Table 3.

Intervention details

	First author	Year	VR technique	Technology	Procedure of VR-based intervention	Control group
1	Ascione	2023	VR-ABMT	HTC Vive Pro Eye head-mounted display with built-in Tobii eye tracker; VR environment developed on Unity 3D software.	Participants, embodied in a virtual avatar matching their physical characteristics, completed the ABMT in a VR setting. This involved directing attention to geometric figures appearing on various body parts of the avatar to balance attention across weight and non-weight-related body areas.	n.a.
2	Behrens	2023	VR-BE	Valve Index headset and controllers, VIVE trackers, Lenovo Legion Y740 laptop	Participants underwent four 30-min VR exposure sessions to a body of higher weight, aiming to elicit and manage fear of weight gain. The VR environment featured a u-shaped changing cabin with two virtual mirrors showing the avatar from front, side, and first-person perspectives.	n.a.
3	Bektas	2023	VR-FE	Oculus Quest 2 headsets with Unity3D game engine and Oculus Integration SDK.	Participants were exposed to one of three VR kitchen scenarios (kitchen only, kitchen plus virtual pet, and kitchen plus avatar), where they interacted with virtual foods. This setup was used to measure food-specific trait and state disgust, eye gazes towards, and touching of virtual foods, before and after VR exposure.	n.a.
4	Di Lernia	2023	VR-BS	Oculus Rift DK2, connected to a portable computer for the virtual reality illusion. The illusion was facilitated by synchronous visuotactile stimulation.	Participants experienced a VR full-body illusion in both synchronous (experimental) and asynchronous (control) conditions to assess the effect on body perception. The procedure included body size estimation tasks and embodiment questionnaires, performed at two time points: upon hospital admission and after a 12-week rehabilitation program.	Healthy controls underwent the same VR intervention in a single experimental session, allowing for comparative analysis with patients with AN.
5	Ferrer-Garcia	2021a	VR-BE	The study utilized HTC-VIVE head-mounted displays, VR controllers, and body trackers for full-body tracking, alongside a FOVE VR headset with eye-tracking for certain assessments.	The experimental group underwent AN-VR-BE, involving immersion in a VR environment where patients were exposed to a virtual body matching their real body size and then gradually introduced to a healthy BMI increase across sessions.	The control group received the standard treatment without the VR-based body exposure sessions.
6	Ferrer-Garcia	2021b	VR-BE	VR system including HTC-VIVE head-mounted display (HMD), VR controllers, body trackers, and a FOVE VR-HMD with eye-tracking technology. Powerful VR-ready computers with high-end CPU processors and graphic cards were used to run 3D immersive environments.	Participants in the experimental group received five sessions of AN-VR-BE, involving exposure to a virtual body matching their real-size silhouette and BMI. Small BMI increases were applied over successive sessions until reaching a healthy BMI target. The intervention aimed to reduce FGW by allowing patients to confront their body image fears in a controlled, virtual environment. Procedures included visuomotor and visuo-tactile stimulation to elicit the Full Body Illusion (FBI) of owning the virtual body.	Control group received treatment as usual (TAU) only.
7	Fisher	2020		Oculus Rift headset for VR exploration; VR software developed by C2CARE under the UNITY 3D framework; head-tracking technology for implicit measurement of explicit choices.	Participants evaluated their perceived and desired body figures using both paper-based FRS and VR-based avatar rating scale. In VR, participants engaged with ten 3D standardized female avatars arranged in a circle for a 15-minute session, during which they were asked to choose avatars that best represented their current and desired body forms. The head-tracking software calculated the time spent looking at each avatar (Fixation Time Percentage - FTP).	Comparison made with paper-based FRS.
8	Malighetti	2020	VR-BS	VR intervention included a head-mounted display connected to a laptop and a motion tracker (Microsoft Kinect sensor), immersing participants in a virtual environment and embodying them in a virtual avatar.	The intervention consisted of four sessions with VR embodiment from both egocentric and allocentric perspectives. The BMI of the avatar was progressively increased to normal weight across sessions. Participants recalled negative and positive life events to associate emotions with body sizes and estimated their real and ideal BMI using VR body size estimation tasks.	n.a.
9	Malighetti	2021	VR-CBT	The intervention was delivered using a stand-alone head-mounted display (HMD), specifically the Oculus Go.	The treatment comprised an initial assessment session, followed by two sessions focusing on emotion regulation and four sessions on emotional rescripting. Techniques included mindfulness-based strategies for exploring landscapes in VR to identify emotional states, immersive metaphorical journeys, and anchoring positive emotions to real-life experiences.	n.a.
10	Matamala-Gomez	2021	VR-BS	Virtual Reality (VR) with a head-mounted display (Oculus Rift), connected to a laptop and a Kinect Sensor for motion tracking.	The VR-based intervention involved embodying participants in a virtual avatar from both first-person and third-person perspectives, across four sessions. The technique aimed to create a body swap illusion, allowing participants to experience ownership, agency, and self-location in a virtual body that mirrors their perceived real body size. This intervention focused on modifying participants’ long-term memory of their body through visuomotor synchronization and autobiographical recall within the VR environment.	n.a.
