Do people with a high score on a scale for eating in response to negative emotions also show high food intake in response to positive emotions? We studied these effects in 60 female students that were preselected on the basis of extreme high or low scores on an emotional eating questionnaire. Using a between subject design we experimentally tested the difference in food intake following a mood induction designed to induce joy or sadness (the joy vs. sad mood condition). The high and low emotional eaters did not differ in their food intake, but emotional eating significantly moderated the relationship between mood condition and food intake. Whereas low emotional eaters ate similar amounts after the sad and after the joy mood condition, high emotional eaters ate significantly more after the sad mood condition than after the joy mood condition. A further finding was that a similar moderator effect for emotional eating was found for intake of sweet food but not for intake of salty food. These findings would suggest that eating in response to negative and to positive emotions refer to two different constructs.

This article reviews research into the use of virtual reality in the study, assessment, and treatment of body image disturbances in eating disorders and nonclinical samples. During the last decade, virtual reality has emerged as a technology that is especially suitable not only for the assessment of body image disturbances but also for its treatment. Indeed, several virtual environment-based software systems have been developed for this purpose. Furthermore, virtual reality seems to be a good alternative to guided imagery and in vivo exposure, and is therefore very useful for studies that require exposure to life-like situations but which are difficult to conduct in the real world. Nevertheless, review highlights the lack of published controlled studies and the presence of methodological drawbacks that should be considered in future studies. This article also discusses the implications of the results obtained and proposes directions for future research.

Since the late 1990s the use of virtual reality (VR) has expanded in the field of mental disorders. During this time, several VR-based applications have been developed for the treatment of eating disorders (ED) and obesity. Both these pathologies involve disturbances related to eating behavior, weight, and body image. Although effective and well-established protocols are now available for the treatment of ED and obesity, relapses are frequent and a proportion of patients do not improve after intervention. In this context, VR has been shown to be a useful technology for enhancing traditional cognitive-oriented therapies. The main objective of this review was therefore to examine the evidence regarding the efficacy of VR-based treatments as a component of therapeutic interventions for ED and obesity. To this end, three databases (PsycInfo, Medline, and PsycArticles) were searched for the period 1986–2012. Only research articles and case studies were selected. Although several methodological deficiencies were detected in the reviewed studies, there is fair evidence for the effectiveness of VR-based treatments in ED and obesity. VR-based interventions usually combine exposure to VR environments with cognitive therapies. The VR component seems to be especially suitable for reducing body image disturbances, such as body image dissatisfaction, and for increasing self-esteem and self-efficacy. The rationale for the use of VR in these areas is also presented and discussed.

This article reviews the 6-month followup data of a randomized, multicenter, parallel-group study conducted at five clinical sites in three European cities, which compared two second-level treatments for bulimia nervosa (BN) and binge eating disorder (BED): virtual reality-based cue exposure therapy (VR-CET) versus additional cognitive behavioral therapy (A-CBT). Post-treatment outcomes of this study were previously published and details of its design can be found at clinicaltrials.gov (identifier: NCT02237300). This article focuses on the evolution of symptoms assessed after 6 months of followup in a subgroup of 58 patients from the original study. In this study 64 patients with eating disorders (EDs) (35 with BN and 29 with BED), who still showed active episodes of binge eating by the end of a structured CBT program (first-level treatment), were randomly assigned to one of two second-level treatments (A-CBT or VR-CET). Frequency of binge and purge episodes, and attitudinal features of binge-related EDs (bulimia, drive for thinness, and body dissatisfaction) were assessed before starting the second-level treatment ( n = 64), at the end ( n = 64), and at 6-month followup ( n = 58). Mixed between-within subject analyses of variance were used to compare outcomes of both second-level treatments over time. Although both treatment conditions showed statistically significant improvements at the end and after 6-month followup, obtained reductions were greater after VR-CET, regarding binge and purge episodes, as well as the decrease of self-reported tendency to engage in overeating episodes. Accordingly, abstinence from binge episodes were higher in VR-CET than A-CBT at followup (70 percent vs. 26 percent, respectively; χ ² = 11.711, p = 0.001). These results provide further support for the use of VR-CET as an effective second-level intervention for BN and BED treatment-resistant patients.

In vivo body exposure therapy is considered an effective and suitable intervention to help patients with anorexia nervosa (AN) reduce their body image disturbances (BIDs). However, these interventions have notable limitations and cannot effectively reproduce certain fears usually found in AN, such as the fear of gaining weight (FGW). The latest developments in virtual reality (VR) technology and embodiment-based procedures could overcome these limitations and allow AN patients to confront their FGW and BIDs. This study aimed to provide further evidence of the efficacy of an enhanced (by means of embodiment) VR-based body exposure therapy for the treatment of AN. Thirty-five AN patients (16 in the experimental group, 19 in the control group) participated in the study. FGW, BIDs, and other body-related and ED measures were assessed before and after the intervention and three months later. The experimental group received treatment as usual (TAU) and five additional sessions of VR-based body exposure therapy, while the control group received only TAU. After the intervention, ED symptoms were clearly reduced in both groups, with most of the changes being more noticeable in the experimental group. Specifically, after the intervention and at follow-up, significant group differences were found in the FGW and BIDs, with the experimental group showing significantly lower values than the control group. The current study provides new insights and encouraging findings in the field of exposure-based therapies in AN. VR technology might improve research and clinical practice in AN by providing new tools to help patients confront their core fears (i.e., food- or weight-related cues) and improve their emotional, cognitive, and behavioral responses to their body image.