External Eating as a Predictor of Cue-reactivity to Food-related Virtual Environments

Marta Ferrer-Garcia, José Gutiérrez-Maldonado, Joana Pla-Sanjuanelo, Ferran Vilalta-Abella, Alexis Andreu-Gracia, Antonios Dakanalis, Fernando Fernandez-Aranda, Adela Fusté-Escolano, Joan Ribas-Sabaté, Giuseppe Riva, Carmina Saldaña, Isabel Sánchez

Research output: Chapter in Book/Report/Conference proceedingChapter


The objective of this study was to assess the association between external eating style and food craving experienced during exposure to food cues in virtual reality (VR) environments in both clinical and non-clinical samples. According to the externality theory, people with external eating experience higher reactivity when exposed to food cues, which in turn increases the probability of overeating. Forty patients with eating disorders (23 with bulimia nervosa and 17 with binge eating disorder) and 78 undergraduate students were exposed to 10 different food cues in four VR environments (kitchen, dining room, bedroom, and café). After 30 seconds of exposure to each VR environment, food craving was assessed using a visual analog scale. External, emotional and restrictive eating styles were also assessed using the DEBQ. The results showed a strong association between external eating and cue-elicited food craving. After controlling for the presence of eating disorder diagnosis, external eating was the best predictor of reported food craving. The results lend support to the externality theory but highlight the need for further research in specific patterns of functioning in patients with bulimia nervosa and binge eating disorder.

Original languageEnglish
Title of host publicationAnnual Review of Cybertherapy and Telemedicine 2015: Virtual Reality in Healthcare: Medical Simulation and Experiential Interface
PublisherIOS Press
Number of pages6
ISBN (Electronic)9781614995944
Publication statusPublished - 2015

Publication series

NameStudies in Health Technology and Informatics
ISSN (Print)09269630
ISSN (Electronic)18798365


  • binge-eating disorder
  • bulimia nervosa
  • External eating
  • food craving
  • virtual reality exposure

ASJC Scopus subject areas

  • Biomedical Engineering
  • Health Informatics
  • Health Information Management


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