Objective This study aimed to assess the impact of the COVID‐19 pandemic on the efficacy of an intensive treatment based on enhanced cognitive behavioral therapy (CBT‐E) in patients with anorexia nervosa. Methods This cohort study analyzed 57 patients with anorexia nervosa who experienced the COVID‐19 pandemic during intensive CBT‐E, comparing their outcomes (body mass index [BMI], eating‐disorder and general psychopathology, and clinical impairment) with those of patients with anorexia nervosa matched by gender, age, and BMI given the same treatment before the COVID‐19 outbreak as controls. Patients were assessed at baseline, at the end of treatment and after 20 weeks of follow‐up. Results More than 75% of patients during the pandemic versus 85% of controls completed the treatment, a difference that was not significant. BMI, eating disorder and general psychopathology and clinical impairment scores improved significantly from baseline to 20‐week follow‐up in both groups. However, the improvement was more marked in controls than in those treated during the COVID‐19 pandemic. Conclusion Patients with anorexia nervosa given intensive CBT‐E during the COVID‐19 pandemic had significantly improved psychopathology, albeit to a lesser extent than patients given the same treatment before the COVID‐19 pandemic. Public significance statement In this study, the outcome of 57 patients with anorexia treated with intensive enhanced cognitive behavior therapy during the COVID‐19 pandemic was compared with a matched group treated before the pandemic hit. The rate of remission from anorexia nervosa was similar between the two groups. However, patients exposed to the COVID‐19 pandemic showed lesser improvement than those not exposed.

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