Virtual Reality Mood Induction and Body Image Disturbance in Adolescents With Eating Disorders: An Experimental Study

Eating disorders (EDs) are severe psychiatric conditions characterized by body image disturbance, yet the role of affective states in the maintenance of body image symptoms among adolescents remains poorly understood. Virtual reality-based mood induction procedures (VR-MIPs) offer a controlled method for examining how experimentally induced affect influences body image outcomes. This within-subjects experimental study tested the hypotheses that a positive-MIP would improve, and negative MIP would worsen, body image disturbance indices in female adolescents with EDs. Forty-two female adolescents diagnosed with an ED, predominantly anorexia nervosa (92.85%), (Age: M = 15.88, SD = 1.40, BMI: M = 18.30, SD = 2.60) completed two experimental sessions involving positive and negative VR-MIPs. Assessments included perceived and ideal body size estimation, depressive symptoms, state affect and body satisfaction. The positive-MIP successfully induced the intended affective changes and produced increases in ideal body size estimation and reductions in body dissatisfaction. Although these effects did not survive conservative correction for multiple comparisons, the converging effect-size and Bayesian estimates provide preliminary evidence that should be examined in adequately powered samples. In contrast, the negative-MIP did not produce significant body image-related changes, and the manipulation check did not confirm the intended mood induction, limiting the interpretability of findings for this condition. These findings point to the potential value of incorporating positive affect induction strategies within body image interventions for female adolescents with EDs. Replication in larger, diagnostically diverse samples and inclusion of male and non-binary adolescents are needed to consolidate these preliminary findings. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT04617886.