When working with the family of a client with anorexia nervosa, which issue must be addressed?

Family systems theory suggests that anorexia nervosa often develops within a specific homeodynamic environment characterized by enmeshment and overprotection. In these families, the adolescent may feel a lack of autonomy, leading them to use food restriction as a way to exert sovereignty over the only thing they feel they can govern, that is, their own body. Rationale: A. Although issues of maturation and the physical changes of puberty are often central to the client's internal struggle, sexual identity is generally not the primary systemic issue addressed in family therapy for anorexia. The focus is more on the transition from childhood to independent adolescence. B. Clients with anorexia typically possess an extreme, pathological level of self-discipline. The goal of therapy is often to decrease this rigid internal regulation rather than address a lack of it. High self-discipline is a symptom of the disorder's ego-syntonic nature, not the underlying familial conflict. C. Control is the core psychological issue in the family of a client with anorexia. The family often struggles with allowing the client to develop a separate identity. By controlling their caloric intake to a life-threatening degree, the client is making a bid for individualization in a system that feels suffocatingly restrictive. D. Codependence is a term more frequently associated with substance use disorders and "enabling" behaviors. The family of an anorexic client is often enmeshed, but the clinical priority is addressing the power struggles and the need for personal agency rather than the rescue-victim cycles typical of codependency.