Why is it so hard for patients with ED to choose recovery, make a plan, and stick with it? Why can't patients simply decide that they will get help, enter into a treatment program, and start eating?
There seems to be evidence that patients with ED may have a hard time planning their meals/food intake ahead of time. While they could do this well in all other areas of their lives, making decisions and plans about their meals/recovery was harder. Are patients stupid or dumb because of this? No. It is simply that their brains have not had to think about eating in so long. So, making plans for recovery is something new to them. And new things take time to get used to or to master.
Why is this important? Does it really matter if meals are planned beforehand?
Well, yes. Kind of. Imagine this: if the patient is anxious about food intake, it is already difficult to eat. Now, it is time for the individual to eat. And there are so many options to choose from! Instead of thinking, 'hmm...what looks good to me? What do I WANT to eat now?', the individual may simply choose not to eat because he or she is overwhelmed. Or, there might not be any (or little) food options, and the person may therefore feel that they don't 'have an appetite' or are too anxious to go find food elsewhere (or doesn't have time, etc.).
Or what about an event where one does not plan meals, opens the fridge, and discovers that there is no food inside? Do you think ED will tell them to go to the grocery store and buy it? NO! 'You don't have what you need to eat? Oh well. I guess that means you cannot eat', Again, ED wins. So, by planning, the patient ensures that they are one step ahead of ED. They are prepared for all the challenges he might throw at me because they know that he will take any small chance to make them slip back into his control.
So, while the brain chemistry of ED patients may show that there is some difficulties with planning, this does not mean that patients are stupid or silly. It does not mean that they cannot make decisions. It simply means that their brains have been used to avoiding food, so it will take time to get used to it again. In the meantime, planning is the safest way to go. Plan your meals, what you will eat, when you will eat, who will make your food, etc. It may sound challenging and boring, but putting in about ten minutes to plan a week's meals will save patients the anxiety and stress of not eating and falling back into ED's traps. 10 minutes from a day planning meals for the next week saves the individual a lifetime of health issues related to ED. 10 minutes of planning what they will eat for the week means that ED has NO TIME to try to convince them not to eat. 10 minutes of planning - that's all it takes. An ounce of prevention is worth a pound of cure.