Table 2 Core procedures and nutritional and physical rehabilitation protocols of intensive CBT-E

Core procedures

 • Assisted eating (three meals and one snack a day)

 • Weekly review meeting (with the clinical psychologist, dietician, nurse, and physician)

 • Collaborative weighing one a week

 • Individual CBT-E sessions

 • Group treatment sessions

Nutritional rehabilitation protocol

 • Weight goal: BMI ≥ 19

 • Expected speed of weight gain: 1 to 1.5 kg per week

 • Daily calorie content of the meal plan is established collaboratively with the patient according to the following guidelines:

  —Week 1: Menu A (1500 kcal)

  —Week 2: Menu B (2000 kcal)

  —Afterward:

   ○ If the weight increases between 1 and 1.5 kg per week, the meal plan is maintained with the same calorie content as the previous week

   ○ If the weight increases to less than 1 kg per week, the meal plan is increased by 500 kcal per day. For example, from Menu B to Menu C (2500 kcal) or from Menu C to Menu D (3000 kcal)

   ○ If the weight increases more than 1.5 kg per week, the meal plan is reduced by 250 kcal per day. For example, from Menu C to Menu B / C (2250 kcal)

   ○ When the patient reaches a BMI of 19, the program’s goal is to identify a weight range of 3 kg that can be achieved without adopting a calorie restriction. In most patients, weight maintenance occurs with a diet between 2000 (Menu B) and 2500 kcal (Menu C)

Physical rehabilitation protocol

 • All patients above a BMI of 15 participate in two 30-min sessions per week of calisthenics with a physiotherapist