BRIEF REPORT Day-hospital enhanced cognitive behavior therapy for adults with eating disorders: Immediate and follow-up effects Riccardo Dalle Grave MD | Laura Dametti PsyD | Maddalena Conti PsyD | Chiara Bersan PsyD | Anna Dalle Grave PsyD | Simona Calugi PhD Department of Eating and Weight Disorders, Villa Garda Hospital, Garda, Italy Correspondence Riccardo Dalle Grave, Department of Eating and Weight Disorders, Villa Garda Hospital, Via Montebaldo, 89, I-37016 Garda (VR), Italy. Email: rdalleg@gmail.com Action Editor: Tracey Wade Abstract Objective: To assess outcomes in adult patients with eating disorders administered enhanced cognitive behavioral therapy (CBT-E) in a day-hospital setting. Method: Forty-three consecutive patients with eating disorders (86% females; mean age 28.8 [SD = 11.8]) were admitted to a 13-week day-hospital CBT-E program. Twenty-five (58.1%) patients were underweight (i.e., body mass index [BMI] <18.5 kg/m 2 ; BMI 15.4 [SD = 2.2]) and 18 not (mean BMI 23.1 [SD = 6.3]) at base- line. All patients responded poorly to prior outpatient treatment. Body mass index and Eating Disorder Examination Questionnaire (EDE-Q), Brief Symptom Inventory (BSI), and Clinical Impairment Assessment (CIA) scores were recorded at baseline, end of treatment, and 20-week follow-up. Results: In 37 patients (86.0%) who completed the treatment, there were substantial improvements in eating-disorder features, general psychopathology, clinical impair- ment, and body weight (only in underweight patients), which were well maintained at follow-up. Discussion: Day-hospital CBT-E is a promising treatment for adults with eating disorders. KEYWORDS Anorexia nervosa, body weight, Bulimia nervosa, cognitive behavior therapy, day hospital, drop-out, eating disorders, outcome, psychopathology, treatment 1 | INTRODUCTION Outpatient treatment is effective in many patients with eating disor- ders and is the recommended setting of care for most (National Guideline Alliance, 2017). However, some patients do not respond to outpatient treatment and require more intensive interventions. Day hospital is a less burdensome alternative to residential treat- ments for patients not responding to outpatient treatments. Although day-hospital treatment may be as intensive as inpatient treatment, it is cheaper and allows patients to address some environmental factors (e.g., socializing with others, social pressure to thinness, food expo- sure) maintaining their eating disorders in real time, as they return home every evening (Zipfel et al., 2002). Most of the day-hospital treatments for adults with eating disor- ders described in the literature are not theory driven. They incorpo- rate a mix of strategies and procedures, combining different psychological interventions with assisted eating and medical and psy- chiatric management, generally delivered in group settings (Zipfel et al., 2002). This eclectic approach, stemming from different theories, makes its replication problematic. Cognitive behavior therapy for eating disorders (CBT-ED), on the other hand, is recommended by NICE guidelines as an effective, evidence-based treatment for all eating disorder categories (National Guideline Alliance, 2017). CBT-E (E = “enhanced”), the most clinically trialed form of CBT-ED, was initially designed to address eating disor- der psychopathology in adult outpatients (Fairburn, Cooper, & Received: 3 September 2021 Revised: 15 October 2021 Accepted: 15 October 2021 DOI: 10.1002/eat.23632 Int J Eat Disord. 2021;1–6. wileyonlinelibrary.com/journal/eat © 2021 Wiley Periodicals LLC. 1