11	Max	2023	VR-FE	Oculus Rift CV1 head-mounted display with Leap Motion sensor for real-time hand tracking, allowing participants to interact with virtual stimuli through actual hand movements.	Participants completed practice trials followed by the main task, where they had to recognize and collect one of two simultaneously presented objects (food vs. office tools), with the task designed to measure both the speed of recognition/approach and the collection of food objects compared to office tools.	n.a.
12	Nameth	2021	VR-CET	Oculus Rift head-mounted displays (HMD), Oculus sensors, and Oculus controllers were used to provide immersive VR experiences simulating real-life triggering eating-related situations.	The intervention involved up to eight one-hour sessions, starting with an assessment phase followed by an intervention phase where patients were exposed to virtual environments and food cues designed to provoke cravings and urges to eat without allowing actual binge eating.	n.a.
13	Natali	2024	VR-FE	Oculus Integration SDK for Unity was installed on Oculus Quest 2 headsets to visualize the VR kitchen environment. Participants experienced full immersion in a room-scale environment, facilitated by two Oculus Touch controllers for interaction with user interface menus and scene objects.	The study examines the potential of two interventions—positive mood induction and social support—to enhance the effectiveness of virtual food exposure in alleviating food-related anxiety. Participants were assigned to one of three conditions: virtual food exposure alone (baseline condition), virtual food exposure combined with positive mood induction (positive mood condition), or virtual food exposure combined with social support (social support condition). In the social support condition, an avatar provided participants with supportive and motivational dialogue aimed at empowering them to confront the voice of their eating disorder.	n.a.
14	Porras-Garcia	2020a	VR-BE	VR head-mounted display (HTC-VIVE) with full body motion tracking using additional body trackers.	The patient underwent five VR exposure sessions, starting with an avatar matching the patient’s current BMI. The BMI of the avatar was gradually increased in each session to simulate weight gain towards a healthy BMI. The intervention aimed to reduce FGW, body-related anxiety, and BID by allowing the patient to experience a full-body illusion (FBI) of a healthier body.	n.a.
15	Porras-Garcia	2020b	VR-BE	HTC-VIVE head-mounted display with full-body motion tracking and FOVE-Eye Tracking for eye movement detection	Participants owned a virtual body resembling their silhouette and BMI. The FBI over the virtual body was induced through visuo-motor and visuo-tactile stimulation. Subsequently, FBI, FGW, body anxiety, and body-related attentional bias towards weight-related and non-weight-related body areas were assessed.	Healthy college women divided into those with low and high body dissatisfaction.
16	Porras-Garcia	2020c	VR-BE	HTC-VIVE HMD with body trackers and FOVE Eye Tracking for gaze detection and registration. Virtual avatars created with Unity 3D and Blender 2.78.	Five sessions of VR body exposure therapy were conducted, starting with the patient’s current BMI and progressively increasing the BMI of the avatar across sessions. The therapy aimed to systematically expose the patient to her virtual silhouette in a mirror within the VR environment, with body parts that produced anxiety being illuminated and focused upon	n.a.
17	Provenzano	2020	VR-BE	Virtual reality environments created with 3D modeling software, presenting participants with personalized avatars to embody their perceived body size, and avatars representing a verisimilar loss and gain of their original weight.	Participants were exposed to personalized avatars through visuo-tactile stimulation, aiming to induce embodiment and assess changes in body image distortion. The study evaluated embodiment, body dissatisfaction, and emotional response to different-sized avatars.	The healthy control group was subjected to the same VR intervention procedure to compare body image distortion, embodiment, and emotional responses between patients with AN and individuals without eating disorders. This comparison aimed to elucidate the specific effects of VR body exposure therapy on the cognitive-emotional components of body image distortion in AN.
18	Sansoni	2024	VR-CBT	During VR-CBT sessions, participants wore a head-mounted display through which scenarios were presented. Utilizing the NeuroVR software, participants engaged with fourteen virtual critical environments.	Participants attended five weekly CBT-group sessions and underwent ten biweekly one-hour VR sessions utilizing NeuroVR software, featuring diverse virtual environments.	The group received five-week treatment periods, during which two licensed psychotherapists conducted CBT sessions.
19	Serino	2019	VR-BS	The protocol utilized a head-mounted display (HMD Oculus Rift DK2) connected to a portable computer, with a Razer Hydra motion-tracking device for inducing multisensory stimulation.	The patient underwent three sessions of the VR-based body swapping illusion, incorporating synchronous and asynchronous visuotactile stimulation to induce ownership over a virtual body. The intervention was designed to assess and potentially alter the patient’s body representation disturbances.	n.a.
20	Schroeder	2024		A mobile VR task was developed for the stand-alone Meta Quest 2 head-mounted display by the research team. The Meta Quest 2 controller was utilized within the virtual environment, depicted as a white right hand, with its position and movement continuously updated at the refresh rate.	The methodology involved investigating behavioral trajectories of food avoidance using a novel kinematic task in VR to record spatial displacement in stop-and go-trials to virtual food and control objects. Inhibitory control abilities were assessed through stopping performance, and habitual avoidance of virtual food was measured across both go-and stop-trials.	The healthy control group was subjected to the same VR intervention procedure