Supplementary Material for: Virtual Reality Exposure to a Healthy Weight Body Is a Promising Adjunct Treatment for Anorexia Nervosa

<b><i>Introduction/Objective:</i></b> Treatment results of anorexia nervosa (AN) are modest, with fear of weight gain being a strong predictor of treatment outcome and relapse. Here, we present a virtual reality (VR) setup for exposure to healthy weight and evaluate its potential as an adjunct treatment for AN. <b><i>Methods:</i></b> In two studies, we investigate VR experience and clinical effects of VR exposure to higher weight in 20 women with high weight concern or shape concern and in 20 women with AN. <b><i>Results:</i></b> In study 1, 90% of participants (18/20) reported symptoms of high arousal but verbalized low to medium levels of fear. Study 2 demonstrated that VR exposure to healthy weight induced high arousal in patients with AN and yielded a trend that four sessions of exposure improved fear of weight gain. Explorative analyses revealed three clusters of individual reactions to exposure, which need further exploration. <b><i>Conclusions:</i></b> VR exposure is a well-accepted and powerful tool for evoking fear of weight gain in patients with AN. We observed a statistical trend that repeated virtual exposure to healthy weight improved fear of weight gain with large effect sizes. Further studies are needed to determine the mechanisms and differential effects.

引言/研究目标：神经性厌食症（anorexia nervosa, AN）的治疗效果有限，对体重增加的恐惧是预测治疗结局与复发的强相关因素。本研究提出一种用于暴露于健康体重情境的虚拟现实（virtual reality, VR）装置，并评估其作为神经性厌食症辅助治疗手段的潜力。方法：通过两项研究，我们针对20名存在高体重担忧或体型担忧的女性，以及20名神经性厌食症患者，探究其在虚拟现实暴露于更高体重情境下的体验与临床效应。结果：在第一项研究中，90%的受试者（18/20）报告出现高唤醒症状，但自述恐惧程度为低至中等水平。第二项研究显示，虚拟现实暴露于健康体重情境可诱发神经性厌食症患者的高唤醒反应，且四次暴露疗程呈现出改善体重增加恐惧的趋势。探索性分析揭示了个体对暴露疗法的三类反应模式，有待进一步深入探究。结论：虚拟现实暴露疗法是一种易于被接受且有效的工具，可在神经性厌食症患者中诱发体重增加恐惧。本研究观察到，重复进行健康体重情境的虚拟现实暴露可改善患者的体重增加恐惧，且效应量较大，呈统计学趋势。未来需开展进一步研究以明确其作用机制与差异化效应。