Experience Success: Virtual Reality Skills Training to Enhance e-Weight Loss

Overweight and obesity are major health problems, affecting over two-thirds of US adults.
Commercially available Internet-based weight loss programs are currently used by millions of
overweight/obese individuals in the U.S, but weight losses are often poor, likely because
these products on the whole do not incorporate empirically validated behavioral weight loss
strategies that have been researched for over 40 years. Similarly, the weight losses
obtained via research-based online weight loss programs are about half the size of those
obtained via in-person treatment, likely because of the lack of (1) "hands-on" training in
behavioral weight control strategies, and (2) support and guidance from group leaders and
peers, both of which are hallmarks of traditional in-person treatment. The goal of this
application is to improve commercial Internet -delivered behavioral obesity treatments by
developing a virtual reality (VR) system that can be integrated into existing Internet
weight control programs, such as Weight Watchers Online. The VR system will allow users to
experience learning, implementing, and mastering behavioral weight control strategies in
controlled virtual settings. The VR system will: (a) increase awareness of barriers to
weight control behaviors, (b) teach skills to cope with these barriers, (c) build confidence
using these skills, and (d) increase commitment to using these skills in real-world
situations. The design of the VR System is based on Social Cognitive Theory, which states
that health behaviors are learned by observing and imitating peers and role models, and by
receiving social reinforcement. A randomized controlled trial (RCT) will be conducted with N
= 125 participants to test the efficacy of 4 scenarios for improving weight losses obtained
in a popular paid commercial weight loss program (Weight Watchers Online) over 6 months.

Inclusion Criteria:

- body mass index (BMI) 25-45 kg/m^2

- English speaking and literate

- able to walk 2 blocks unassisted without stopping

- access to a computer and the Internet

Exclusion Criteria:

- report of a heart condition, chest pain during periods of activity or rest, or loss
of consciousness

- a medical condition that would affect the safety and/or efficacy of a weight
management program involving diet and physical activity

- report of a condition that in the judgment of the Principal Investigator would render
the participant potentially unlikely to be able to follow the study protocol for 6
months, including terminal illness, substance abuse, eating disorder, dementia, or
other significant uncontrolled psychiatric problem

- currently pregnant, within 6-months postpartum, or intend to become pregnant within 6
months

- plan to move out of the local geographic area within 6 months

- previous participation in a weight loss study at the Weight Control and Diabetes
Research Center of Brown University and The Miriam Hospital within the last 2 years

- current participation in another behavioral weight control program