Some of you will see this title, “NEDA” and know exactly what it is.

Others of you have no clue, and for that I am grateful.

NEDA stands for National Eating Disorders Awareness.

There is a week dedicated to National Eating Disorders Awareness Week, and I never thought I’d write a post on A Gutsy Girl about the topic.

But here we are.

According to NEDA,

Eating disorders are serious but treatable mental and physical illnesses that can affect people of every age, sex, gender, race, ethnicity, and socioeconomic group. National surveys estimate that 20 million women and 10 million men in America will have an eating disorder at some point in their lives.

While no one knows for sure what causes eating disorders, a growing consensus suggests that it is a range of biological, psychological, and sociocultural factors.

The purpose of this post is not to share my full story because that’s going to take a very long time (since I’ve never openly and honestly shared it here).

Instead, the purpose is to tell you why I’m finally ready to talk about it.


My friend Nicole wrote on Instagram,

the reason i got away with it is because MOST PEOPLE WITH EATING DISORDERS DON’T LOOK LIKE THEY HAVE THEM. not every eating disorder is anorexia; not everyone suffering from an eating disorder is underweight; or a woman; or a white woman. it can be anyone, including your mom, dad, cousin, best friend, neighbor, favorite celeb, or even a fellow influencer projecting a healthy image here on the gram.

in my case, because i was never “too thin,” everyone assumed that i was the picture of good health, but inside, my body was shutting down and i needed help.

Once she said it like that, I knew I could and should start sharing my story, too.

Why? Not for me, but for you.

NEDA and Me

NEDA Sarah Kay Hoffman A Gutsy Girl #NEDA #guthealth #agutsygirl #healthyliving

I believe mine began as early as I can remember but because (as Nicole stated) I was never “too thin,” no one knew and I got by with everything. 

I’ve thought it and done it all, and it was never an act out of true vanity (like so many people believe an ED is), but instead an act of trying to be “enough.” 

And I never needed physical help because anything and everything that was physically happening to me was unseen

Sure, people may have thought I was thin at one point or another, but it was never too thin or never to the point where they would say anything.

Until someone did say something. And that’s when it all started changing for me, though it would still be a very long time until forever changes were made.

Again, all of the above are part of this very long and detailed story that I will share over time; not today.

What are Eating Disorders?

You might not be ready and willing to admit it yet (I stayed there for years), but it’s there.

This is because an eating disorder is not just anorexia and/or bulimia.

According to NEDA, here are all eating disorders:

  1. anorexia nervosa
  2. bulimia nervosa
  3. binge eating disorder
  4. orthorexia
  5. other specified feeding or eating disorder (OSFED)
  6. avoidant restrictive food intake disorder
  7. pica
  8. rumination disorder
  9. unspecified feeding or eating disorder
  10. laxative abuse
  11. compulsive exercise
  12. diabulimia

The very first step in realizing if you’re part of this is admitting that you fall under one (or several) of the above. How might you know?

Check out all of the signs and symptoms associated with each HERE.

NEDA and A Gutsy Girl

NEDA Sarah Kay Hoffman A Gutsy Girl #NEDA #guthealth #agutsygirl #gut

Listen, almost every single one of you who read this blog are A Gutsy Girl in some way, shape, or form (or a loved one is).

And I learned long ago that so many of you (us) found ourselves here because of disordered eating. 

The list above is long and complicated. If you click into each eating disorder on the NEDA website, you’ll find the health consequences associated with each. 

Click HERE to save these for later.

NEDA and the Gutsy Girl

After going through them all, here are the ones that I have found are most common in the A Gutsy Girl community:

  1. Loss of menstrual cycle (in women)
  2. Persistent fatigue and sluggishness
  3. Altered resting heart rate
  4. Stomach cramps, other non-specific gastrointestinal complaints (constipation, acid reflux, etc.)
  5. Abnormal laboratory findings (anemia, low thyroid and hormone levels, low potassium, low blood cell counts, slow heart rate)
  6. Dizziness
  7. Feeling cold all the time
  8. Sleep problems
  9. Dry skin
  10. Thinning of hair on head, dry and brittle hair
  11. Impaired immune functioning 
  12. Noticeable fluctuations in weight, both up and down 
  13. Body weight is typically within the normal weight range; may be overweight
  14. Difficulties concentrating
  15. Female Athlete Triad (in women) 

But you know what that can and oftentimes does translate to? Problems with the….

