# Innovative Approaches to Eating Disorders Treatment:
## 3 Results
### VR Exposure Intervention  
Seven studies used VR exposure interventions combined with various techniques. In general, there is heterogeneity between the studies; the sample sizes vary between 20 to 145. Some studies used only one group, while others divided the sample into different comparison groups. Participants included those with AN, BN, and healthy individuals with attentional bias or ED-related concerns. There is also heterogeneity in the variables measured; the majority measured food or body concerns, and half measured behavioral variables related to attentional bias. Even when the same variable was measured, different questionnaires were used. For detailed measurements used in each study, consult Tables 2 and S1.  
Four of these studies, Study 2 [28] and [29; 34; 35], focused on populations with AN and BN, all involving women except the study by [PERSON] et al. [34], which had a mixed sample with a female majority. These studies consistently showed that VR exposure significantly reduced body-related concerns and food anxiety--[28] Study 2 and [34; 35], stabilized body mass index (BMI; [35]), and reduced weight-related attentional bias [29]. [PERSON] et al. [29] used a single session of VR body exposure within attentional bias modification training (ABMT)--attentional bias is defined as the propensity to provide more attention to a stimulus or information, usually disorder-relevant information, than other information. Attentional bias toward body areas associated with weight gain is a maintaining factor in ED and may also contribute to the development of ED in healthy women [36; 37]. [PERSON] et al. found reductions in both attentional bias toward weight-related areas and body dissatisfaction, but without a control group. [PERSON] et al. (Study 2, [28]) used multiple VR body exposure sessions with educational sessions, also without a control group, reporting significant reductions in fear of gaining weight (FGW) per session but no cumulative session-to-session differences. [PERSON] et al. [34] employed a single session of VR exposure to a kitchen environment, comparing three conditions: baseline, social support (another avatar), and positive mood (a pet). The positive mood group demonstrated less food-related anxiety than the baseline, which served as a control group. [PERSON] et al. [35] compared VR-CBT to a control group, finding significant reductions in binge eating, purging episodes, body-related concerns, FGW, and a more stable BMI in the VR-CBT group.  
The remaining three studies involved healthy women, either based on their baseline attentional bias toward body areas [32; 33] or high concern about weight and shape (Study 1, [28]). Both [PERSON] et al. [32] and [PERSON] et al. [33] used single-session VR body exposure within an ABMT, showing that VR-ABMT effectively reduced attentional biases. Comparison groups were based on initial attentional bias. [PERSON] et al. (Study 1, [28]) used a single session of VR body exposure combined with psychoeducation but found no significant improvements, marking it as the only study without intervention-related changes. The researchers suggested that the absence of significant changes in this study was due to the brief 15 min exposure being less effective than longer exposure. However, there are other differences between [PERSON] et al.'s Study 1 and 2 not mentioned by the authors. In Study 1, the educational session occurred immediately before exposure and focused on refraining from avoidance behaviors. In Study 2, the session was held on a different day and provided information on maladaptive cycles of fear of weight gain and avoidance behaviors, helping the participants understand how exposure could improve their well-being. The time between the first session and the first exposure allowed participants to reflect on the information they had been given for longer, draw their own conclusions, and seek out more information if they wished.