A 17-year-old with severe anorexia has bradycardia, hypotension, and BMI < 15 but is refusing psychiatric care. Which plan reflects the best prioritization of multidisciplinary treatment steps?

• A. Defer all medical intervention and first attempt outpatient nutritional counseling only to respect patient autonomy, because medical stabilization should only be used as a last resort after lengthy psychotherapeutic work.
• B. Start high-intensity exercise programs to rebuild muscle mass immediately, postponing medical monitoring and psychiatric therapy because exercise will normalize physiological variables fastest.
• C. Begin with elective cosmetic counseling and body image workshops before addressing medical or psychiatric needs because improving body image in group settings is the single most effective measure for severe anorexia with cardiac signs.
• D. Immediate medical stabilization (monitoring vitals, correcting electrolytes, inpatient care if unstable), concurrent engagement of psychiatric services for psychological assessment and therapy as tolerated, and initiation of nutrition rehabilitation under medical supervision — early coordinated intervention is vital.

Answer: (D)