Virtual reality-enhanced cognitive-behavioral therapy for morbid obesity: A randomized controlled study with 1 year follow-up

Gian Mauro Manzoni, Gian Luca Cesa, Monica Bacchetta, Gianluca Castelnuovo, Sara Conti, Andrea Gaggioli, Fabrizia Mantovani, Enrico Molinari, Georgina Cárdenas-López, Giuseppe Riva

Research output: Contribution to journalArticle


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.

Original languageEnglish
Pages (from-to)134-140
Number of pages7
JournalCyberpsychology, Behavior, and Social Networking
Issue number2
Publication statusPublished - Feb 1 2016


ASJC Scopus subject areas

  • Human-Computer Interaction
  • Applied Psychology
  • Communication
  • Computer Science Applications
  • Social Psychology

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