The way we look at our own body really matters! Body-related attentional bias as a predictor of worse clinical outcomes after a virtual reality body exposure therapy

Body-related attentional bias (AB) experienced by anorexia nervosa (AN) patients has been associated with body image disturbances and other eating disorders (ED)-related symptoms. The aim of this study was to assess whether the body-related AB reported by AN patients before a virtual reality (VR)-based body exposure therapy predicted worse clinical outcomes after treatment. Thirteen AN outpatients participated in the study. AB was recorded using an eye-tracker incorporated in a VR-Head Mounted Display. Results showed that AN patients attended to their weight-related body parts for longer and more frequently than to their non-weight-related body parts. Statistically significant (p <.05) negative and positive correlations between pre-intervention bodyrelated AB measures and the difference between pre- and post-assessment fear of gaining weight, body dissatisfaction, and body appreciation measures were also found. Showing higher body-related AB before the intervention marginally predicted a lower reduction of fear of gaining weight (p =.08 and p=.07) and body dissatisfaction (p =.05 and p=.06) at post-treatment, and significantly predicted a lower increase of body appreciation scores after the intervention (p <.001). Results suggest that body-related AB may reduce the efficacy of VR-based body exposure therapy in patients with AN.