EATING DISORDERS

Eating Disorders defines abnormal eating practices that has negative effects on the physical and mental health of the person suffering from them. There are three pathologies within eating disorders: Anorexia, Bulimia and Binge eating. Within eating disorder treatment, obesity is also a chronic disease that could be treated with the help of psychologic methods.

Virtual Reality therapy has today become an alternative method of treating Eating Disorders. VR becomes a great asset to help the minds of patients to “reeducate”, and reduce their dysfunctional thought and feelings that causes the eating disorder. Some exercises used in the evaluation and management of these disorders still relies on “paper and pen”. VR helps to optimize these therapeutic processes by immersing patients in a modular and adaptive reality according to the cognitive distortions that are very present in these pathologies. The factors dealt with are emotional, with exposure to social, behavioral and physiological situations. Virtual reality therapies compliment the usual treatments in a necessary multidisciplinary fashion. Food education can also be offered in a virtual aspect making this learning more fun for better therapeutic engagement.

Dysmorphobia

In this app C2Nutri – the Silhouette Test has been reproduced to a virtual environment. The immersion presented in the VR-environment promotes accuracy to the evaluation by acting as an additional qualitative diagnostic tool. Thanks to this test, you can assess the severity of the dysmorphophobia or get informed about irrational body-expectations by the patient. In order to correct cognitive distortions linked to body image, an environment reproducing a virtual body that can be modulated by BMI in front of a mirror is included in the C2Nutri application. This application also makes it possible to increase awareness of the disorder by confronting the patient with his real silhouette in comparison with the self-perceived silhouette.

Food Cravings

Simulating food craving is made possible thanks to C2Nutri: Here the patient can be exposed to supermarket shelves, multiple food stimuli (sweet, salty), apartment full of foods. The patients will be able to benefit from cognitive and behavioral treatment. Being placed in front of food stimuli and temptation situations – whose accessibility is maximized by virtual reality; patients will be able to apply the therapeutic strategies taught by the practitioner. The “ecology” of the environments will facilitate the transfer of learning and thus optimize the patient’s personal and mental empowerment.

Nutritional Education

As a care giver, you will through the C2Apps connected to malnutrition be able to compose “e-meals”, that gives you immediate feedback on nutritional knowledge of the patient. This makes you able to assist in the assessment and reintroduction of “banned” foods for the patients, by exposing them to the food craving. This learning module is a multidisciplinary tool. It’s use is conceived through the prism of nutritional education and adapted for different professionals: nutritionist doctor, dietitian, psychologist, nurse. In addition, this application is intended for a large patient base: people suffering from obesity or anorexia, bulimics, compulsive eaters and diabetics … 

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c2care r&d

C2Care is also a scientific committee and a network of partners. With a scientific reasearch & development department, we validate our software with a constant concern about the therapeutic effectiveness. Today, we collaborate with Universities and health establishments in the realization of experimental work on the treatment of addiction disorders by virtual reality. Numerous experimental studies have been made with our partners.

Dr Bat’s team at Salvator Hospital in Marseille, France, has carried out a study on VR in the evaluation of dysmorphophobia in anorexic patients. Currently, other experimental protocols are under development. The work focuses on the impact of virtual reality care in addition to usual therapy.

The Grésivaudan clinic in Grenoble, France, will begin multidisciplinary work in 2020 on the management of anorexia by virtual reality. The research is directed by Dr. Sansonetti-Perrin.

HOW DOES A SESSION TAKE PLACE?

The progress of a session in virtual reality will depend on the processes to be treated. Targeting food craving will use the same methodology as that is used for addictions. Patients will be exposed to the craving-inducing diets, which will provide practitioners with a “window” to actively see cognitions related to behavior problem.

For anorexia, the therapeutic focus will be on the treatment of dysmorphophobia. Patients will first take the virtual reality “silhouette test”. The assessment of the severity of dysmorphophobia will be made more qualitative by the benefit of immersion into VR.

In order to reduce distortions linked to body image and to increase insight, modular virtual body exposures added to body swapping techniques constitutes additional methodologies to the usual treatments.

WHO CAN BE TREATED?

Children, adolescents, adults and seniors can benefit from Virtual Reality Exposure Therapy.

However, restrictions exist for:

– Children under 4 years old because the lens of the eye is not yet fully formed

– People with epilepsy

– Pregnant women (precautionary measure taken in the absence of concrete medical data)

– Psychotics in the decompensation phase

 

STUDIES PROVING EFFECTIVENESS OF VIRTUAL REALITY

Keizer (2016) a réalisé une étude visant à évaluer l’impact d’un traitement par réalité virtuelle sur la dysmorphophobie auprès de patientes atteintes d’anorexie. Le paradigme reposait sur un traitement perceptivo-tactile in virtuo des zones corporelles atteintes par les distorsions cognitives. Les résultats ont démontré une amélioration de l’estimation corporelle et souligne ainsi l’intérêt de la réalité virtuelle dans les stratégies thérapeutiques des troubles des représentations corporelles. Ces résultats ont été corroborés par Serino (2019). Cet auteur met l’emphase sur la rapidité des gains thérapeutiques obtenus lors de l’utilisation de la réalité virtuelle. 

Ferrer-Garcia (2017) est venu explorer le potentiel d’un traitement couplant thérapie cognitivo-comportementale (TCC) et thérapie in virtuo comparé à une TCC seule. Les troubles pris en charge étaient la boulimie et les accès hyperphagiques. Le traitement TCC-In virtuo a démontré une efficacité significativement supérieure au traitement TCC seul. Les variables évaluées (craving alimentaire, anxiété, attitudes dysfonctionnelles) ont vu leur score diminuer significativement en comparaison au groupe contrôle (TCC).

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