The goal of this clinical trial is to see if a short virtual reality (VR) program can be used safely and comfortably with people receiving care for anorexia nervosa. The study will also check if people are willing to take part and complete the full week of VR sessions. The main questions the study will answer are: Can the investigators recruit and keep participants in the study? Do participants complete most of the VR sessions? Do they find the experience helpful and acceptable? Are there any side effects, like nausea or dizziness? Participants will: * Take part in one VR session each weekday (about 20 to 30 minutes) for one week * Continue their usual care during this time * Answer questions before and after the VR sessions about their anxiety, mood, motivation, and experience * Some participants may join a short interview or focus group to share feedback The VR program includes scenes for food-related exposure, calming music, motivational phrases, and goal setting. The app was designed with help from people with lived experience of anorexia and based on psychological therapies used in treatment. Who can take part: * Adults aged 18 or older * People receiving or waiting for care for anorexia nervosa at South London and Maudsley NHS Foundation Trust (SLaM) * People who are medically stable and able to give informed consent Why this matters: This study will help researchers understand if using VR in eating disorder services is practical, safe, and acceptable. The results will help plan a larger trial in the future to see if this type of VR treatment can support recovery from anorexia nervosa. Taking part is voluntary, and participants can stop at any time.
This single-site, open-label feasibility clinical trial will test a brief virtual reality (VR) program (OASIS) delivered alongside treatment as usual for adults with anorexia nervosa. OASIS was co-developed by South London and Maudsley NHS Foundation Trust (SLaM), King's College London, and SyncVR Medical UK with input from people with lived experience. The VR sessions are designed to support recovery by providing: * Food-related exposure scenes to practise approaching commonly avoided foods * Relaxing environments with music * Motivational prompts and goal-setting within the VR experience Participants complete five supervised VR sessions over one week (about 20-30 minutes each) in inpatient, day service, or outpatient settings. A clinician or trained researcher is present for all sessions. Pacing can be adjusted, and sessions can be paused or stopped at any time. Feasibility will be assessed using study process measures (for example, recruitment and retention, session completion, and brief usability/acceptability feedback) and session logs. Safety is monitored during every session and via routine clinical information already collected in care; no additional research blood tests are required. Participants complete brief assessments at baseline and after the one-week intervention. These include validated self-report measures of eating-disorder symptoms, food-related fear, mood/anxiety, and motivation, plus very short ratings around sessions to track immediate experience (for example, anxiety or relaxation). A subset may take part in a short interview or focus group to describe what felt helpful or difficult and suggest refinements. There is no randomization or control arm in this feasibility phase. Findings will be used to decide whether and how to run a larger randomized controlled trial, including practical procedures (for example, session dose and outcome burden), expected adherence, safety monitoring steps, and willingness to be randomized.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
OTHER
Masking
NONE
Enrollment
45
Immersive VR sessions including (a) food-related exposure scenes, (b) relaxing music, and (c) motivational prompts and goal-setting. Delivered once daily on weekdays for one week (five sessions; ≈20-30 minutes each), supervised by a clinician or trained researcher. Sessions may be paused or stopped at any time.
Session adherence to the VR intervention
Proportion of scheduled VR sessions completed per participant, recorded from session logs. A session counts as completed if ≥20 minutes are delivered. Primary endpoint = % of participants who complete ≥4 of 5 sessions; the investigators will also report mean (SD) sessions completed.
Time frame: Baseline to end of Week 1 (5 weekdays)
Recruitment and retention feasibility
Recruitment = % of eligible approached who consent. Retention = % of consented who complete the 1-week assessment.
Time frame: Months 2-10 (recruitment) and Baseline to end of Week 1 (retention)
EDE-Q Global Score
Change in global score on the Eating Disorder Examination Questionnaire (EDE-Q) from baseline to end of Week 1. Score (0-6); higher scores indicate greater severity of eating disorder symptoms.
Time frame: Baseline and end of Week 1
EFQ Total Score
Change in total score on the Eating and Food Questionnaire (EFQ) from baseline to end of Week 1. Units: Score (0-50); higher scores indicate more maladaptive eating behaviors.
Time frame: Baseline and end of Week 1
FOFM Score
Change in score on the Fear of Food Measure (FOFM) from baseline to end of Week 1. Units: Score (0-40); higher scores indicate greater food-related anxiety.
Time frame: Baseline and end of Week 1
M3VAS Items
Change in visual analog scale ratings (M3VAS) for mood and anxiety from baseline to end of Week 1. Units: Score (0-100 mm); higher scores indicate greater symptom severity.
Time frame: Baseline and end of Week 1
DASS-42 Total Score
Change in total score on the Depression Anxiety Stress Scales (DASS-42) from baseline to end of Week 1. Units: Score (0-126); higher scores indicate greater psychological distress.
Time frame: Baseline and end of Week 1
Acceptability/usability of VR
Study-specific 0-10 ratings of acceptability/helpfulness (higher = better); summarized as mean (SD).
Time frame: End of Week 1
Willingness outcomes
(a) Willingness to try foods encountered in VR outside sessions (four 0-10 items: willingness, readiness, confidence, 1-week likelihood); (b) willingness to participate in a future randomized trial (Yes/No).
Time frame: End of Week 1
Feasibility of assessment battery
Completion rates across all planned questionnaires; instruments with \>25% missing at either time point flagged as infeasible for a future trial.
Time frame: Baseline and end of Week 1
Safety (adverse events and VR-related symptoms)
Counts/types of adverse events (including nausea, dizziness, headache); % of participants with ≥1 event.
Time frame: During sessions through end of Week 1
Body Mass Index (BMI)
Change in body mass index (BMI) from baseline to end of Week 1. Units: kg/m²; higher values indicate higher body mass.
Time frame: Baseline and end of Week 1
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