Gemesi Kathrin, Döllinger Nina, Weinberger Natascha-Alexandra, Wolf Erik, Mal David, Keppler Sebastian, Wenninger Stephan, Bader Emily, Wienrich Carolin, Luck-Sikorski Claudia, Latoschik Marc Erich, Israel Johann Habakuk, Botsch Mario, Holzapfel Christina
Institute for Nutritional Medicine, School of Medicine and Health, Technical University of Munich, Munich, Germany.
Psychology of Intelligent Interactive Systems (PIIS) Group, University of Würzburg, Würzburg, Germany.
BMC Med Inform Decis Mak. 2025 Apr 25;25(1):176. doi: 10.1186/s12911-025-02993-x.
A negative body image can have an impact on developing and maintaining obesity. Using virtual reality (VR) to conduct cognitive behavioral therapy (CBT) is an innovative approach to treat people with obesity. This multicenter non-randomized pilot study examined the feasibility and the effect on eating behavior and body perception of a newly developed VR system to conduct body image exercises.
Participants with a body mass index (BMI) ≥ 30.0 kg/m without severe mental diseases attended three study visits in an interval of one to four weeks to receive virtual (VR intervention) or traditional (non-VR intervention) body image exercises. Data on anthropometrics, eating behavior (Dutch Eating Behavior Questionnaire, DEBQ), body perception (Body Shape Questionnaire, BSQ; Multidimensional Assessment of Interoceptive Awareness, MAIA), and satisfaction (standardized interview and questionnaire) were collected.
In total, 66 participants (VR intervention: 31, non-VR intervention: 35) were included. The majority was female (52/66, 78.8 %), the mean age was 45.0 ± 12.8 years, and the mean BMI was 36.8 ± 4.3 kg/m. Both intervention groups showed non-significant body weight reduction (VR intervention: 1.7 ± 3.3 %, non-VR intervention: 0.9 ± 3.0 %) and showed no statistically significant difference between the groups (p = 0.35). Scores of DEBQ, BSQ, and MAIA showed over time no statistically significant changes neither between the two groups nor within the groups (all p ≥ 0.05). The overall satisfaction of the VR group with the two virtual body image exercises was high (4.1 ± 0.8 on a 5-point Likert scale).
The intervention with the developed VR system was feasible and the virtual and traditional body image exercises resulted in statistically non-significant weight loss. It seems that single focus on body image is not successful in improving eating behavior and body perception in people with obesity. Long-term human intervention studies with larger sample sizes are necessary to examine the efficacy of integrating this kind of VR system into standard obesity therapy.
This study was registered in the German Clinical Trials Register (Registration number: DRKS00027906, Date of registration: 8 February 2022).
负面身体形象会对肥胖的发展和维持产生影响。使用虚拟现实（VR）进行认知行为疗法（CBT）是治疗肥胖症患者的一种创新方法。这项多中心非随机试点研究考察了一种新开发的用于进行身体形象锻炼的VR系统的可行性及其对饮食行为和身体感知的影响。
体重指数（BMI）≥30.0kg/m²且无严重精神疾病的参与者每隔一至四周参加三次研究访视，接受虚拟（VR干预）或传统（非VR干预）身体形象锻炼。收集了人体测量学、饮食行为（荷兰饮食行为问卷，DEBQ）、身体感知（身体形状问卷，BSQ；内感受觉知多维评估，MAIA）和满意度（标准化访谈和问卷）的数据。
总共纳入了66名参与者（VR干预组：31名，非VR干预组：35名）。大多数为女性（52/66，78.8%），平均年龄为45.0±12.8岁，平均BMI为36.8±4.3kg/m²。两个干预组的体重均有非显著下降（VR干预组：1.7±3.3%，非VR干预组：0.9±3.0%），且两组之间无统计学显著差异（p = 0.35）。DEBQ、BSQ和MAIA的得分随时间推移在两组之间以及组内均无统计学显著变化（所有p≥0.05）。VR组对两种虚拟身体形象锻炼的总体满意度较高（5分制李克特量表上为4.1±0.8）。
使用所开发的VR系统进行干预是可行的，虚拟和传统身体形象锻炼导致的体重减轻在统计学上不显著。似乎单纯关注身体形象对改善肥胖症患者的饮食行为和身体感知并不成功。需要进行更大样本量的长期人体干预研究，以检验将这种VR系统整合到标准肥胖治疗中的疗效。
本研究已在德国临床试验注册中心注册（注册号：DRKS00027906，注册日期：2022年2月8日）。
