VR-based cue-exposure therapy (VR-CET) versus VR-CET plus pharmacotherapy in the treatment of bulimic-type eating disorders

Treatment guidelines recommend antidepressant medication for bulimic-type eating disorders either as an alternative to or in combination with cognitive behavioural therapy (CBT). This study compared the efficacy of two second-line treatments of patients with bulimic-type eating disorders resistant to CBT: virtual reality-based cue-exposure therapy (VR-CET) alone or VR-CET in combination with pharmacotherapy. Results showed that bingeing episodes, bulimic symptomatology (the bulimia EDI-3 score) and food cravings (FCQ-T/S) were significantly reduced after both interventions. However, no significant differences were found between the combined intervention and VR-CET alone. Improvements from the treatments continued at the 6-month follow-up. Our results support the use of VR-CET as an effective treatment of bulimic-type eating disorders, reducing bulimic symptoms and food cravings. The addition of antidepressants to VR-CET does not provide any additional benefit.