DANI BLUM2026年6月22日 Ard SuRetatrutide, the most powerful weight-loss drug in development, is not expected to hit the U.S. market before next year, at the earliest. But Adil Kalam, a 37-year-old in Brooklyn, already has 20 vials of it in his freezer.瑞他鲁肽是目前研发中最强效的减肥药，预计最早也要到明年才能进入美国市场。但在布鲁克林，37岁的阿迪尔·卡拉姆已经在冰箱里存放了20瓶瑞他鲁肽。Mr. Kalam used Bitcoin to purchase the drug from an online retailer selling $99 vials labeled “for research purposes only.” His first order arrived in a cardboard box, the vials of powdered medication packaged in bubble wrap.卡拉姆使用比特币从一家网上零售商那里购买了这种药物，每支标价99美元，标签上注明“仅限研究用途”。他的第一笔订单装在一个纸箱里送达，装有粉末状药物的安瓿被气泡膜包裹着。“It didn’t really inspire confidence,” Mr. Kalam admitted.“这确实让人不太放心，”卡拉姆承认。Mr. Kalam and eight of his friends order the drug in bulk. He understands that there is a risk in taking a drug that has not been approved by the Food and Drug Administration. But he didn’t want to wait for the regulatory process to play out if he could take it sooner.卡拉姆和他的八个朋友批量订购了这种药物。他明白，服用尚未获得美国食品药品监督管理局(FDA)批准的药物存在风险。但他不想干等监管程序走完，希望能够尽快服用。Mr. Kalam is tapping into a thriving black market for retatrutide, a peptide medication developed by Eli Lilly. On social media, influencers and medical spas advertise the drug using code words like “ratatouille” for retatrutide or “peps” for peptides to skirt restrictions on advertising drugs online. More dedicated users buy in bulk from China, trading recommendations for sellers over conversations on Reddit, Discord and WhatsApp, and pooling their resources to get third-party testing.卡拉姆正涉足一个繁荣的瑞他鲁肽黑市，这是一种由礼来公司研发的肽类药物。在社交媒体上，网红和医疗水疗中心使用暗语来宣传这种药物，用“ratatouille”（料理鼠王）指代瑞他鲁肽，或用“peps”指代肽类，以规避在线药品广告的限制。更执着的用户会从中国批量购买，在Reddit、Discord和WhatsApp上交流卖家推荐信息，并集资进行第三方检测。There are no clear estimates of how big this market is, but the information experts do have suggests it is sizable. An analysis of F.D.A. data by the Partnership for Safe Medicines, a nonprofit coalition linked to the pharmaceutical industry, showed that 15 pounds — perhaps hundreds of thousands of doses — of retatrutide have flowed into the country between January and April 2026. Some of those doses may have been shipped to scientists studying the drug. But a portion of that is probably going to the illicit market, said Shabbir Imber Safdar, the executive director of the nonprofit.目前尚无关于该市场规模的明确估计，但专家掌握的信息表明其规模相当庞大。与制药行业有关联的非营利联盟安全药品合作组织对FDA数据的分析显示，2026年1月至4月，有约6.8公斤的瑞他鲁肽流入美国，可能相当于数十万剂。该非营利组织的执行主任沙比尔·因伯·萨夫达尔表示，其中部分剂量可能是运给研究该药物的科学家，但还有一部分很可能流向了非法市场。“The bottom line is, the demand is fully there,” said Timothy Mackey, a professor at the University of California San Diego who studies counterfeit medications. “And there are lots of ways to get it.”“归根结底，需求切实存在，”加州大学圣地亚哥分校研究假冒药物的教授蒂莫西·麦基说。“而且获取它的途径有很多。”Eli Lilly has warned that products claiming to contain retatrutide may be contaminated or contain other substances entirely. “Any claim that black market retatrutide is the same as Lilly’s genuine medicine as studied in clinical trials is false,” Michael Jamison, a spokesman for the company, wrote.礼来公司已发出警告，非正规渠道声称含有瑞他鲁肽的产品可能受到污染，或完全是其他物质。“任何声称黑市瑞他鲁肽与临床试验中礼来正品药物相同的说法，都是虚假的，”该公司发言人迈克尔·贾米森写道。A Murky Marketplace隐秘混乱的市场The black market for retatrutide is an extreme example of consumers flouting the traditional medical system to get their hands on potent new weight-loss drugs. Millions of people have sought out unapproved compounded versions of these drugs from telehealth companies and medical spas as they look for cheaper and more accessible alternatives to brand-name versions.瑞他鲁肽的黑市交易是消费者为获取强效新型减肥药而无视传统医疗体系的一个极端例子。数以百万计的人为寻找比品牌药更便宜、更容易获取的替代品，通过远程医疗公司和医疗水疗中心寻找这些药物未经批准的配制版本。