A 32-Year-Old Woman Comes to the Office at Her Husband's

A 32-year-old woman comes to the office at her husband's insistence for evaluation of weight loss.  She is unconcerned about her weight loss and explains that she is training for a marathon and would like to lose more to reach an ideal running weight.  The patient has lost 15.0 kg (33 lb) in the last 6 months and has not had a menstrual period for the past 2 months.  Medical history is significant for depression in her 20s that responded well to selective serotonin reuptake inhibitors.  Current medications include multivitamins, polyethylene glycol for constipation, and calcium and green tea extract supplements.  She has no depressed or anxious mood, cold or heat intolerance, or change in sleep pattern.
Temperature is 36.4 C (97.5 F) , blood pressure is 105/60 mm Hg, pulse is 56/min and regular, and respirations are 12/min.  There is no orthostasis.  BMI is 16 kg/m².  There is no edema.  The abdomen is soft and nontender.
Complete blood count and blood chemistry studies are normal.  Pregnancy test is negative.
In addition to referral for nutritional rehabilitation, which of the following is the most appropriate treatment for this patient?

A) Aripiprazole
B) Bupropion
C) Cognitive-behavioral therapy
D) Fluoxetine
E) Olanzapine