What is the first consideration in the management of an adolescent with an eating disorder and weight concerns?

• A. Nutritional restoration
• B. Behavioral modification
• C. Individual psychotherapy
• D. Family therapy

Answer: (A)

The first priority in managing an adolescent with an eating disorder and weight concerns is nutritional restoration. Malnutrition from an eating disorder can rapidly destabilize the body—affecting heart rate and blood pressure, causing electrolyte abnormalities and hypoglycemia, and impairing organ function. Restoring weight and normalizing caloric intake helps reverse these medical problems and makes the patient more able to participate in therapeutic interventions.

In practice, this often means medical stabilization with supervised refeeding, careful monitoring of electrolytes, and a gradual, protected increase in calories to avoid refeeding syndrome. Once medical stability and nutritional status are improved, behavioral strategies, psychotherapy, and family-based therapy can be effectively implemented to address the underlying factors sustaining the disorder.