Virtual reality in the treatment of eating and weight disorders

The clinical use of Virtual Reality (VR) with eating disturbances is based on theory-driven psychological treatment techniques (Ferrer-Garcia & Gutierrez-Maldonado, 2012; Ferrer-Garcia et al. 2013; Koskina et al. 2013). First, VR can reduce eating-related anxiety during and after exposure to virtual food, helping to disrupt the reconsolidation of adverse, food-related memories (Koskina et al. 2013; Pla-Sanjuanelo et al. 2015). Second, a recent neuroscientific model of body image disturbances – the Allocentric Lock Theory – suggested that eating disorders may be associated with impairment in the ability to update a stored, negative allocentric (offline) representation of one's body with real-time (online/egocentric), perception-driven inputs (Riva & Gaudio, 2012; Riva, 2014; Dakanalis et al. 2016). As demonstrated by two of the above RCTs (Cesa et al. 2013; Manzoni et al. 2016), the addition of VR sensory training to unlock the body memory (body image rescripting protocol) by increasing the contribution of new, egocentric/internal, somatosensory information directly related to the existing allocentric memory improved the efficacy of CBT at 1-year follow-up.