There are specific rules for describing fatty acids, according to their structure and the position of their double bonds. In the last example above, the double bonds occur on the sixth and ninth carbon atoms from the methyl end of the carbon chain. It would be written as C18: 2n-6 because it has 18 carbons (C18), two double bonds (:2) and the first double bond occurs on the sixth carbon from the end (n-6).

Qmega-3s and Omega-6s are often in the news because nutritionists now believe they need to be present in the diet in the right balance. (Some of the products which come from the Omega-3 and Omega-6 fatty acids oppose each other in such complex processes as blood clotting and inflammation. This opposition keeps the balance between, for example, the blood clotting and blood thinning mechanisms.)

In many modem diets they are not well balanced, with many more Omega-6s than Omega-3s being eaten. The two major competitors are an Omega-6 fatty acid called linoleic acid (C18:2n-6) and an Omega-3 called Underlie acid (C18:3n-3): both are essential for humans. linoleic add definitely has advantages over the saturated fats for blood cholesterol, but too much of it will not only add to total fat intake, but may upset the balance between Omega-6 and Omega-3- Rich sources of linoleic acid are vegetable oils and margarines. Rich sources of linolenic acid are fish and shellfish. Oleic acid (C18:n-9), the monounsaturated fatty acid found in olive and canola oils, has its only double bond on the 9th carbon from the methyl end of the chain. It does not compete with the other two essential fatty acids and is generally regarded as an all-round good guy in its effect on cholesterol and other metabolic processes, but it does add to total fat intake.

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After a year or two of constant vomiting, a patient may end up with crumbling, ugly teeth. The most common symptom is perimolysis-dental erosion due to calcium loss brought about by the acid in the vomitus – but patients wind up with a lot of cavities as well. Some report that their teeth are abnormally sensitive to temperature changes. Many bulimics, aware of the danger, try to compensate by brushing vigorously after each vomiting episode. Ironically, overenthusiastic scrubbing only hastens erosion. Eating-disordered people may eat a lot of citrus fruit or candy to stave off hunger, which further damages teeth. Starvation and malnutrition also weaken the bones of the jaw.

Disordered eating and purging may lead to chemical imbalances in the brain. Consequently, bulimics may experience sleep difficulties as well as mood changes such as depression.

Vomiting does more than just remove food. The bitter taste of vomit comes from the mix of stomach acid and other digestive juices secreted during the process of eating. Your body works hard to make that juice. Like little factories, the pancreas, the liver, the gallbladder, and other organs manufacture different enzymes and other substances to enable you to break down fats and absorb calories. Those substances are made up of proteins, minerals, and other elements that were absorbed from previous meals and stored in these organs.

Thus, when you throw up, you not only remove nutrients you need now, but you also deplete the reserves of those nutrients absorbed during previous meals. Without these life-giving substances, your heart can’t function properly, nor can your other muscles and tissues. As a result you may experience weakness, fatigue, constipation, depression, even heart failure. Another serious complication can arise for those patients who use ipecac to induce vomiting. Ipecac is a nonprescription medicine used to trigger vomiting after accidental poisoning. Unfortunately, repeated use of ipecac may weaken muscles (including the heart); fatal heart difficulties have occurred in a number of bulimic patients who abused this drug.

The loss of chemical building blocks also makes it harder to manufacture the hormones needed to regulate various body systems, including the reproductive system. By definition, all anorexics experience loss of menstrual periods; about 20 percent of bulimics become amenorrheic, while about 50 percent experience menstrual irregularities.

Poor eating habits affect the brain and the nervous system. Some eating-disordered patients show abnormalities on brainwave (electroencephalograph, or EEG) tracings. Just what this means medically, however, is not yet clear. Sleep is affected too; bulimics may enter the rapid-eye movement (REM) phase of sleep sooner than normal. Disturbed sleep at night means fatigue the next day. Some patients report feeling muscle spasms or tingling sensations.

Vomiting removes a lot of fluid. So does abuse of laxatives and diuretics. Such practices can lead to chronic dehydration, which in turn poses the risk of permanent kidney damage.

Using laxatives is like locking the barn door after the horse has escaped. By the time food enters the large intestine, nearly 90 percent of its calories have already been absorbed anyway. In the course of a day, laxatives might help you get rid of the caloric equivalent of one measly candy bar.

But is it worth it? The risks of laxative abuse include dehydration, poor absorption of food and its nutrients, abdominal and muscular cramps, mineral imbalances, and swelling or clubbing of the fingers. Some of my patients admit taking anywhere from four to a hundred (!) laxative tablets every day.

Abuse of laxatives can cause the bowel to become dependent on these substances to function normally. The bowel loses its ability to contract in a coordinated way to move the fecal material along. A kind of backup in the biological sewage system results, leading to bloating and abdominal distension. When the patient stops taking laxatives, severe constipation may occur, in some cases requiring surgical intervention.

Some bulimics try to control appetite through excessive use of diet pills, which may contain the stimulants known as amphetamines. Side effects of these substances include mood changes, irritability, fatigue, and insomnia. The attempt to suppress appetite artificially only works for so long; eventually, the desire to eat becomes overwhelming. Thus, ironically, the use of appetite suppressants might actually lead to an eating binge. Another stimulant widely abused by bulimics is caffeine, both to suppress appetite and to improve mood and energy level.

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All her life, Betty had enjoyed swimming for recreation and physical fitness. While working as an elementary school psychologist in Jacksonville, Horida, she swam for 45 minutes, twice a week. She rounded out her exercise program with step-aerobics classes and strength training.

Shortly after Betty retired, her regular workouts came to a screeching halt. She took time off to decorate her condominium and spend 2 months traveling across the United States, Canada, and abroad. Betty returned home renewed and invigorated—but discouraged about her 15-pound weight gain. She decided to jump back into the pool to work off those extra pounds.

Betty swam for an hour, 3 days a week. She also lifted weights twice a week and enjoyed an occasional bike ride or long walk.

Within 3 months, Betty lost those nagging 15 pounds. She has maintained a healthy weight of 133 for 6 years.

At age 67, Betty, now a resident of Show Low, Arizona, remains passionate about swimming. In fact, she even began entering competitions. To date, she has won 11 medals—many for first place— and has advanced to national competition in backstroke and breaststroke.

“Swimming is such a peaceful and relaxing sport,” Betty says. “When I do the backstroke, I stare up at the sky and daydream. I know what runners mean when they talk about a runner’s high. After a challenging swim, I enjoy my swimmer’s high.”

WINNING ACTION

Slim down in the swimming pool. You may have heard that swimming isn’t an ideal activity for losing weight. But in one study, women who swam burned the same amount of fat as women who walked. The trick is to make sure the water is the right temperature—at least 80°F. If the water is too cold, you may start feeling hungry as your body craves extra calories to burn for warmth. Also, be sure to swim continuous laps, rather than stopping each time you reach the wall. Do as many laps as you can in 20 to 30 minutes.

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