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ans
The answer is: B
When body weight drops 35% below the minimum normal for age and height, electrolytes are apt to become severely imbalanced. Ventricular tachycardia and arrhythmia occur and the patient with anorexia nervosa becomes vulnerable to sudden death. These characteristics develop due to prolonged starvation. Suicide can occur in instances when the patient becomes depressed and loses all hope. Antidepressants have little positive effect. Supportive care by an understanding physician may accomplish as much as formal psychotherapy. Behavior modification techniques and group and family therapy (family interrelationships appear to be significant) are sometimes helpful. Explicit contracts for a weight-goal diet and a healthy exercise pattern can also be beneficial. Realistic reviews of the dangers of starvation and sincere assurance from the physician that "we will not let you get fat" can also be helpful. The physician should be perceived as an advisor and partner, not as an enemy or parental surrogate. Hospitalization may be lifesaving if hypokalemia, hypotension, and prerenal azotemia are present. The prognosis is variable with approximately half of the anorectic patients achieving normal weight, 20% improve but remain underweight, 20% are not cured and remain anorectic, 5% become obese, and 6% die. Even of those who reach normal weight or improve, two-thirds will continue binge eating, vomiting, and laxative use, making treatment and monitoring a lifelong endeavor.
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