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.

Journal of Medical Internet Research - International Scientific Journal for Medical Research, Information and Communication on the Internet #Preprint #PeerReviewMe: Warning: This is a unreviewed preprint. Readers are warned that the document has not been peer-reviewed by expert/patient reviewers or an academic editor, may contain misleading claims, and is likely to undergo changes before final publication, if accepted, or may have been rejected/withdrawn. Readers with interest and expertise are encouraged to sign up as peer-reviewer, if the paper is within an open peer-review period. Please cite this preprint only for review purposes or for grant applications and CVs (if you are the author). Background: Despite the worldwide growth in mHealth tools and the possible benefits for both patients and healthcare providers, their overall adoption levels by health professionals remain relatively low. Objective: In the present study, we aim (1) to investigate attitudes of healthcare providers and mHealth experts towards mHealth tools in the health context in general, and (2) to test the acceptability and feasibility of a specific mHealth tool, called TCApp, for patients with an Eating Disorder (ED) among patients and ED specialists. Methods: To examine this, we conducted an explorative qualitative study with 3 in-depth group discussions with several groups of stakeholders: the first focus group was conducted with 11 experts on mHealth from the Catalan Association of Health Entities and 10 healthcare professionals from the Spanish College of Doctors of Barcelona. The second focus group involved 9 patients with an ED who had used the TCApp during 12 weeks and the third one, involved 8 ED specialists who had monitored patients online. Results: The focus groups showed that healthcare providers and mHealth experts reported more often barriers and less facilitators for mHealth adoption, thereby indicating that mHealth techniques are difficult to obtain and use. Most barriers were attributed to external factors related to the human or organizational environment (i.e. lack of time due to workload, lack of direct interest at a legislative or political level, among others) rather than internal factors related to individual obstacles. The results of the mHealth intervention study indicated that the TCApp was considered as easy to use and useful, although patients and ED specialists monitoring them online reported different adoption problems, such as lack of personalization of the device, lack of motivational and interactive components or difficulties in complying with the study protocol. Conclusions: In general, this study shows that both health professionals and patients foresee difficulties that need to be solved before adoption and usage of mHealth techniques can be effectively used in the near future. Findings are in line with previous studies, suggesting that healthcare providers are quite resistant and conservative about integrating mHealth technologies in their daily practice, although they acknowledge their possible benefits and cost-effectiveness.

Confinement during the COVID‐19 pandemic is expected to have a serious and complex impact on the mental health of patients with an eating disorder (ED) and of patients with obesity. The present manuscript has the following aims: (1) to analyse the psychometric properties of the COVID Isolation Eating Scale (CIES), (2) to explore changes that occurred due to confinement in eating symptomatology; and (3) to explore the general acceptation of the use of telemedicine during confinement. The sample comprised 121 participants (87 ED patients and 34 patients with obesity) recruited from six different centres. Confirmatory Factor Analyses (CFA) tested the rational‐theoretical structure of the CIES. Adequate goodness‐of‐fit was obtained for the confirmatory factor analysis, and Cronbach alpha values ranged from good to excellent. Regarding the effects of confinement, positive and negative impacts of the confinement depends of the eating disorder subtype. Patients with anorexia nervosa (AN) and with obesity endorsed a positive response to treatment during confinement, no significant changes were found in bulimia nervosa (BN) patients, whereas Other Specified Feeding or Eating Disorder (OSFED) patients endorsed an increase in eating symptomatology and in psychopathology. Furthermore, AN patients expressed the greatest dissatisfaction and accommodation difficulty with remote therapy when compared with the previously provided face‐to‐face therapy. The present study provides empirical evidence on the psychometric robustness of the CIES tool and shows that a negative confinement impact was associated with ED subtype, whereas OSFED patients showed the highest impairment in eating symptomatology and in psychopathology.