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Cyberpsychol Behav Soc Netw. 2016 Feb;19(2):134-40. doi: 10.1089/cyber.2015.0208. Epub 2015 Oct 2.

Virtual Reality-Enhanced Cognitive-Behavioral Therapy for Morbid Obesity: A Randomized Controlled Study with 1 Year Follow-Up.

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1 Psychology Research Laboratory, Ospedale San Giuseppe, Istituto Auxologico Italiano , Verbania, Italy .
2 Department of Psychology, Catholic University of the Sacred Heart , Milan, Italy .
3 Applied Technology for Neuro Psychology Lab, Istituto Auxologico Italiano , Verbania, Italy .
4 Centro Obesità e Nutrizione Clinica (CONC) , Ospedale Privato Accreditato Villa Igea, Forlì (FC), Italy .
5 CESCOM-Centre for Research in Communication Sciences, University of Milan-Bicocca , Milan, Italy .
6 Laboratorio de Enseñanza Virtual y Ciberpsicología, Facultad de Psicología, Universidad Nacional Autónoma de México , México, Mexico .


It is well known that obesity has a multifactorial etiology, including biological, environmental, and psychological causes. For this reason, obesity treatment requires a more integrated approach than the standard behavioral treatment based on dietary and physical activity only. To test the long-term efficacy of an enhanced cognitive-behavioral therapy (CBT) of obesity, including a virtual reality (VR) module aimed at both unlocking the negative memory of the body and to modify its behavioral and emotional correlates, 163 female morbidly obese inpatients (body mass index >40) were randomly assigned to three conditions: a standard behavioral inpatient program (SBP), SBP plus standard CBT, and SBP plus VR-enhanced CBT. Patients' weight, eating behavior, and body dissatisfaction were measured at the start and upon completion of the inpatient program. Weight was assessed also at 1 year follow-up. All measures improved significantly at discharge from the inpatient program, and no significant difference was found among the conditions. However, odds ratios showed that patients in the VR condition had a greater probability of maintaining or improving weight loss at 1 year follow-up than SBP patients had (48% vs. 11%, p = 0.004) and, to a lesser extent, than CBT patients had (48% vs. 29%, p = 0.08). Indeed, only the VR-enhanced CBT was effective in further improving weight loss at 1 year follow-up. On the contrary, participants who received only the inpatient program regained back, on average, most of the weight they had lost. Findings support the hypothesis that a VR module addressing the locked negative memory of the body may enhance the long-term efficacy of standard CBT.

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