BackgroundThe rising trend in obesity calls for innovative weight loss programs. While behavioral-based face-to-face programs have proven to be the most effective, they are expensive and often inaccessible. Internet or Web-based weight loss programs have expanded reach but may lack qualities critical to weight loss and maintenance such as human interaction, social support, and engagement. In contrast to Web technologies, virtual reality technologies offer unique affordances as a behavioral intervention by directly supporting engagement and active learning.ObjectiveTo explore the effectiveness of a virtual-world weight loss program relative to weight loss and behavior change.MethodsWe collected data from overweight people (N = 54) participating in a face-to-face or a virtual-world weight loss program. Weight, body mass index (BMI), percentage weight change, and health behaviors (ie, weight loss self-efficacy, physical activity self-efficacy, self-reported physical activity, and fruit and vegetable consumption) were assessed before and after the 12-week program. Repeated measures analysis was used to detect differences between groups and across time.ResultsA total of 54 participants with a BMI of 32 (SD 6.05) kg/m2 enrolled in the study, with a 13% dropout rate for each group (virtual world group: 5/38; face-to-face group: 3/24). Both groups lost a significant amount of weight (virtual world: 3.9 kg, P < .001; face-to-face: 2.8 kg, P = .002); however, no significant differences between groups were detected (P = .29). Compared with baseline, the virtual-world group lost an average of 4.2%, with 33% (11/33) of the participants losing a clinically significant (≥5%) amount of baseline weight. The face-to-face group lost an average of 3.0% of their baseline weight, with 29% (6/21) losing a clinically significant amount. We detected a significant group × time interaction for moderate (P = .006) and vigorous physical activity (P = .008), physical activity self-efficacy (P = .04), fruit and vegetable consumption (P = .007), and weight loss self-efficacy (P < .001). Post hoc paired t tests indicated significant improvements across all of the variables for the virtual-world group.ConclusionsOverall, these results offer positive early evidence that a virtual-world-based weight loss program can be as effective as a face-to-face one relative to biometric changes. In addition, our results suggest that a virtual world may be a more effective platform to influence meaningful behavioral changes and improve self-efficacy.
Obesity is a costly condition that can reduce quality of life and increase the risk for many serious chronic diseases and premature death. The rising rates, high prevalence, and adverse consequences of obesity call for the development and testing of new and innovative approaches that address weight loss barriers and bring help to those most affected by obesity. In this article, we examine the effectiveness of a 12-week behavioralbased weight loss program delivered via a 3D virtual world, Club One Island™ (COI) in Linden Lab's Second Life. Intervention design was informed by social cognitive theory and emerging research on avatar identification and the Proteus Effect. Our results offer strong preliminary evidence that not only can a 3D VW-based program be as effective as a content similar in-person intervention relative to positive biometric changes, but it may serve as a more effective platform to influence meaningful behavioral changes and increased self-efficacy.
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