidence B
If you need weight-loss medication, get a prescription from a doctor — don’t buy it from online shops that ship it without one.
By regulation, prescription drugs must be sold only with a valid prescription, and pharmacies must keep that prescription on file for at least five years. Online sellers of prescription drugs must also have a genuine prescription and verify the buyer’s identity. So when you see an online shop that doesn’t require a consultation or a prescription and ships the product right away, there are only two possibilities: either the product isn’t actually the drug it claims to be, or the shop is breaking the law. In either case, no one can be held responsible for dosage or contraindications if something goes wrong. Those few dozen yuan you spend on a doctor’s visit buys you exactly this protection.
Cost
A single doctor’s visit plus a round trip to the clinic. T…
Benefit
The “Measures for the Supervision and Administration of the Quality of Drug Operation and Use” require retail…
07Evidence A
Sex hormone therapy should only be used when prescribed by a doctor and with regular follow‑up; do not buy it online and do not adjust the dose on your own.
This section does not discuss whether hormone therapy is appropriate, only how to use it safely. A study followed transgender individuals for about four years. Transgender women taking estrogen had a noticeably higher rate of venous thrombosis than age‑matched controls — 4.1 extra cases per 1,000 people in two years and 16.7 extra cases per 1,000 in eight years. Such risks must be monitored through long‑term follow‑up, and that monitoring only happens when a clinician checks you regularly. When people buy hormones online and adjust doses themselves, there is no one to provide that oversight.
Cost
Regular doctor visits and blood tests are required. Over a…
Benefit
Researchers examined electronic medical records from Kaiser Permanente, a large health‑care system. They ident…
08Evidence B
If the feeling of “being unattractive” has reached the point where you constantly check your reflection and obsess over changes, get a body image assessment before considering surgery.
When we combine data from 33 studies, we find that 15.04% of people seeking cosmetic surgery meet the criteria for body dysmorphic disorder — a condition where a flaw barely noticeable to others becomes a major source of distress. Among dermatology patients seeking cosmetic treatments, the rate is 12.65%. In both groups, over 70% are women. Surgery can alter facial features, but it cannot break the cycle of constant self‑scrutiny and dissatisfaction; this often leads to repeated operations. Spending a modest amount on an initial evaluation can help determine whether you fall into this category, guiding your decision about surgery.
Cost
A single visit to a psychiatrist or clinical psychologist…
Benefit
A comprehensive review of those 33 studies shows that the prevalence of body dysmorphic disorder among cosmeti…
