Development and Evaluation of a Virtual Reality Puzzle Game to Decrease Food Intake: Randomized Controlled Trial

Yunxin Liu, Angelos Stamos, Siegfried Dewitte, Zeph M C van Berlo, Laura N van der Laan, Yunxin Liu, Angelos Stamos, Siegfried Dewitte, Zeph M C van Berlo, Laura N van der Laan

Abstract

Background: Virtual reality (VR) has gained popularity in daily life, and VR food cues seem to elicit food cravings, similar to real food cues. However, little is known about the impact of VR food cues on actual food intake.

Objective: In real life (RL), exposure to food cues in a situation in which the desire to eat food interferes with the completion of a food-related task reduces the subsequent food intake (ie, the pre-exposure effect). In this study, we examine, on the one hand, whether the pre-exposure effect could be replicated in RL and, on the other hand, whether this effect could be extended to VR contexts.

Methods: The study used a 2 (stimulus type: food vs nonfood) × 2 (mode: VR vs RL) between-subject design (n=175). Participants were randomly assigned to 1 of the 4 conditions.

Results: We found the main effect of mode on food intake, with a higher food intake after both VR conditions than after RL conditions (P=.02). In addition, among female participants, we found that exposure to both food cues (ie, VR and RL) resulted in lower food intake than exposure to both nonfood cues (P=.05). In contrast, this effect was not observed among male participants (P=.34). Additionally, VR and RL cues generated similar emotional and behavioral responses (eg, arousal and game difficulty).

Conclusions: We were unable to replicate the exposure effect in our complete sample. Subgroup analyses, however, showed that for women, exposure to food cues (either in VR or in RL) reduces food intake, indicating that a VR pre-exposure procedure may effectively be applied exclusively for women.

Trial registration: ClinicalTrials.gov NCT05169996; https://ichgcp.net/clinical-trials-registry/NCT05169996.

Keywords: food cravings; hedonic consumption; pre-exposure; self-control; virtual reality.

Conflict of interest statement

Conflicts of Interest: None declared.

©Yunxin Liu, Angelos Stamos, Siegfried Dewitte, Zeph M C van Berlo, Laura N van der Laan. Originally published in JMIR Serious Games (https://games.jmir.org), 03.02.2022.

