New Technologies for Improving the Psychological Treatment of Obesity

Most clinicians and patients consider obesity just as a problem of energy balance: more energy input than expenditure. However, the epidemiological data and the clinical practice clearly show that obesity is more complex than described by this simple equation. In particular the chapter underlined the possible role of negative body image in the etiology of this disturbance. Specifically, we suggested that unhealthful weight-control behaviors, that induce significant weight gain over time, may be driven by an allocentric negative body image that is no more updated by contrasting egocentric representations driven by perception (allocentric lock). In other words, subjects are locked to an allocentric negative representation of their body that their sensory inputs are no more able to update even after the dramatic body changes following a successful diet or bariatric surgery. In the chapter we also discussed the possible role of virtual reality (VR) in addressing this problem within an integrated treatment approach. Specifically, we suggested that adding a 10-session experiential protocol based on the free NeuroVR (www.neurovr.org) virtual reality software to the classical treatment of obesity may improve its long-term outcome. The characteristics of the protocol and the outcome of two controlled clinical trials used to test it (VEPSY UPDATED - ISRCTN59019572, and AVATOB - NCT01394393) are detailed and discussed.