JMIR Publications

ABSTRACT

Background:

The current use of Virtual Reality (VR) interventions, based on Cognitive Behavioral Therapy principles, has been proven effective as an additional component to standard psychological therapy for obesity. These interventions successfully promote healthy behaviors and address negative body image concerns. However, they have not fully addressed certain underlying causes of obesity, such as lack of motivation to change, low self-efficacy, and internalized weight stigma, which often impede treatment adherence and long-term lifestyle habit changes. To tackle these concerns, the present study introduces the VR self-counseling paradigm, which incorporates embodiment and body-swapping techniques, along with motivational strategies, to help people with obesity effectively address some of the root causes of their condition.

Objective:

To assess the clinical efficacy of ConVRself, a VR platform that allows participants to engage in motivational self-conversations.

Methods:

A randomized controlled trial was conducted with 68 participants from the bariatric surgery waiting list from the Obesity Unit of the Vall d’Hebron University Hospital. Participants were randomly assigned to one of the three groups: Control Group (CG) only received the treatment as usual from the Obesity Unit; Experimental Group 1 (EG1), after intensive Motivational Interviewing training, engaged in 4 sessions of virtual self-conversations with ConVRself, undergoing the embodiment and body-swapping techniques; Experimental Group 2 (EG2) participants engaged in 4 sessions led by a virtual counselor with a pre-recorded discourse, only undergoing the embodiment technique. VR interventions from both groups were assisted by a clinical researcher. Readiness to change habits, eating habits, psychological variables, and adherence and satisfaction with the VR platform were measured at baseline, post-intervention, one week, and four weeks post-intervention.

Results:

Regarding primary outcomes, EG1 (n=24) and EG2 (n=22) showed significant improvements in "Confidence to lose weight" compared to the CG (n=22) at all assessment points. Similarly, EG1 demonstrated a significant increase after the intervention in "Readiness to exercise more" compared to CG. Regarding secondary outcomes, EG1 showed a significant reduction of “Uncontrolled eating” and “Emotional Eating” compared to the CG, as well as in their “Anxiety” levels compared to EG2 and CG. In addition, all participants reported high VR-interventions adherence and satisfaction. No significant timexgroup effect for the rest of the variables was reported.

Conclusions:

This study revealed that using VR self-conversations, based on motivational interviewing principles, may have benefits in helping people with obesity to enhance their readiness to change habits and self-efficacy, and reduce dysfunctional eating behaviors and anxiety. Clinical Trial: ClinicalTrials.gov NCT05094557