  1. Cardiovascular system
  2. Gastrointestinal system
  3. Neurological system
  4. Endocrine system
  5. Other

In terms you might relate to right now, things like: 

  1. IBS
  2. SIBO specific
  3. Hypothyroid
  4. “Adrenal Fatigue”
  5. Infertility

Don’t believe it about the gastrointestinal system?

This below is directly from NEDA:

Gastrointestinal System

Slowed digestion known as gastroparesis. Food restriction and/or purging by vomiting interferes with normal stomach emptying and the digestion of nutrients, which can lead to:

  • Stomach pain and bloating
  • Nausea and vomiting
  • Blood sugar fluctuations
  • Blocked intestines from solid masses of undigested food
  • Bacterial infections
  • Feeling full after eating only small amounts of food

Constipation, which can have several causes:

  • Inadequate nutritional intake, which means there’s not enough in the intestines for the body to try and eliminate
  • Long-term inadequate nutrition can weaken the muscles of the intestines and leave them without the strength to propel digested food out of the body
  • Laxative abuse can damage nerve endings and leave the body dependent on them to have a bowel movement

Binge eating can cause the stomach to rupture, creating a life-threatening emergency.

Vomiting can wear down the esophagus and cause it to rupture, creating a life-threatening emergency.

  • Frequent vomiting can also cause sore throats and a hoarse voice.

When someone makes themselves vomit over a long period of time, their salivary (parotid) glands under the jaw and in front of the ears can get swollen. This can also happen when a person stops vomiting.

Both malnutrition and purging can cause pancreatitis, an inflammation of the pancreas. Symptoms include pain, nausea, and vomiting.

Intestinal obstruction, perforation, or infections, such as:

  • Mechanical bowel problems, like physical obstruction of the intestine, caused by ingested items.
  • Intestinal obstruction or a blockage that prevents food and water from passing through the intestines.
  • Bezoar, a mass of indigestible material found trapped in the gastrointestinal tract (esophagus, stomach, or intestines).
  • Intestinal perforation, caused by the ingestion of a nonfood item that creates a hole in the wall of the stomach, intestines or bowels.
  • Infections such as toxoplasmosis and toxocariasis may occur because of ingesting feces or dirt.
  • Poisoning, such as heavy metal poisoning caused by the ingestion of lead-based paint.

This is Me

There was a time when I would critique every single last thing about the images and my lack of being “good enough.” 

And, if you look closely, my tattoo says, “I am enough.”

About Sarah Kay Hoffman A Gutsy Girl

If I could go back in time, I wouldn’t tell myself to “just not think like that.”

It’s not that easy, and anyone who has ever had any type of eating disorder knows this.

Instead, I would have sought out someone to talk to immediately. I would have taken action instead of feeling shame and embarrassment, saving myself so much of my story.

Truthfully, I 100% attribute almost every last health issue to years of playing this Russian Roulette with my health. 

We never intend to, but the sooner you can realize and admit you are, the better off you’ll be in the long run. 

This is why when I research and write about gut healing and overall health these days, it’s far more from the angle of,

How can I eat as many things as possible without hurting my progress?

I strive to be open and honest about the repercussions of what happens when you do not eat enough.

Because they are very real, and if you want to fully heal, it’s going to take a lot of work: mind, body, soul. 

But you totally can.

I am living proof.

And YOU are enough.

If you liked this post, you might also enjoy:

  1. Food Fear and Gut Healing
  2. Celiac, SIBO, and Eating Disorders
  3. Link Between Eating Disorders and Gut Health


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  1. It has taken many years to work through my struggles with food. Still a work in progress but better. Great information Sarah

  2. I know deep down, this is where this started for me. A broken little girl, trying to find control, in what was becoming a broken home.I Found myself with anorexia at 14. Although that only lasted a few years, with the loss of my period, hair on my head and growth of fuzzy body hair, it was just the beginning on me trying to “control” as much as I could to feel safe. The past 10 years have been so stressful and as I sit and look back, I’ve lost 15 lbs. Exercise was becoming a religion. Periods all over the place. Fatigue, headaches, etc. I’ve looked better than ever and it’s hard to admit than when you hear that, it doesn’t propel you to keep up with the madness. This is where the constipation began and has turned into IBS, then Sibo that I can’t seem to beat, to two autoimmune diseases and pelvic floor prolapse at 44. This is all from stress! I know it at my core.
    Your blog is so beautiful and speaks to my soul, as I’m sure it does to many others. It’s important work. Thank YOU for being open and honest and helping us to be more insightful. Prayers for healing for all of us here who suffer. 🙏🏻

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