Virtual Reality in the Treatment of Patients with Overweight and Obesity: A Systematic Review

Perceptions of Immersive Virtual Reality for Physical Activity Among Individuals with Hypertension at Risk of Cardiovascular Disease: A Qualitative Study

Background: Hypertension, obesity, and a sedentary lifestyle are interrelated, forming a vicious cycle that deteriorates cardiovascular health. In addition to being a pathology, hypertension is a risk factor for cardiovascular diseases, one of the leading causes of mortality worldwide. Interventions that combine weight loss and physical activity (PA) reduce cardiovascular risk, but many people face barriers in adhering to regular PA regimens such as a lack of time or motivation. Immersive virtual reality (IVR) has emerged as an innovative alternative to promote PA. This study explored the perceptions of individuals with hypertension and cardiovascular risk regarding the use of IVR as a tool for PA. Methods: Fifteen hypertensive adults with cardiovascular risk completed twelve IVR exercise sessions over thirty days. Semi-structured interviews were conducted. Results: The thematic analysis identified three main themes: (1) PA, sedentary lifestyle, and health; (2) experiences and perceptions of IVR and PA; and (3) IVR as a useful and safe tool. The participants found IVR engaging, motivating, and effective in overcoming barriers such as a lack of time and social anxiety. Gamification and immersion facilitated greater adherence and enjoyment. Conclusions: The participants of this study perceived IVR as an innovative, engaging, and motivating tool for promoting PA. The participants positively valued IVR's ability to overcome common barriers such as lack of time, adverse weather conditions, and lack of motivation, as well as its immersive and gamified features, which enhanced the adherence to and enjoyment of PA. These results suggest that IVR could complement traditional exercise programs by facilitating the initiation of active routines in sedentary individuals.

Effectiveness and acceptance of virtual reality vs. traditional exercise in obese adults: a pilot randomized trial

Introduction

Obesity is a significant global health concern, increasing the risk of various diseases and health complications. Effective and engaging exercise interventions are urgently needed for obesity management. This pilot study examines the effectiveness of virtual reality (VR)-based exercise compared to traditional exercise, both combined with Self-Determination Theory (SDT)-based counseling, individuals with obesity.

Methods

Forty individuals with overweight/obesity were randomly assigned to either a VR-based exercise group (intervention) or a traditional exercise group (control), with both groups receiving SDT-based counseling over 4 weeks. Assessments were conducted pre- and post-intervention.

Results

Participants in the VR-based exercise group showed significant reductions in BMI (2.6%) and body fat mass (5.3%) and consequently in hips circumference, compared to the control group. They also exhibited greater increases in physical activity levels, and improved psychological outcomes, including basic psychological needs (BPN), self-efficacy, self-esteem, and attitudes toward the program comparing with the control group. Moreover, the intervention group scored higher in interest/enjoyment and attitudes towards exercise compared with the control group and showed great results in perceived enjoyment, intention for future use, usability, and positive perceptions of using the VR system. Based on the participants' interviews, VR-based exercise was found to be more enjoyable and engaging.

Discussion

These findings suggest that VR-based exercise combined with counseling is more effective than traditional exercise in reducing weight, increasing physical activity, and improving psychological outcomes individuals with obesity. The immersive nature of VR may enhance motivation and adherence to exercise programs, offering a promising alternative for obesity management. However, the study's small sample size, short duration, and reliance on self-reported measures may limit its generalizability. Future research should explore long-term adherence, effectiveness in diverse populations, psychological mechanisms behind engagement, and comparisons with emerging fitness technologies like AI-powered platforms.

The Role of Virtual Reality in Childhood Obesity Treatment: A Narrative Review

Childhood obesity is a critical public health issue linked to long-term complications like type 2 diabetes and cardiovascular disease. This narrative review aimed to examine the effectiveness of virtual reality (VR)-based interventions in supporting key components of obesity treatment-physical activity (PA), nutrition education, and behavior change-particularly in children under 12. Using the intensive health behavior and lifestyle treatment (IHBLT) approach, we synthesized findings from studies published between 2014 and 2024. Of the studies reviewed, only one study met inclusion criteria, showing that VR-based interventions effectively increased light-intensity PA and reduced sedentary behavior in children, though these effects were not sustained long-term. The scarcity of studies limits the generalizability of these findings, emphasizing the need for caution in interpretation. Our review highlights a significant gap in the literature regarding VR's role in childhood obesity treatment. Future research should explore the efficacy of VR in promoting PA, enhancing nutrition education, and supporting sustained behavior changes. Expanding this evidence base is vital for developing accessible and engaging interventions tailored to young children. Addressing this gap could enhance obesity treatment options, offering innovative and effective strategies to improve health outcomes in this vulnerable population.

