My body

This is a scenario specially designed to work through the cognitive restructuring the distortion of the body image of some patients with eating disorders. This tool allows, on the one hand, for the patient to modulate the body dimensions of a human avatar according to how he perceives himself, and on the other hand, for the healthcare professional to generate a silhouette with the real body dimensions of the patient. This allows the patient to reflect how he perceives his body image, being able to contrast it later with his real body image (by superimposing the silhouette with the objective dimensions of the patient on top of the first avatar). The objective is that the patient can observe and check on his own the difference (and therefore, the distortion) that there is between the perception of his own body and how it really is. The patient must become aware of how body dissatisfaction is maintaining his eating disorder.

Given the high anxiety that some patients often feel in situations that require the measurement or vision of their body (weigh them, measure certain parts of the body, expose them in front of the mirror, etc.), this task can also function as exposure therapy to their own body. In that case, we remind you that the healthcare professional has the option of asking the subjective units of distress (SUDs) experienced by the patient throughout the exercise. Also, to reduce maladaptive emotions, this VR task may also be combined with the systematic desensitization (SD) technique.

SETTINGS VARIABLES

Chest
It can be chosen, according to the BMI of the patient, for the size of this part of the body to be: Very slim; Slim; Normal; Wide; Quite wide; Very wide.

Gender
It can be chosen, according to the gender of the patient, for the avatar to be a Male or a Female.

Height
It can be chosen, according to the height of the patient, the most approximated height for the avatar: 5’ 3”; 5’ 7”; 5’ 11”; 6’ 3”

Hip
It can be chosen, according to the BMI of the patient, for the size of this part of the body to be: Very slim; Slim; Normal; Wide; Very wide.

Legs
It can be chosen, according to the BMI of the patient, for the size of this part of the body to be: Very slim; Slim; Normal; Wide; Quite wide; Very wide.

Neck
It can be chosen, according to the Body Mass Index (BMI) of the patient, for the size of this part of the body to be: Very slim; Slim; Normal; Wide; Quite wide; Very wide.

Skin color
It can be chosen, according to the skin color of the patient, for the avatar to be White skin or Black skin.

Waist
It can be chosen, according to the BMI of the patient, for the size of this part of the body to be: Very slim; Slim; Normal; Wide; Quite wide; Very wide.

Below is a table of equivalences between the BMI of the patient and the category to be selected for all parts of the body of the real silhouette :

Category	BMI (Kg/m2)
Very slim	<17 (Severely underweight)
Slim	17-18.49 (low weight)
Normal	18.5 – 24.9 (Normal weight)
Wide	25-29.9 (Overweight)
Quite wide(*)	30 – 39.9 (Obesisty)
Very wide	≥40 (Morbid obesity)

(*) For the “Hip” value, the category “Very wide” will be assigned when the BMI is ≥ 30.

Later, when the patient is in the environment, will be able to modify the body dimensions of the avatar through the plus (+) and minus (-) symbols that appear on both sides of each body part, by clicking on the corresponding symbol with the Touch panel to select the VR glasses (or, depending on the model of glasses, staring at the symbol until the circle that appears is completed). You can increase (+) or reduce (-) the size of a certain part of the body as the symbol is selected. In this part, the tool allows the patient to adjust the size of the aforementioned body parts (Neck, chest, waist, hips and legs) through the glasses, to make them correspond to the size that they think they have in their body.

Finally, from the Events tab, the healthcare professional can activate the option Compare Avatars; this will make the contour of a silhouette appear with the actual dimensions of the patient (previously introduced by the therapist through the configuration variables) and superimpose it on the avatar generated by the patient. The difference in body size between the avatar handled by the patient and the actual silhouette will reflect the degree of distortion of the body image presented by the patient.