Testing virtual reality-based cue-exposure software: Which cue-elicited responses best discriminate between patients with eating disorders and healthy controls?

Purpose: Virtual reality (VR) technologies have been proposed as a new tool able to improve on in vivo exposure in patients with eating disorders. This study assessed the validity of a VR-based software for cue exposure therapy (CET) in people with bulimia nervosa (BN) and binge eating disorder (BED). Methods: Fifty eight outpatients (33 BN and 25 BED) and 135 healthy participants were exposed to 10 craved virtual foods and a neutral cue in four experimental virtual environments (kitchen, dining room, bedroom, and cafeteria). After exposure to each VR scenario, food craving and anxiety were assessed. The frequency/severity of episodes of uncontrollable overeating was also assessed and body mass index was measured prior to the exposure. Results: In both groups, craving and anxiety responses when exposed to the food-related virtual environments were significantly higher than in the neutral-cue virtual environment. However, craving and anxiety levels were higher in the clinical group. Furthermore, cue-elicited anxiety was better at discriminating between clinical and healthy groups than cue-elicited craving. Conclusions: This study provides evidence of the ability of food-related VR environments to provoke food craving and anxiety responses in BN and BED patients and highlights the need to consider both responses during treatment. The results support the use of VR-CET in the treatment of eating disorder patients characterized by binge-eating and people with high bulimic symptoms

VR-based cue-exposure therapy (VR-CET) versus VR-CET plus pharmacotherapy in the treatment of bulimic-type eating disorders

Treatment guidelines recommend antidepressant medication for bulimic-type eating disorders either as an alternative to or in combination with cognitive behavioural therapy (CBT). This study compared the efficacy of two second-line treatments of patients with bulimic-type eating disorders resistant to CBT: virtual reality-based cue-exposure therapy (VR-CET) alone or VR-CET in combination with pharmacotherapy. Results showed that bingeing episodes, bulimic symptomatology (the bulimia EDI-3 score) and food cravings (FCQ-T/S) were significantly reduced after both interventions. However, no significant differences were found between the combined intervention and VR-CET alone. Improvements from the treatments continued at the 6-month follow-up. Our results support the use of VR-CET as an effective treatment of bulimic-type eating disorders, reducing bulimic symptoms and food cravings. The addition of antidepressants to VR-CET does not provide any additional benefit

Using virtual reality for cue-exposure therapy in a case of bulimia nervosa

This case study describes the use of a virtual reality-based cue-exposure therapy (VR-CET) for a patient diagnosed with bulimia nervosa (BN) who was resistant to standard cognitive behavioral therapy (CBT). After six VR-CE booster sessions, both anxiety and food craving dropped significantly. No binging and purging episodes were reported at the end of the treatment. Patient\u2019s mood and confidence to change were also improved. Finally, both eating symptoms and food craving were reduced at the end of the VR-CET. These results support the use of VR-CE as an effective component for the treatment of BN to reduce bulimia symptoms, body dissatisfaction and craving, especially in patients resistant to conventional treatments