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      Web‐based virtual reality to enhance behavioural skills training and weight loss in a commercial online weight management programme: The Experience Success randomized trial

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          Summary

          Objective

          Commercial online weight management programmes are popular and easily accessible but often lack training in empirically validated behaviour change strategies and produce suboptimal outcomes. This study evaluated the effects of a Web‐based virtual reality (VR) programme for enhancing behavioural skills training and weight loss when offered as an adjunct to a commercial online weight management programme.

          Methods

          N = 146 adults with overweight/obesity (body mass index [BMI] 27‐40 kg/m 2) were randomized to 6 months of no‐cost access to the Weight Watchers (WW) online platform alone or enhanced with the Experience Success (WW + ES) programme, consisting of four Web‐based VR sessions for training in behavioural weight‐loss skills related to the home environment, the workplace, physical activity and social situations (i.e., a party at a friend's house). Weight was measured at the research centre at baseline, 3 and 6 months.

          Results

          Both groups achieved statistically significant weight loss across the trial, with no difference in mean ± standard error (SE) weight loss between WW and WW + ES at 3 months (2.7 ± 1.1 kg vs. 4.2 ± 1.1 kg, respectively; P = .086) but greater weight loss in WW + ES at 6 months (2.6 ± 1.3 kg vs. 4.9 ± 1.3 kg, respectively; P = .042).

          Conclusions

          This study demonstrates the potential of Web‐based VR skills training to enhance outcomes of commercial online weight management programmes that are widely accessible. Compared with traditional didactic methods for online skills training, VR simulation provides opportunities to learn behavioural skills via modelling and experiment with skills in real‐world situations. More research is needed to identify specific behavioural mechanisms by which ES may improve outcomes.

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          Most cited references22

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          Health promotion from the perspective of social cognitive theory

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            Lifestyle modification approaches for the treatment of obesity in adults.

            The U.S. Preventive Services Task Force has recommended that primary care clinicians screen all adults for obesity and provide those affected intensive multicomponent behavioral interventions. Approximately 95 million U.S. adults qualify for such care, also referred to as lifestyle modification. Using the Guidelines (2013) for Managing Overweight and Obesity in Adults as a framework, this article reviews the principal components of comprehensive lifestyle modification, which include diet, physical activity, and behavior therapy. To lose weight, the Guidelines recommend participation for 6 months in high-intensity programs that provide ≥14 counseling sessions with a trained interventionist. When provided face-to-face, individual or group treatment, participants lose up to 8 kg (8% of weight) in 6 months and experience improvements in cardiovascular disease risk factors and quality of life. To prevent weight regain, the Guidelines recommend participation for 1 year in weight-loss-maintenance programs that provide at least monthly counseling. High levels of physical activity, frequent monitoring of body weight, and consumption of a reduced calorie diet are associated with long-term weight loss. Investigators currently are seeking to increase the availability of lifestyle modification by delivering it in community-based programs, as well as on digital platforms (e.g., Internet and Smartphone). Digitally-delivered programs lower costs and expand treatment reach; their efficacy is likely to improve further with the addition of new technologies for monitoring food intake, activity, and weight. Ultimately, to improve long-term weight management, individual lifestyle counseling must be joined with collective and institutional efforts to improve our nation’s eating and activity environments.
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              How does desktop virtual reality enhance learning outcomes? A structural equation modeling approach

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                Author and article information

                Contributors
                jthomas4@lifespan.org
                Journal
                Obes Sci Pract
                Obes Sci Pract
                10.1002/(ISSN)2055-2238
                OSP4
                Obesity Science & Practice
                John Wiley and Sons Inc. (Hoboken )
                2055-2238
                27 August 2020
                December 2020
                : 6
                : 6 ( doiID: 10.1002/osp4.v6.6 )
                : 587-595
                Affiliations
                [ 1 ] Department of Psychiatry and Human Behavior Warren Alpert Medical School of Brown University, The Miriam Hospital/Weight Control and Diabetes Research Center Providence Rhode Island USA
                [ 2 ] College of Education University of Oregon Eugene Oregon USA
                [ 3 ] Virtually Better, Inc. Decatur Georgia USA
                [ 4 ] Department of Human Services, Sheila C. Johnson Center for Clinical Services University of Virginia Charlottesville Virginia USA
                Author notes
                [*] [* ] Correspondence

                J. Graham Thomas, Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, The Miriam Hospital Weight Control and Diabetes Research Center, 196 Richmond Street, Providence, 02903 RI, USA.

                Email: jthomas4@ 123456lifespan.org

                Author information
                https://orcid.org/0000-0001-7549-2431
                https://orcid.org/0000-0002-6150-5649
                Article
                OSP4451 OSP4-2020-05-0034.R1
                10.1002/osp4.451
                7746971
                33354337
                a92ddddb-1cf0-43f9-8b89-a30516b942b3
                © 2020 The Authors. Obesity Science & Practice published by World Obesity and The Obesity Society and John Wiley & Sons Ltd.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.

                History
                : 09 May 2020
                : 30 July 2020
                : 09 August 2020
                Page count
                Figures: 3, Tables: 3, Pages: 9, Words: 6907
                Funding
                Funded by: National Heart, Lung, and Blood Institute , open-funder-registry 10.13039/100000050;
                Award ID: K23 HL136845
                Funded by: National Institute of Diabetes and Digestive and Kidney Diseases , open-funder-registry 10.13039/100000062;
                Award ID: R42 DK103537
                Categories
                Original Article
                Original Articles
                Custom metadata
                2.0
                December 2020
                Converter:WILEY_ML3GV2_TO_JATSPMC version:5.9.5 mode:remove_FC converted:18.12.2020

                obesity,virtual reality,weight loss
                obesity, virtual reality, weight loss

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