Abstract

BackgroundBehavioral weight loss interventions promote clinically significant weight loss over 12 months, but weight regain remains problematic and a substantial proportion of participants do not achieve long-term weight loss maintenance. Novel methods are needed that instill habit strength for sustaining weight control behaviors long term. Virtual reality (VR) has the potential to provide opportunities within behavioral treatment for patients to practice desired weight control behaviors in the frequency and magnitude necessary to build durable habits. A pilot randomized trial was done to test the feasibility integrating virtual reality (VR) into standard behavioral weight loss treatment.MethodsParticipants were 15 adults (43 years; 46.7% Hispanic), with overweight or obesity who were randomly assigned to a 4-week Standard Behavioral Weight Loss plus Non-Weight-Related VR app (i.e., Control Group) or Standard Behavioral Weight Loss plus Weight-Related VR app (i.e., Intervention Group). The Intervention’s VR tool was designed to enable practice of behavioral skills taught in weekly group meetings, including managing social and home environmental cues for eating and activity.ResultsParticipants were recruited over 3 months, and retention at the final assessment visit was high (86.6%). The VR footage and resulting app were rated as highly realistic (6.7 on a 10-point scale), and the VR program overall was rated as highly satisfactory (3.6 on a 4-point scale). Adverse effects of eye strain and motion sickness were minimal (~ 2 on a 7-point scale). As expected, the intervention and control groups both lost weight and unadjusted means (SD) averaged 3.4% (2.7) and 2.3% (3.6), respectively, over the 4 weeks. Overall, participants reported preferring a VR approach above traditional weight loss programs (rating of 5 on a 7-point scale).ConclusionsFuture research is needed to develop and test the feasibility of using VR for other weight control skills with a larger sample size and longer evaluation period to determine if VR can improve standard behavioral weight loss outcomes by intensifying practice opportunities and building habit strength for weight loss maintenance.Trial registrationNCT04534088; date of registration: 09/01/2020, retrospectively registered.

Highlights

  • Behavioral weight loss interventions promote clinically significant weight loss over 12 months, but weight regain remains problematic and a substantial proportion of participants do not achieve long-term weight loss maintenance

  • Most Virtual reality (VR) research in the field of obesity has involved participants experiencing VR during weekly sessions in a clinic or an inpatient setting [9], having them interact with a cartoon graphic, or use an avatar in a “virtual world” like a video game [10]

  • Retention at the final assessment was high with 85.7% (6/7) of controls and 87.5% (7/8) of intervention participants completing the visit; two participants did not complete the final assessment due to reported lack of availability on the final assessment day (n = 1) and unable to contact (n = 1)

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Summary

Introduction

Behavioral weight loss interventions promote clinically significant weight loss over 12 months, but weight regain remains problematic and a substantial proportion of participants do not achieve long-term weight loss maintenance. Virtual reality (VR) has the potential to provide opportunities within behavioral treatment for patients to practice desired weight control behaviors in the frequency and magnitude necessary to build durable habits. Virtual reality (VR) has potential to overcome limitations in standard behavioral weight loss by providing opportunities to practice desired weight control behaviors in the frequency and magnitude necessary for durable habit formation [4,5,6,7,8]. By filming real-world environments, the 360 video VR has the potential to increase potency of the standard behavioral treatment approach, improve patient engagement and the ability to tolerate uncomfortable risk-related cues, and improve practice of desired behaviors in the frequency needed to promote habit strength in the behavioral skills of long-term weight loss maintenance

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