Translating Virtual Reality Cue Exposure Therapy for Binge Eating into a Real-World Setting: A Pilot Study
Open accessAbstract
Binge-eating disorder (BED) and bulimia nervosa (BN) have adverse psychological and medical consequences. Novel interventions, like the integration of virtual reality (VR) with cue-exposure therapy (VR-CET), enhance outcomes for refractory patients compared to cognitive behavior therapy (CBT). Little is known about the feasibility and acceptability of translating VR-CET into real-world settings. To investigate this question, adults previously treated for BED or BN with at least one objective or subjective binge episode/week were recruited from an outpatient University eating disorder clinic to receive up to eight weekly one-hour VR-CET sessions. Eleven of 16 (68.8%) eligible patients enrolled; nine (82%) completed treatment; 82% (9/11) provided follow-up data 7.1 (SD=2.12) months post-treatment. Overall, participant and therapist acceptability of VR-CET was high. Intent-to-treat objective binge episodes (OBEs) decreased significantly from 3.3 to 0.9/week (p < .001). Post-treatment OBE 7-day abstinence rate for completers was 56%, with 22% abstinent for 28 days at follow-up. Among participants purging at baseline, episodes decreased from a mean of one to zero/week, with 100% abstinence maintained at follow-up. The adoption of VR-CET into real-world clinic settings appears feasible and acceptable, with a preliminary signal of efficacy. Findings, including some loss of treatment gains during follow-up may inform future treatment development.
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Systematic reviews have observed that some studies combining immersive virtual reality with cognitive behavioral therapy yielded better results.
“Systematic reviews have observed that some studies have combined IVR with other techniques, such as cognitive behavioral therapy (CBT), yielding better results [15][16][17].”
From Immersive Virtual Reality in Psychotherapeutic Interventions for Youth with Eating Disorders: A Pilot Study in a Rural Context (2025) · cites this paper as [17]
The Introduction reports that VR combined with cue-exposure therapy improved outcomes for patients with binge-type eating disorders who had not responded to treatment. The Discussion says prior studies found VR-CET superior to additional CBT after an unsuccessful CBT course. This paper is an uncontrolled pilot study, not a systematic review, and those passages do not describe immersive VR combined with CBT. (LLM, conf=0.86)
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- Authors
- Nameth, K., Brown, T., Bullock, K., Adler, S., Riva, G., Safer, D., & Runfola, C.
- Affiliations
- Stanford University (US)
- Università Cattolica del Sacro Cuore (IT)
- Corresponding author
- Nameth, Katherine
- Runfola, Cristin
- Venue
- Journal of Clinical Medicine
- Publisher
- MDPI AG
- Published
- 2021-03-04
- Volume
- 10
- Issue
- 7
- Pages
- 1511-1511
- ISSN
- 2077-0383 (ISSN-L)
- PMC
- PMC8038593
- OpenAlex
- W3144887865
- Cited by
- 17
- References
- 54
- Citations by year
- 2026: 3 · 2025: 3 · 2024: 3 · 2022: 6 · 2021: 2
- FWCI
- 1.88
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Journal of Clinical Medicine (publishedVersion, cc-by)
- Preprints.org (acceptedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- National Eating Disorders Association (133020)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
- Physical Sciences › Computer Science › Human-Computer Interaction › Virtual Reality Applications and Impacts
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- binge eating disorder, bulimia nervosa, eating disorders, treatment feasibility, acceptability, purging behavior
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