Virtual Reality for Enhancing the Cognitive Behavioral Treatment of Obesity: A Controlled Study with One-Year Follow-up
|
If you are the presenter of this abstract (or if you cite this abstract in a talk or on a poster), please show the QR code in your slide or poster (QR code contains this URL). |
Abstract
Background: For many, obesity is just a problem of energy regulation: more energy input than expenditure. However, as obese subjects know well, habits and desires often override metabolic need. Additional research identifies unhealthful weight-control behaviors (fasting, vomiting or laxative abuse)
induced by a negative experience of the body, as the common antecedents of both obesity and eating disorders. In particular, according to the "Allocentric Lock Hypothesis - ALH" (doi:10.1016/j.mehy.2011.10.039; doi:10.1016/j.mehy.2012.03.036) individuals with obesity may be locked to an allocentric (observer view) negative memory of the body that is no longer updated by contrasting egocentric representations driven by perception. In other words, these patients may be locked to an allocentric negative representation of their body that their sensory inputs are no longer able to update even after a
demanding diet and a significant weight loss.
Objective: Though the ALH has yet to be backed by research data, we decided to test the hypothesis clinically. In particular, we decided to include a Virtual Reality (VR) protocol aimed at unlocking the negative memory of the
body (its description can be found here: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3125918/ while the software can be downloaded here: http://www.neurovr.org) within an inpatient, medically-managed intensive cognitive-behavioral obesity treatment. We tested its efficacy in a controlled trial.
Methods: Our multimodal approach was tested within a controlled trial (ISRCTN59019572) with CBT and an integrated treatment including nutritional groups, a low-calorie diet (1,200 kcal/day) and physical training. The
sample included 163 morbid obese females with a B.M.I.>40 and a documented history of failures.
Results: Though further studies are needed, the results are promising. First, findings illustrate that a medically-managed intensive inpatient obesity treatment, independently from the specific approach, can substantially decrease weight (5-10%; effect size: 0.72) and improve the psychological well-being (effect size: 0.16/0.26) in a relatively brief period (6/8 weeks) even in a hard-to-treat population. Second, data also
suggest that the inclusion of virtual reality may further improve the long-term outcome. The multimodal protocol was significantly better after one-year follow-up in maintaining the results of the treatment than both CBT
(% of subjects who maintained or improved the weight reduction: MA [22/46, 48%] vs CBT [11/38, 29%], Odds Ratio [OR], 2.25; 95% Confidence Interval [CI] 0.91 - 5.58) and IT (% of subjects who maintained or improved the
weight reduction: MA [22/46, 48%] vs IT [3/26, 29%], OR, 7.03; 95% CI 1.85 - 26.70).
Conclusions: These data support the hypothesis that the integration of a VR treatment, aimed at unlocking the negative memory of the body, may improve the long term outcome of an obesity treatment. Moreover, it offers a first clinical support to the ALH hypothesis.
induced by a negative experience of the body, as the common antecedents of both obesity and eating disorders. In particular, according to the "Allocentric Lock Hypothesis - ALH" (doi:10.1016/j.mehy.2011.10.039; doi:10.1016/j.mehy.2012.03.036) individuals with obesity may be locked to an allocentric (observer view) negative memory of the body that is no longer updated by contrasting egocentric representations driven by perception. In other words, these patients may be locked to an allocentric negative representation of their body that their sensory inputs are no longer able to update even after a
demanding diet and a significant weight loss.
Objective: Though the ALH has yet to be backed by research data, we decided to test the hypothesis clinically. In particular, we decided to include a Virtual Reality (VR) protocol aimed at unlocking the negative memory of the
body (its description can be found here: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3125918/ while the software can be downloaded here: http://www.neurovr.org) within an inpatient, medically-managed intensive cognitive-behavioral obesity treatment. We tested its efficacy in a controlled trial.
Methods: Our multimodal approach was tested within a controlled trial (ISRCTN59019572) with CBT and an integrated treatment including nutritional groups, a low-calorie diet (1,200 kcal/day) and physical training. The
sample included 163 morbid obese females with a B.M.I.>40 and a documented history of failures.
Results: Though further studies are needed, the results are promising. First, findings illustrate that a medically-managed intensive inpatient obesity treatment, independently from the specific approach, can substantially decrease weight (5-10%; effect size: 0.72) and improve the psychological well-being (effect size: 0.16/0.26) in a relatively brief period (6/8 weeks) even in a hard-to-treat population. Second, data also
suggest that the inclusion of virtual reality may further improve the long-term outcome. The multimodal protocol was significantly better after one-year follow-up in maintaining the results of the treatment than both CBT
(% of subjects who maintained or improved the weight reduction: MA [22/46, 48%] vs CBT [11/38, 29%], Odds Ratio [OR], 2.25; 95% Confidence Interval [CI] 0.91 - 5.58) and IT (% of subjects who maintained or improved the
weight reduction: MA [22/46, 48%] vs IT [3/26, 29%], OR, 7.03; 95% CI 1.85 - 26.70).
Conclusions: These data support the hypothesis that the integration of a VR treatment, aimed at unlocking the negative memory of the body, may improve the long term outcome of an obesity treatment. Moreover, it offers a first clinical support to the ALH hypothesis.
Medicine 2.0® is happy to support and promote other conferences and workshops in this area. Contact us to produce, disseminate and promote your conference or workshop under this label and in this event series. In addition, we are always looking for hosts of future World Congresses. Medicine 2.0® is a registered trademark of JMIR Publications Inc., the leading academic ehealth publisher.
This work is licensed under a Creative Commons Attribution 3.0 License.