Integrating Physical Rehabilitation with Enhanced Cognitive Behavioural Therapy in Eating Disorders: The Villa Garda Approach

Eating disorders present unique challenges in physical rehabilitation due to the complex interplay between malnutrition-related physical impairments and psychological factors that maintain pathological exercise behaviors. This paper describes therapeutic procedures for integrating physical rehabilitation within an enhanced cognitive behavior therapy (CBT-E) framework for patients with eating disorders in a specialized inpatient setting. The approach addresses both the physical adaptations to malnutrition and the psychological mechanisms that perpetuate excessive exercise. A three-phase progressive model is presented, incorporating systematic assessment protocols, graduated exposure strategies, and real-time monitoring of cognitive and emotional processes during physical activity. The model is designed to restore functional capacity while simultaneously addressing the psychopathological features that maintain the disorder. Clinical implications, current limitations, and future research directions are discussed, with particular emphasis on the potential role of fitness assessment as a therapeutic tool within personalized CBT-E formulation.