Effectiveness of virtual reality interventions in promoting healthy eating and physical activity among children: A systematic review

Background

Childhood obesity significantly impacts health, making the promotion of healthy behavior (HB) among children crucial to address this issue. Virtual reality (VR) has emerged as a promising tool for encouraging HB in children.

Objective

This systematic review aims to evaluate the literature on the application of VR in promoting healthy dietary habits and physical activity (PA) among children.

Method

A systematic search was conducted across Web of Science, PubMed, and Scopus databases in January 2024 according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, focusing on English-language studies published between 2013 and 2023. The quality of the studies was assessed using the Cochrane Risk of Bias 2 and Risk of Bias in Nonrandomized Studies of Interventions tools. This review is registered at PROSPERO, CRD4202347801.

Result

A total of 25 studies involving participants aged 4-15 years were assessed. Sixteen studies focused on increasing PA through VR interventions, and six studies focused on healthy eating. Most studies utilized nonimmersive (n = 11) or semi-immersive (n = 10) VR technologies. Six theories were employed across the studies, and five design strategies were categorized. While most studies reported improvements in PA (n = 9) and healthy eating (n = 6), the short durations and small sample sizes limited the assessment of long-term impacts.

Conclusion

This review reveals the promising potential of VR as an effective tool to enhance PA and promote healthier eating among children. However, it also highlights the need for further rigorous research to explore the long-term effects of VR interventions on child HB change. These findings provide valuable input into the development of more effective VR interventions that can be applied in child health strategies.

The effect of Virtual Reality Cycling with Music on simple obesity in college students: evidence from a randomized controlled trial in China

Background

Simple obesity has become an increasingly prevalent health concern among college students. Existing research indicates that traditional exercise methods may not sufficiently engage this population, particularly those facing barriers to regular physical activity. Thus, this study investigated how combining VR cycling with music influenced fat reduction in this population.

Method

This study recruited 78 Chinese college students with simple obesity (BMI ≥ 28 kg/m2) and randomly assigned them to either an experimental group (VR cycling combined with music, n = 41) or a control group (traditional cycling, n = 37). Both groups engaged in 12 weeks of cycling training, three times a week, for 45 min per session. Key physiological indicators, such as weight, BMI, waist circumference, and hip circumference, were measured at baseline, mid-intervention, and post-intervention.

Results

The VR cycling with music group exhibited significant improvements in key physiological metrics compared to the control group. Notable changes included a 4.1% reduction in weight, a 2.8% decrease in BMI, and a 2.8% reduction in waist circumference. Hip circumference also decreased by 2.5%, while the waist-to-hip ratio dropped by 0.016 units. Furthermore, the intervention led to a 7.2% increase in vital capacity, with all outcomes showing statistical significance (p<0.01). The experimental group also reported higher levels of enjoyment and engagement throughout the intervention period.

Conclusion

Participants in the experimental group experienced significant reductions in weight, BMI, and both waist and hip circumferences, as well as a notable improvement in vital capacity. The study highlights that combining virtual reality cycling with music resulted in more substantial weight loss and fat reduction in obese college students, compared to traditional cycling methods.

Assessing the Clinical Efficacy of a Virtual Reality Tool for the Treatment of Obesity: Randomized Controlled Trial

BACKGROUND

Virtual reality (VR) interventions, based on cognitive behavioral therapy principles, have been proven effective as complementary tools in managing obesity and have been associated with promoting healthy behaviors and addressing body image concerns. However, they have not fully addressed certain underlying causes of obesity, such as a lack of motivation to change, low self-efficacy, and the impact of weight stigma interiorization, which often impede treatment adherence and long-term lifestyle habit changes. To tackle these concerns, this study introduces the VR self-counseling paradigm, which incorporates embodiment and body-swapping techniques, along with motivational strategies, to help people living with obesity effectively address some of the root causes of their condition.

OBJECTIVE

This study aims to assess the clinical efficacy of ConVRself (Virtual Reality self-talk), a VR platform that allows participants to engage in motivational self-conversations.