Figures

References

1. 1. van der Laan LN, de Ridder DTD, Viergever MA, Smeets PAM. The first taste is always with the eyes: a meta-analysis on the neural correlates of processing visual food cues. Neuroimage. 2011 Mar 01;55(1):296–303. doi: 10.1016/j.neuroimage.2010.11.055.S1053-8119(10)01533-8
2. 1. Chandon P, Wansink B. Does food marketing need to make us fat? A review and solutions. Nutr Rev. 2012 Oct;70(10):571–93. doi: 10.1111/j.1753-4887.2012.00518.x. doi: 10.1111/j.1753-4887.2012.00518.x.
3. 1. Goddyn H, Dewitte S. Handling tempting food in a non-consummatory context reduces subsequent consumption of other tempting food: an extension beyond sweet snacks. Food Qual Prefer. 2017 Apr;57:97–103. doi: 10.1016/j.foodqual.2016.12.004.
4. 1. Geyskens K, Dewitte S, Pandelaere M, Warlop L. Tempt me just a little bit more: the effect of prior food temptation actionability on goal activation and consumption. J Consum Res. 2008 Dec 01;35(4):600–610. doi: 10.1086/591106.
5. 1. Duh H, Grubliauskiene A, Dewitte S. Pre-exposure to food temptation reduces subsequent consumption: a test of the procedure with a South-African sample. Appetite. 2016 Jan 01;96:636–641. doi: 10.1016/j.appet.2015.10.024.S0195-6663(15)30075-1
6. 1. de Boer C, de Ridder D, de Vet E, Grubliauskiene A, Dewitte S. Towards a behavioral vaccine: exposure to accessible temptation when self-regulation is endorsed enhances future resistance to similar temptations in children. Appl Psychol Health Well Being. 2015 Mar;7(1):63–84. doi: 10.1111/aphw.12037.
7. 1. Ledoux T, Nguyen AS, Bakos-Block C, Bordnick P. Using virtual reality to study food cravings. Appetite. 2013 Dec;71:396–402. doi: 10.1016/j.appet.2013.09.006.S0195-6663(13)00388-7
8. 1. Kang H, Shin J, Ponto K. How 3D virtual reality stores can shape consumer purchase decisions: the roles of informativeness and playfulness. J Interact Mark. 2020 Feb;49:70–85. doi: 10.1016/j.intmar.2019.07.002.
9. 1. Diemer J, Alpers GW, Peperkorn HM, Shiban Y, Mühlberger A. The impact of perception and presence on emotional reactions: a review of research in virtual reality. Front Psychol. 2015;6:26. doi: 10.3389/fpsyg.2015.00026. doi: 10.3389/fpsyg.2015.00026.
10. 1. Gorini A, Griez E, Petrova A, Riva G. Assessment of the emotional responses produced by exposure to real food, virtual food and photographs of food in patients affected by eating disorders. Ann Gen Psychiatry. 2010 Jul 05;9:30. doi: 10.1186/1744-859X-9-30. 1744-859X-9-30
11. 1. Siegrist M, Ung C, Zank M, Marinello M, Kunz A, Hartmann C, Menozzi M. Consumers' food selection behaviors in three-dimensional (3D) virtual reality. Food Res Int. 2019 Mar;117:50–59. doi: 10.1016/j.foodres.2018.02.033. S0963-9969(18)30126-1
12. 1. Ferrer-Garcia M, Gutierrez-Maldonado J, Treasure J, Vilalta-Abella F. Craving for food in virtual reality scenarios in non-clinical sample: analysis of its relationship with body mass index and eating disorder symptoms. Eur Eat Disord Rev. 2015 Sep;23(5):371–8. doi: 10.1002/erv.2375.
13. 1. Flavián C, Ibáñez-Sánchez S, Orús C. The impact of virtual, augmented and mixed reality technologies on the customer experience. J Bus Res. 2019 Jul;100:547–560. doi: 10.1016/j.jbusres.2018.10.050.
14. 1. Stamos A, Goddyn H, Andronikidis A, Dewitte S. Pre-exposure to tempting food reduces subsequent snack consumption in healthy-weight but not in obese-weight individuals. Front Psychol. 2018;9:685. doi: 10.3389/fpsyg.2018.00685. doi: 10.3389/fpsyg.2018.00685.
15. 1. Grubliauskiene A, Dewitte S. Temptation in the background: non-consummatory exposure to food temptation enhances self-regulation in boys but not in girls. Front Psychol. 2014 Jul 21;5:788. doi: 10.3389/fpsyg.2014.00788. doi: 10.3389/fpsyg.2014.00788.
16. 1. Dewitte S, Bruyneel S, Geyskens K. Self-regulating enhances self-regulation in subsequent consumer decisions involving similar response conflicts. J Consum Res. 2009 Oct 01;36(3):394–405. doi: 10.1086/598615.
17. 1. Florack A, Haasova S, Hirschauer S, Serfas BG. Playing with food: the effects of food pre-exposure on consumption in young children. Physiol Behav. 2018 Oct 15;195:76–81. doi: 10.1016/j.physbeh.2018.07.022.S0031-9384(18)30539-0
18. 1. Ung C, Menozzi M, Hartmann C, Siegrist M. Innovations in consumer research: the virtual food buffet. Food Qual Prefer. 2018 Jan;63:12–17. doi: 10.1016/j.foodqual.2017.07.007.
19. 1. van Herpen Erica, van den Broek Eva, van Trijp Hans C M, Yu T. Can a virtual supermarket bring realism into the lab? Comparing shopping behavior using virtual and pictorial store representations to behavior in a physical store. Appetite. 2016 Dec 01;107:196–207. doi: 10.1016/j.appet.2016.07.033.S0195-6663(16)30302-6
20. 1. Ferrer-Garcia M, Pla-Sanjuanelo J, Dakanalis A, Vilalta-Abella F, Riva G, Fernandez-Aranda F, Sánchez I, Ribas-Sabaté J, Andreu-Gracia A, Escandón-Nagel N, Gomez-Tricio O, Tena V, Gutiérrez-Maldonado J. Eating behavior style predicts craving and anxiety experienced in food-related virtual environments by patients with eating disorders and healthy controls. Appetite. 2017 Oct 01;117:284–293. doi: 10.1016/j.appet.2017.07.007.S0195-6663(17)30247-7
21. 1. Ferrer-García M, Gutiérrez-Maldonado J, Pla J. Cue-elicited anxiety and craving for food using virtual reality scenarios. Stud Health Technol Inform. 2013;191:105–9.
22. 1. van der Waal NE, Janssen L, Antheunis M, Culleton E, van der Laan LN. The appeal of virtual chocolate: a systematic comparison of psychological and physiological food cue responses to virtual and real food. Food Qual Prefer. 2021 Jun;90:104167. doi: 10.1016/j.foodqual.2020.104167.
23. 1. Oliver JH, Hollis JH. Virtual reality as a tool to study the influence of the eating environment on eating behavior: a feasibility study. Foods. 2021 Jan 05;10(1):89. doi: 10.3390/foods10010089. foods10010089
24. 1. van Berlo ZMC, van Reijmersdal EA, Smit EG, van der Laan LN. Augmented Reality and Virtual Reality. London: Springer; 2020. Mar, Inside advertising: the role of presence in the processing of branded VR content; pp. 11–22.
25. 1. van Berlo ZM, van Reijmersdal EA, Smit E, van der Laan LN. Brands in virtual reality games: affective processes within computer-mediated consumer experiences. J Bus Res. 2021 Jan;122:458–465. doi: 10.1016/j.jbusres.2020.09.006.
26. 1. Martí-Parreño J, Aldás-Manzano J, Currás-Pérez R, Sánchez-García I. Factors contributing brand attitude in advergames: entertainment and irritation. J Brand Manag. 2012 Apr 27;20(5):374–388. doi: 10.1057/bm.2012.22.
27. 1. Bradley MM, Lang PJ. Measuring emotion: the Self-Assessment Manikin and the semantic differential. J Behav Ther Exp Psychiatry. 1994 Mar;25(1):49–59. doi: 10.1016/0005-7916(94)90063-9.0005-7916(94)90063-9
28. 1. Stroebele N, de Castro JM. Influence of physiological and subjective arousal on food intake in humans. Nutrition. 2006 Oct;22(10):996–1004. doi: 10.1016/j.nut.2006.07.003.S0899-9007(06)00273-5
29. 1. Skorka-Brown J, Andrade J, May J. Playing 'Tetris' reduces the strength, frequency and vividness of naturally occurring cravings. Appetite. 2014 May;76:161–5. doi: 10.1016/j.appet.2014.01.073.S0195-6663(14)00082-8
30. 1. Robinson E, Hardman CA, Halford JCG, Jones A. Eating under observation: a systematic review and meta-analysis of the effect that heightened awareness of observation has on laboratory measured energy intake. Am J Clin Nutr. 2015 Aug;102(2):324–37. doi: 10.3945/ajcn.115.111195.ajcn.115.111195

Source: PubMed