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Using Virtual Reality to Lose Weight

Researchers are exploring the possible benefits of using virtual reality to treat eating disorders and obesity.

By Lorna Collier
American Psychological Association

Lori Blanck is attempting to maintain a recent 30-pound weight loss — a feat she's struggled with in the past. But this time the 56-year-old veteran of diets, pills and supplements is trying a new tool to help keep the pounds off: virtual reality.

Blanck is participating in a University of Kansas Medical Center study that is looking at the use of Second Life — a three-dimensional, immersive environment, where people interact as avatar versions of themselves — to promote and maintain weight loss. The 18-month, National Institutes of Health-funded study follows an earlier pilot study that found that when people used avatars to practice healthy eating and exercise, they were more likely to lose weight.

"I'm getting such a kick out of it — it's definitely motivating," says Blanck, who designed her avatar to look like a slightly fitter version of herself, in spiffy exercise togs. As Blanck steps her avatar through Zumba moves and practices better food choices at the virtual grocery store, she says she feels like "it's really me doing these things."

The University of Kansas Medical Center researchers are among a number of scientists worldwide who are examining the use of virtual reality therapy to treat patients with weight issues. The technology is being studied not only for its value in helping patients achieve and maintain weight loss but also as a tool in treating anorexia and binge eating. Researchers are also finding evidence that the use of virtual worlds with avatars can help reverse body-image misperceptions.

Several studies show that virtual reality can help people struggling with obesity lose weight. In the University of Kansas Medical Center pilot study, for example, 20 participants were randomized to two groups. The first received counseling and instruction in the university's Second Life "island" for nine months, while the second group spent three months going to weekly face-to-face counseling sessions in the real world and then six months in Second Life. Researchers found that those who had spent the entire nine months in Second Life and had no face-time with counselors lost more weight and kept it off, were more active, and ate more fruits and vegetables than the face-to-face group.

The new, $1.2 million NIH-funded study now underway has 202 participants, and uses a new Second Life island built for this study with input from University of Kansas psychologists, dietitians and exercise scientists. The new island — Healthy U — includes more virtual environments, such as walking trails, a gym with a swimming pool, a home to host parties, a "mindful eating room" with calming music where participants learn not to wolf down food, a library, a restaurant and a convenience store. It's too early to say whether this study will show benefits for Second Life as the first study did, says Debra K. Sullivan, PhD, who chairs the department of dietetics and nutrition, ran the pilot study and is leading the new one.

Research studies in Italy, Mexico and Spain have shown that incorporating virtual reality with cognitive behavior therapy (CBT) can help improve patients' body image. Researchers are combining CBT sessions that help patients work through body issues, weight control challenges, stress and other issues with experiential simulations held in virtual realms. Some studies find these VR-enhanced sessions are more effective than conventional CBT.

MindTrip MagazineIn a study of 90 morbidly obese patients with binge eating disorder, researchers from the Istituto Auxologico Italiano in Verbania, Italy, reported that patients who were treated with a combination of inpatient treatment, CBT and VR were better able to lose weight and keep it off for one year, as well as reduce the number of binging episodes, than those who received inpatient treatment alone or inpatient treatment with conventional CBT.

Another study combining CBT with virtual reality also had positive results, according to a team of Spanish researchers led by José Helio Marco, PhD, from the Catholic University of Valencia. The study of 34 participants with a variety of eating disorders compared those who received cognitive behavior therapy with those who also received CBT with virtual reality to improve their satisfaction with their bodies. At the one-year follow-up, patients who had received both therapies improved more and maintained this improvement better than those with CBT alone or than controls.

Given indications of its benefits for obesity and eating disorder treatment, why hasn't virtual reality therapy found its way into clinical practice? One issue is the cost of equipment, says Dawn McDaniel, PhD, director of research at Virtually Better, an Atlanta-based company that provides virtual software for mental health applications, such as PTSD and phobia therapies. Virtual reality clinical applications can be expensive to set up due to hardware such as double-monitor systems (so the therapist can monitor and control what the patient sees), head-mounted gear, tactile platforms to produce vibrations and even a scent machine to create smells, she says.

In an effort to address cost concerns, J. Graham Thomas, PhD, assistant professor of psychiatry and human behavior at Alpert Medical School at Brown University, partnered with Virtually Better to develop a virtual reality program to help foster weight loss. Armed with a $225,000 NIH Small Business Technology Transfer grant, Thomas's goal is to create a consumer application for easy online use on home computers. For their pilot study, the team created "Experience Success," a software program with one social scenario — a party at a friend's house — where participants practice weight loss skills, such as selecting healthy food from a buffet. Thomas has applied for NIH funding for a second phase of the project, which would create more scenarios and conduct randomized trials to see if the program improved weight loss.

If the program proves successful, people would access it on their own computers, without the use of 3D glasses or other immersive equipment. "We wanted something that could be commercialized and could be scaled up very easily," Thomas says.

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