METHODS

A randomized controlled trial was conducted with 68 participants from the bariatric surgery waiting list from the obesity unit of the Vall d'Hebron University Hospital in Barcelona, Spain. Participants were assigned to 1 of 3 groups: a control group (CG), which only received treatment as usual from the obesity unit; experimental group 1 (EG1), which, after intensive motivational interviewing training, engaged in 4 sessions of VR-based self-conversations with ConVRself, and underwent embodiment and body-swapping techniques; and experimental group 2 (EG2), which engaged in 4 VR-based sessions led by a virtual counselor with a prerecorded discourse, and only underwent the embodiment technique. In the case of both EG1 and EG2, the VR interventions were assisted by a clinical researcher. Readiness to change habits, eating habits, and psychological variables, as well as adherence and satisfaction with ConVRself were measured at baseline, after the intervention, 1 week after the intervention, and 4 weeks after the intervention.

RESULTS

Regarding the primary outcomes, EG1 (24/68, 35%) and EG2 (22/68, 32%) showed significant improvements in confidence to lose weight compared to the CG (22/68, 32%) at all assessment points (β=-.16; P=.02). Similarly, EG1 demonstrated a significant increase after the intervention in readiness to exercise more compared to the CG (β=-.17; P=.03). Regarding the secondary outcomes, EG1 participants showed a significant reduction in uncontrolled eating (β=.71; P=.01) and emotional eating (β=.29; P=.03) compared to the CG participants, as well as in their anxiety levels compared to EG2 and CG participants (β=.65; P=.01). In addition, participants from the experimental groups reported high adherence and satisfaction with the VR platform (EG1: mean 59.82, SD 4.00; EG2: mean 58.43, SD 5.22; d=0.30, 95% CI -0.30 to 0.89).

CONCLUSIONS

This study revealed that using VR self-conversations, based on motivational interviewing principles, may have benefits in helping people with obesity to enhance their readiness to change habits and self-efficacy, as well as reduce dysfunctional eating behaviors and anxiety.

TRIAL REGISTRATION

ClinicalTrials.gov NCT05094557; https://www.clinicaltrials.gov/study/NCT05094557.

Time to act on childhood obesity: the use of technology

Childhood obesity is rapidly increasing worldwide and there is an urgent need to implement treatment and prevention programs. Over the last decade, in addition to increasing rates of childhood obesity, we have also observed rapid technological and digital development. The Covid-19 pandemic has largely contributed to both expansions but has also allowed an opening towards a broader vision of medicine, through new therapeutic opportunities such as mobile healthcare. The digital and technological delivery of obesity prevention and treatment programs can represent an innovative tool to support children and families to overcome some limitations and barriers such as the accessibility of programs that prevent them from adopting healthy lifestyle changes. This review aimed to summarize the impact of different digital interventions for children and adolescent affected by obesity.

Digital communication and virtual reality for extending the behavioural treatment of obesity - the patients' perspective: results of an online survey in Germany

BACKGROUND

CBT has been found effective for the treatment of EDs and obesity. However not all patients achieve clinically significant weight loss and weight regain is common. In this context, technology-based interventions can be used to enhance traditional CBT but are not yet widespread. This survey therefore explores the status quo of pathways of communication between patients and therapists, the use of digital applications for therapy as well as attitudes towards VR from the perspective of patients with obesity in Germany.

METHODS

This cross-sectional online survey was conducted in October 2020. Participants were recruited digitally through social media, obesity associations and self-help groups. The standardized questionnaire included items concerning current treatment, paths of communication with their therapists, and attitudes toward VR. The descriptive analyses were performed with Stata.

RESULTS

The 152 participants were mostly female (90%), had a mean age of 46.5 years (SD = 9.2) and an average BMI of 43.0 kg/m² (SD = 8.4). Face-to-face communication with their therapist was considered of high importance in current treatment (M = 4.30; SD = 0.86) and messenger apps were the most frequently used digital application for communication. Participants were mostly neutral regarding the inclusion of VR methods in obesity treatment (M = 3.27; SD = 1.19). Only one participant had already used VR glasses as part of treatment. Participants considered VR suitable for exercises promoting body image change (M = 3.40; SD = 1.02).

DISCUSSION

Technological approaches in obesity therapy are not widespread. Face-to-face communication remains the most important setting for treatment. Participants had low familiarity with VR but a neutral to positive attitude toward the technology. Further studies are needed to provide a clearer picture of potential treatment barriers or educational needs and to facilitate the transfer of developed VR systems into clinical practice.