Serino Silvia, Scarpina Federica, Keizer Anouk, Pedroli Elisa, Dakanalis Antonios, Castelnuovo Gianluca, Chirico Alice, Novelli Margherita, Gaudio Santino, Riva Giuseppe
Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, MilanItaly; Department of Psychology, Università Cattolica del Sacro Cuore, MilanItaly.
"Rita Levi Montalcini" Department of Neuroscience, University of Turin, TurinItaly; Psychology Research Laboratory, IRCCS Istituto Auxologico Italiano, Ospedale San Giuseppe, PiancavalloItaly.
Front Psychol. 2016 Jun 16;7:837. doi: 10.3389/fpsyg.2016.00837. eCollection 2016.
The available clinical guidelines for super-super obese patients (i.e., with body mass index (BMI) > 60 kg/m(2)) that are not suitable for bariatric surgery mandate a palliative multidisciplinary treatment (i.e., production and maintenance of weight loss) provided in a center of excellence. However, the modality and the impact of this approach are still controversial. Moreover, it is not able to address the high level of body dissatisfaction and body distortions that are common among these patients.
We report the case of a non-operable super-super obesity - a 37 year old woman with a BMI of 62 kg/m(2) - receiving a specialized treatment for her obstructive sleep apnea. She entered a multidisciplinary program that promoted healthy behaviors, including physical activities and psychological intervention. To improve body dissatisfaction, which was linked to a significant multisensory impairment of body perception, she also entered a virtual reality (VR) body-swapping illusion protocol. At the end of the current investigation, the patient continued her multidisciplinary program, reporting an increase in the motivation for undertaking healthy behavior and a decrease in the anxiety feelings associated with her clinical condition.
This case provides preliminary evidence that both body dissatisfaction and body-size distortions of non-operable super-super obesity patients could be addressed by a VR body-swapping protocol, which is important because the palliative multidisciplinary treatment recommended for these patients is not able to address them. Interestingly, the use of a VR body-swapping illusion protocol seems to be able to improve not only the experience of the body in these patients but their motivation for change, too.
对于不适宜进行减肥手术的超超级肥胖患者（即体重指数（BMI）>60 kg/m²），现有的临床指南要求在卓越中心提供姑息性多学科治疗（即实现并维持体重减轻）。然而，这种治疗方法的方式和效果仍存在争议。此外，它无法解决这些患者中常见的高度身体不满和身体变形问题。
我们报告了一例无法进行手术的超超级肥胖病例——一名37岁女性，BMI为62 kg/m²，因阻塞性睡眠呼吸暂停接受了专门治疗。她参加了一个促进健康行为的多学科项目，包括体育活动和心理干预。为了改善与身体感知的严重多感官障碍相关的身体不满，她还参加了虚拟现实（VR）身体互换错觉方案。在本次调查结束时，患者继续她的多学科项目，报告称从事健康行为的动机有所增加，与她临床状况相关的焦虑情绪有所减少。
该病例提供了初步证据，表明无法进行手术的超超级肥胖患者的身体不满和身体尺寸变形都可以通过VR身体互换方案来解决，这一点很重要，因为为这些患者推荐的姑息性多学科治疗无法解决这些问题。有趣的是，使用VR身体互换错觉方案似乎不仅能够改善这些患者的身体体验，还能提高他们改变的动机。