While there is no way to fully capture who is seeking out retatrutide online, customers for the drug seem to include people looking to lose more weight than they can with drugs already on the market, as well as bodybuilders and biohackers who also use other peptides.虽然无法完全掌握到底是谁在网上寻找瑞他鲁肽，但该药物的客户群似乎包括那些希望减重幅度超越现有市售药物的人群，以及同时使用其他肽类药物的健美运动员和生物黑客。Many of the people taking what they believe to be retatrutide buy it from online storefronts, which list the drug as a research chemical that is not for human use — a disclaimer that may let them take advantage of a loophole in drug regulation.许多自认为正在服用瑞他鲁肽的人从网络商店购买这种药物，这些商店将该药物列为仅供研究用途、不可用于人体的化学品——这种免责声明可能让他们得以利用药品监管中的漏洞。These websites often ship the drug as a powder that customers prepare and inject.这些网站通常以粉末形式发送药物，由客户自行配制并注射。Other users buy the drug from WhatsApp, Telegram and Discord groups. In one Telegram chat, a user posted dozens of videos a day showing a fridge stocked with vials for sale. In another Telegram group, this one with over 1,400 members, users replied to messages showing boxes that claimed to contain retatrutide and asked whether they could pay in Bitcoin.还有些用户从WhatsApp、Telegram和Discord群组中购买这种药。在一个Telegram聊天群组里，一名用户每天发布数十个视频，展示塞满待售药瓶的冰箱。在另一个拥有1400多名成员的Telegram群组中，有用户回复了展示据称装有瑞他鲁肽包装盒的消息，并询问是否可以用比特币支付。These groups are often run by middle men who place bulk orders of what they say is retatrutide, typically from Chinese labs, and then repackage it or use it to fill empty injection pens, said Luke Turnock, a senior lecturer in criminology at the University of Lincoln in England who studies peptides. Some sellers add their own branding and logos, like illustrations of molecules, that give a scientific sheen to their products.英国林肯大学研究肽类物质的犯罪学高级讲师卢克·特诺克表示，这些群组通常由中间商运营，他们批量订购据称是瑞他鲁肽的药物（通常来自中国实验室），然后将其重新包装或灌装到空的注射笔中。一些卖家还会添加自己的品牌和标志（例如分子示意图），为产品增添一层科学的光环。Some people have even bought these medications from health providers. In April, a federal grand jury indicted a Utah physician who had allegedly sold vials of retatrutide and other peptides to more than 200 patients. According to the indictment, that doctor made his own labels and did not disclose to patients that the medications had been ordered online from a company in China.有些人甚至从医疗服务提供者那里购买这些药物。今年4月，一个联邦大陪审团起诉了一名犹他州的医生，指控他向200多名患者出售了瑞他鲁肽和其他肽类药物的安瓿。根据起诉书，该医生自制了标签，且并未向患者透露这些药物是在网上从中国一家公司订购的。In some cases, patients have been able to fill prescriptions from providers at compounding pharmacies. The F.D.A. has warned companies that make drug ingredients to stop selling retatrutide to compounders. The agency cited one of those companies for unsanitary conditions, including “black chunks” in some of its pharmaceutical ingredients.在某些情况下，患者还能在配制药房凭医嘱配制处方药。FDA已警告药品原料生产商，停止向配制药房出售瑞他鲁肽。该机构还以卫生条件不达标为由点名了其中一家公司，包括发现其部分药物成分中存在“黑色块状物”。Investigators have tried to contain the flood of illicit retatrutide. Between December 2025 and March 2026, customs agents in Ohio caught more than 5,000 shipments of peptides, including retatrutide, smuggled in from China. But border agents can only examine a fraction of the packages that come into the country, said Dan Burke, who previously served as chief of the Investigative Services Division in the F.D.A.’s Office of Criminal Investigations.调查人员曾试图遏制非法瑞他鲁肽的泛滥。2025年12月至2026年3月，俄亥俄州的海关人员查获了5000多批从中国走私入境的肽类药物，其中就包括瑞他鲁肽。但曾任FDA刑事调查办公室调查服务处处长的丹·伯克表示，边境执法人员只能检查入境包裹中的一小部分。