In a patient with anorexia nervosa, the highest treatment priority is:

• A. helping the patient achieve a good self-concept.
• B. observation of all eating acitvities.
• C. correction of nutritional and electrolyte imbalances.
• D. inclusion of the family in the treatment plan.

Answer: (C)

In anorexia nervosa, the top priority is medical stabilization through correcting nutritional and electrolyte imbalances. Severe malnutrition can lead to dangerous shifts in electrolytes (like potassium, phosphorus, and magnesium) and fluid balance, which can cause life-threatening cardiac rhythms, arrhythmias, and organ failure. Addressing these physiological issues first is essential before pursuing therapies aimed at long-term psychosocial goals. Refeeding and weight restoration are started under careful medical supervision to prevent refeeding syndrome, and this stabilization may require hospitalization if the abnormalities are significant. Once the body's condition is stabilized, you can safely focus on other aspects of treatment, such as addressing self-concept, monitoring eating behaviors, and incorporating the family into the plan.