Virtual Reality and Eating Disorders: Why Should We Bring Virtual Reality Therapy to Kentucky?

Virtual Reality and Eating Disorders: Why Should We Bring VR Therapy to Kentucky?
By: Lisa Michelson
 
Within recent years, virtual reality has gained popularity in the entertainment industry. This new domain, where entertainment and technology intersect, has transformed games and television, making a whole new experience for the user. Healthcare providers have also noticed, and have begun to take advantage of this whole new world of possibilities for treating their patients.
 
Here are a few examples of how health professionals, specifically mental health professionals have begun using virtual reality (VR). VR has been used to treat phobias, anxieties, and fears (Garcia-Palacios et al., 2002). In the United States, Duke University has used VR as a form of cognitive behavioral therapy (CBT) for individuals with anxiety disorders (Zielinski et al., 2006). At the University of Southern California, a VR exposure therapy has been developed in order to address PTSD symptoms for individuals returning from military service in Iraq and Afghanistan (Rizzo & Hartholt, 2005). There are VR medical centers, VR clinical trials, and therapies that continue to be developed. In the eating disorder field, virtual reality is being used to implement CBT for individuals who suffer from eating disorder (ED) behaviors and symptoms. The kinds of VR experiences can range from a full body emersion (wearing sensors all over one’s body) to wearing goggles (for the user to see the VR world they have been placed in). Below is a list of some VR scenarios that participants have been placed in for treatment in Bulimia Nervosa (BN) and Binge Eating Disorder (BED) (Regine de Carvalho et al., 2017):
 

• Kitchen with high calorie foods
• Restaurant with low-calorie foods
• Swimming pool
• Small restaurant with a buffet table
• Bedroom
• Bakery/Cafe

 
Furthermore, below is a list of some outcomes that have been observed in utilizing VR in ED treatment (Regine de Carvalho et al., 2017):
 

• Virtual food was as effective as real food in producing physiological responses in ED patients (Gorini et al., 2010)
• ED patients showed body distortion and body dissatisfaction in high-calorie food VR environments than in low calorie food VR environments (Gutierrez-Maldonado, et al., 2010)
• VR was clinically meaningful to patients (Perpina et al., 2013)

 
Although Regine de Carvalho et al. (2017) did a systematic review of VR in the assessment and treatment of BN and BED, the number of studies that utilized VR in the treatment of BN and BED is few. In researching the use of VR in treating Anorexia Nervosa (AN), the number of studies that used VR within the United States was practically non-existent; most of AN and VR research being conducted in Europe, specifically Spain and Italy (Riva et al., 1999; Perpina et al., 1999).
 
In the previously mentioned studies, utilizing VR in ED treatment has been shown to improve behaviors and symptoms in participants. In other words, what is being done in these treatments IS working. However, the use of VR as exposure therapy for eating disorder treatment is still not only infrequently used, but underutilized and underdeveloped in the United States.
 
Here, at the EAT Lab, one of my jobs has been to find collaborators and programmers to develop such technology. While it has been a steep learning curve in understanding what technology would be most user-friendly, financially reasonable, and the best for therapy, we continue to learn more about this technology every week. In our own research into VR software development, it has become apparent why this form of therapy rarely exists in the United States; the combination of technology/entertainment and mental health therapy is still an unchartered (yet exciting!) territory. Communicating the wants/needs of what we, the therapists, want in the VR technology to the software development is like talking between two languages. However, through talking with multiple resources, we have hope that we are closer to brining this technology to Louisville and being amongst the first ED research facilities here to provide this cutting edge therapy to our clients.
 
To address the question that was posed in the title of this article (Why Should We Bring VR Therapy to Kentucky?), we know it can work to improve health outcomes for our clients and we hope that future advancements will provide more insight to our exposure therapy research.