# Innovative Approaches to Eating Disorders Treatment:
## 4 Discussion
### Effectiveness of VR Exposure Intervention  
Five of the seven studies that used VR exposure demonstrated that combining VR with other therapies or techniques improves psychological and behavioral factors related to ED [29, 32, 33, 34, 35]. The remaining two studies [28] showed limited results with VR exposure interventions. Overall, these findings suggest that VR exposure is an effective technique in the treatment of AN and BN, as well as in modifying risk factors for the development of these EDs.  
Three studies [29, 32, 33] utilized ABMT with both women diagnosed with AN and healthy women with prior attentional biases. These studies used a similar task: an avatar was created for each participant replicating their body shape, and geometric figures were superimposed on various body areas to encourage balanced attention. The studies concluded that ABMT effectively reduces attentional bias and body dissatisfaction. While the VR task had good participant acceptance, excessively long sessions were reported as boring and tiring, risked being counterproductive, and potentially contributed to dropouts in future sessions.  
[PERSON] et al. [34] investigated whether VR exposure to a kitchen full of food in three different conditions could reduce food-related anxiety in patients with AN. Social support provided by an avatar was effective in reducing anxiety, although the avatar's appearance was sometimes perceived as aversive. Nonetheless, the general impression of the VRenvironment was that it was realistic and provided a sense of safety greater than that experienced at home. This \"safer\" feeling has been previously linked to greater patient commitment to VR therapy [38], lowering the chances of dropouts. Although the inclusion in this study of participants from different gender identities is encouraging, it remains insufficient to explore potential differences or gaps.  
[PERSON] et al. [35] was the only study to include women with BN, confirming that VR-CBT was more effective than treatment as usual (TAU) in reducing preoccupation with weight and FGW, as well as in reducing binge eating and purging episodes in the post test and 1-month follow-up. Furthermore, BMI remained more stable over the 12-month follow-up in the VR-CBT group compared to the TAU group. However, the relatively small sample size limits the generalizability of these findings.  
Finally, [PERSON] et al. [28] presented two studies on VR exposure: one involving healthy women with high concerns about weight and shape and the other involving women with AN. In the first study, healthy participants received a brief psychoeducational session and were then exposed for 15 min to an avatar with a 30% weight gain. This study did not find significant differences in pre- and post-exposure measures. In the second study, women with AN received an initial educational session followed by four exposure sessions to a VR avatar with an average body shape. The four sessions involved 30 min of exposure. This study effectively reduced FGW between pre- and post-exposure, but there were no significant differences between sessions, indicating that the improvements were not maintained across sessions. The difference in the educational session and the absence of a comparison group exposed to a different VR technique or no exposure at all makes it difficult to determine whether the limited results were due to the need for longer exposures or more sessions, or if pure VR exposure combined with some type of educational sessions has limited effectiveness on the studied variables.