Developing new virtual reality treatments for eating disorders

Eating disorders are serious mental illnesses. They affect all ages and genders, most commonly adolescents and young adults.

Roughly a third of individuals with an eating disorder don’t fully recover. Some are unwell for 10 years or longer.

This makes it important to develop new treatments, to prevent eating disorders affecting young people’s physical, emotional, social, and educational development.

Project aims

The aim of this project is to develop new treatments for eating disorders using immersive virtual reality (VR). The treatments will be designed to address different aspects of eating disorders. These aspects have been selected with the help of patient and public involvement, engagement and participation (PPIEP) focus groups and existing evidence.

We will use the person-based approach to design and optimise these new treatments. The person-based approach is an evidence-based research method used for developing health interventions.

We will use feedback from people with lived experience to design, test, analyse and refine the new treatments. Their views and perspectives will be combined with existing research evidence. This will help ensure the intervention is as engaging and as effective as possible.

The interventions we design will be based around:

• A virtual café environment where people with eating disorders can practice scenarios they find challenging
• A gamified task aimed at retraining attention away from underweight bodies
• An intervention to explore inhabiting and viewing different versions of one’s body in VR

Our work so far

To design the virtual café environment, we first needed to understand the challenges people with eating disorders face when eating out.

We held interviews and focus groups with:

• 15 people, aged 14-25 years, with experience of eating disorders
• 4 parents and carers
• 6 healthcare professionals

Participants described cafés as difficult places where people with eating disorders face unexpected challenges. They may also experience intense, difficult emotions, including feeling anxious, stressed, and overwhelmed. The noise and busyness of the physical café environment contribute to these feelings.

Interactions with other people in cafés also pose a challenge. This includes fears of being judged on their appearance and food choices. Challenges around looking at menus with and without calories, choosing and ordering food, and actually consuming food and drink were also highlighted.

Despite common themes, challenges faced are individual and may depend on a person’s eating disorder diagnosis and stage of recovery.

We created our VR café to reflect the different challenges that people told us they would like to practice in a virtual environment. We then developed it further with young people with experience of a range of different eating disorders, and input from clinicians who work with people with eating disorders.

What next?

We now want to find out whether it’s possible to recruit young people who are currently accessing treatment for an eating disorder in the NHS to a research study where they receive sessions with a clinician using the VR café, alongside their usual treatment.

What we hope to achieve

We want to find out whether people with eating disorders find the VR café helpful and acceptable to use, which people find it most helpful, and at what stage in treatment it is most useful.

We also want to find out whether people will continue to take part until the study ends.

The findings of this study will help us to plan future research studies using the VR café. They will also help us understand whether it might be possible to offer the VR café intervention to people with eating disorders in NHS services on a larger scale.

Our end goal is for our intervention to be used as part of treatment for people with eating disorders.

Would you like to take part in our study?

We’re looking for people aged 14-25 who:

• Find social eating challenging
• Are currently accessing NHS treatment for an eating disorder in Gloucestershire Health and Care NHS Foundation Trust

If this sounds like you, then we would like to invite you to test out our VR café intervention.

We’ll ask you to attend up to 6 individual sessions, lasting 1 hour. During this hour you will be supported by a clinician to use the VR café. We’ll also ask you to complete some questionnaires whilst you are taking part in the study.

While you are in our study, you’ll continue receiving your usual treatment for your eating disorder.

You’ll receive vouchers to thank you for your time, and travel expenses will be reimbursed.

Find out more about the study here.