title: Virtual Reality-Enhanced Cognitive-Behavioral Therapy for Morbid Obesity: A Randomized Controlled Study with 1 Year Follow-Up.
abstract: It is well known that obesity has a multifactorial etiology, including biological, environmental, and psychological causes. For this reason, obesity treatment requires a more integrated approach than the standard behavioral treatment based on dietary and physical activity only. To test the long-term efficacy of an enhanced cognitive-behavioral therapy (CBT) of obesity, including a virtual reality (VR) module aimed at both unlocking the negative memory of the body and to modify its behavioral and emotional correlates, 163 female morbidly obese inpatients (body mass index >40) were randomly assigned to three conditions: a standard behavioral inpatient program (SBP), SBP plus standard CBT, and SBP plus VR-enhanced CBT. Patients' weight, eating behavior, and body dissatisfaction were measured at the start and upon completion of the inpatient program. Weight was assessed also at 1 year follow-up. All measures improved significantly at discharge from the inpatient program, and no significant difference was found among the conditions. However, odds ratios showed that patients in the VR condition had a greater probability of maintaining or improving weight loss at 1 year follow-up than SBP patients had (48% vs. 11%, p = 0.004) and, to a lesser extent, than CBT patients had (48% vs. 29%, p = 0.08). Indeed, only the VR-enhanced CBT was effective in further improving weight loss at 1 year follow-up. On the contrary, participants who received only the inpatient program regained back, on average, most of the weight they had lost. Findings support the hypothesis that a VR module addressing the locked negative memory of the body may enhance the long-term efficacy of standard CBT.
authors.affiliation: 1 Psychology Research Laboratory, Ospedale San Giuseppe, Istituto Auxologico Italiano , Verbania, Italy .|2 Department of Psychology, Catholic University of the Sacred Heart , Milan, Italy .
authors.forename: Gian Mauro
authors.initials: GM
authors.lastname: Manzoni
authors.affiliation: 3 Applied Technology for Neuro Psychology Lab, Istituto Auxologico Italiano , Verbania, Italy .|4 Centro Obesità e Nutrizione Clinica (CONC) , Ospedale Privato Accreditato Villa Igea, Forlì (FC), Italy .
authors.forename: Gian Luca
authors.initials: GL
authors.lastname: Cesa
authors.affiliation: 3 Applied Technology for Neuro Psychology Lab, Istituto Auxologico Italiano , Verbania, Italy .
authors.forename: Monica
authors.initials: M
authors.lastname: Bacchetta
authors.affiliation: 1 Psychology Research Laboratory, Ospedale San Giuseppe, Istituto Auxologico Italiano , Verbania, Italy .|2 Department of Psychology, Catholic University of the Sacred Heart , Milan, Italy .
authors.forename: Gianluca
authors.initials: G
authors.lastname: Castelnuovo
authors.affiliation: 3 Applied Technology for Neuro Psychology Lab, Istituto Auxologico Italiano , Verbania, Italy .
authors.forename: Sara
authors.initials: S
authors.lastname: Conti
authors.affiliation: 2 Department of Psychology, Catholic University of the Sacred Heart , Milan, Italy .|3 Applied Technology for Neuro Psychology Lab, Istituto Auxologico Italiano , Verbania, Italy .
authors.forename: Andrea
authors.initials: A
authors.lastname: Gaggioli
authors.affiliation: 5 CESCOM-Centre for Research in Communication Sciences, University of Milan-Bicocca , Milan, Italy .
authors.forename: Fabrizia
authors.initials: F
authors.lastname: Mantovani
authors.affiliation: 1 Psychology Research Laboratory, Ospedale San Giuseppe, Istituto Auxologico Italiano , Verbania, Italy .|2 Department of Psychology, Catholic University of the Sacred Heart , Milan, Italy .
authors.forename: Enrico
authors.initials: E
authors.lastname: Molinari
authors.affiliation: 6 Laboratorio de Enseñanza Virtual y Ciberpsicología, Facultad de Psicología, Universidad Nacional Autónoma de México , México, Mexico .
authors.forename: Georgina
authors.initials: G
authors.lastname: Cárdenas-López
authors.affiliation: 2 Department of Psychology, Catholic University of the Sacred Heart , Milan, Italy .|3 Applied Technology for Neuro Psychology Lab, Istituto Auxologico Italiano , Verbania, Italy .
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Riva
mesh_terms: D000328:Adult; D001828:Body Image / Q000523:psychology; D015992:Body Mass Index; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005247:Feeding Behavior / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008568:Memory; D008875:Middle Aged; D009767:Obesity, Morbid / Q000523:psychology / Q000628:therapy*; D010549:Personal Satisfaction; D016896:Treatment Outcome; D063367:Virtual Reality Exposure Therapy / Q000379:methods*; D015431:Weight Loss; D055815:Young Adult