Easy Access, Little Certainty易于获取，难辨真伪The traditional process to get a drug approved by the F.D.A. takes years. Beyond clinical trial results, the agency reviews the drug’s ingredients and manufacturing process, including how the drugmaker plans to ensure the medicine is made safely. Investigators also inspect the facilities that will make the new drug. By the time a medicine makes it to market, doctors, statisticians, toxicology specialists and other experts have rigorously examined it.通过FDA批准新药的传统流程需要数年时间。除了临床试验结果外，该机构还会审查药物的成分和制造过程，包括制药商计划如何确保药物的安全生产。调查人员还会检查生产这种新药的设施。到一种药物最终上市时，医生、统计学家、毒理学专家和其他专家已经对其进行了严格的审查。People ordering retatrutide online, by contrast, have few ways of knowing whether they are getting the actual drug, or whether it’s sterile and safe to take.相比之下，在网上订购瑞他鲁肽的人几乎无从得知自己收到的是否是真正的药物，也无法知道它是否无菌以及服用是否安全。There are a number of third-party labs that now market their services to test retratrutide and other peptides, charging hundreds of dollars to analyze a single sample. Some of these labs are legitimate, Mr. Burke said. But others are less legitimate — and more akin to “someone that does this on the side in their basement,” he said.现在有许多第三方实验室在推销自己检测瑞他鲁肽和其他肽类药物的服务，分析单个样本收费数百美元。伯克说，其中一些实验室是正规合法的，但也有一些不太正规——更像是“有人在自家地下室顺便搞的副业，”他说。Mr. Jamison, the spokesman from Eli Lilly, said that proving that two drugs contain the same active ingredient required exhaustive testing, “not just the rudimentary tests commonly reflected on so-called ‘certificates of analysis.’”礼来公司发言人贾米森表示，要证明两种药物含有相同的活性成分，需要进行详尽的测试，“而不仅仅是所谓‘分析证书’中通常体现的那些基础检测。”Dr. Mackey said that some websites claiming to offer retatrutide might just be sending vials of other weight-loss drugs that are currently on the market, like semaglutide. It’s also possible that labs are making retatrutide, since the molecular structure of the drug is publicly available, Dr. Turnock said. But the average buyer is not using a testing service to confirm that, he added.麦基表示，一些声称提供瑞他鲁肽的网站寄出的可能只是目前市场上其他减肥药（如司美格鲁肽）的安瓿。特诺克指出，由于该药物的分子结构是公开的，实验室也有可能自行制造瑞他鲁肽。但他还说，普通买家并不会使用检测服务来证实这一点。“Unless you actually went to China and went to these labs, probably, you’d have no way of knowing,” he said.“除非你真的去了中国，亲眼去看了这些实验室，否则恐怕根本无从知晓，”他说。Even if a vial does contain retatrutide, the dearth of oversight means there are a number of other risks that can arise. The drug could be contaminated, or contain an incorrect dose.即使安瓿里确实含有瑞他鲁肽，缺乏监管也意味着可能会出现许多其他风险。药物可能受到污染，或者剂量不准确。An F.D.A. database showed that 40 people have reported having adverse reactions to retatrutide since 2024, including cardiac issues, appendicitis and blurred vision. Of these patients, 14 were hospitalized, and four were described as having “life-threatening” responses.FDA数据库显示，自2024年以来，已有40人报告对瑞他鲁肽产生不良反应，包括心脏问题、阑尾炎和视力模糊，其中14人住院治疗，其中四人的反应被描述为“危及生命”。Jacob Hanzel, 31, has been buying what he believes is retatrutide from a WhatsApp group since last year.31岁的雅各布·汉泽尔从去年开始一直通过一个WhatsApp群组购买他认为是瑞他鲁肽的药物。Mr. Hanzel first tried to get retatrutide in a clinical trial. When he wasn’t successful, he started shopping online. He felt he desperately needed to lose a significant amount of weight. When he started taking the drug, he weighed 447 pounds.汉泽尔最初试图通过参加临床试验来获得瑞他鲁肽。由于未能如愿，他开始在网上购买。他觉得自己迫切需要大幅减重。开始服用该药物时，他的体重约为202公斤。Mr. Hanzel has asked his doctor to regularly check his heart rate, blood sugar level and other bloodwork to make sure there are no warning signs of issues from the drug. Rather than “blindly trusting” the seller, he said, he also sends every batch to a lab to make sure it is pure, dosed correctly and doesn’t contain heavy metals.汉泽尔先生已要求医生定期检查他的心率、血糖水平和其他血液指标，以确保没有该药物引发问题的预警信号。他说，自己没有“盲目信任”卖家，会将每一批药物都送到实验室，以确保其纯度过关、剂量正确且不含重金属。“I was willing to take this risk,” he said. “While knowing it’s still a risk.”“我愿意冒这个风险，”他说。“尽管我知道这依然是个风险。”Dani Blum是时报健康记者。翻译：纽约时报中文网点击查看本文英文版。