Reshaping restriction: virtual embodiment modulates eating biases in anorexia nervosa

Anorexia nervosa (AN) involves extreme food restriction and body image disturbances, partly sustained by altered responses to food cues, including implicit and behavioral avoidance, especially toward high-calorie foods. We tested whether altering body ownership in virtual reality could modulate such biases. Female participants with restricting-subtype AN (AN-R; n = 29) and healthy controls (HC; n = 31) completed three sessions: a baseline and two full-body illusion (FBI) sessions in which they embodied slimmer or larger avatars than their own body size. Across sessions, they performed a binocular rivalry task and a food-specific approach-avoidance task with high- and low-calorie foods, together with body-size estimation and symptom measures. At baseline, AN-R participants showed greater perceptual salience and stronger avoidance of high-calorie foods than HC. Relative to the baseline, embodying a larger avatar attenuated avoidance in AN-R, whereas HC showed the opposite pattern. These findings suggest that the FBI can transiently modify implicit food-related avoidance in AN-R.