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Why virtual weight loss programs could lead to better health habits

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When Club One approached Anne Massey about studying the success of its new virtual club in Second Life, she accepted the opportunity with some skepticism. But the results surprised her.

When Club One approached Anne Massey about studying the success of its new virtual club in Second Life, she accepted the opportunity with some skepticism. An expert on the intersections of technology, business and society, Massey wondered whether a 3D weight loss club would be as effective as its real-world counterpart.

I spoke last week with Massey, a professor of information systems at Indiana University, about the surprising results -- and about how what this virtual experiment means for the future of weight loss programs. Below are excerpts from our interview.

On how the study was conducted:

We asked the question: Can you deliver a weight loss program through [a 3D virtual] environment that is at least as effective as a real world, face-to-face environment?

We had a group in the traditional face-to-face program. We compared them to two groups that were in the virtual program [Club One Island]. The program runs over 12 weeks. We did baseline measures of their bio-metrics and their behavioral perception. We did post-measures at the end of the program and collected other data along the way.

On how the virtual and real-world programs differed:

In a traditional program, people come to the health club and meet four times a week for various activities. One hour a week would be around nutrition topics. The second hour might be around movement. There's a social aspect to it. A habit-changing course was optional.

In the virtual club, in a 3D environment through a digital representation of yourself as an avatar, you can interact with objects. I could have my avatar running on a 3D treadmill. I could see my avatar hiking. I can see other avatars interact with my avatar. The notion of a 3D environment is to have you feel present in the virtual space, as if you were in a real space. There were structured meetings each week, but a lot of the participants would go into the club to interact with objects and learn about nutrition whenever they wanted to.

On the results of the study:

Both groups showed significant improvements [around their biometrics -- weight, BMI, body fat]. They were able to lose weight. There were no significant differences between the groups at the end. The virtual environment produced results as good as the real world along the biometrics. That was a good thing and a little bit surprising. They did it virtually and still lost weight.

The second set of measures we took were around their health behaviors. These centered on their nutrition, eating habits, their ability to resist eating under a variety of pressures. We asked behavioral questions about their confidence in their ability to perform physical activity. We asked about their actual level of physical activity. Across these behavioral measures, the face-to-face group didn't show any significant improvement. They didn't get worse, but they didn't statistically get better. In contrast, participants in the virtual world showed improvements across a number of measures. Their confidence in their ability to perform physical activity increased. Their eating behaviors improved. The amount of physical activity they were engaging in improved. Their habits and their behavior seemed to be changing.

On why the virtual group saw more behavioral changes than the real-world group:

I'm running on a treadmill in a virtual environment. How's that going to make me more physically fit? If you think about high-performance athletes, they do visualization techniques, such as skiing down the slalom at the Olympics. I can see myself going a certain way and winning a gold medal. That's why this 3D space is potentially so powerful. We believe the participants, by seeing their avatar engaged in physical activity, they translate that from the virtual environment into the real world. Their self confidence in their ability to perform physical activity was significantly improved at the end of the program from where they started.

On how these results could translate into real applications:

There are a lot of people who don't go to a health club. It could be the financial implications, access, it's not convenient, they're embarrassed.

The individual may be more comfortable doing it virtually. They may have more access virtually. From an industry and business perspective, this is powerful in companies that are trying to get their employees to be more healthy. A lot of companies don't have the ability to provide on-site fitness facilities. Many employees today work from the road or the home. This may provide one avenue that may help people address it.

There are a number of other ways virtual environments can be used for types of health intervention: diabetes management, work with autistic children in a 3D environment. It can provide greater access, an environment for people that are not able or willing or comfortable in a real-world setting.

On the next step in this work:

Our next round of data collection will be 2D versus 3D. By 2D, I mean an Internet-based weight loss program, but one that uses a webinar. You receive course content, learn, socialize. But it's not 3D. That will allow us to look at the effect of the avatar. We're going to do an assessment of the 2D and the 3D comparing presence. What's the benefit of the avatar?

The other element in our next round ties into my research which deals with presence -- measuring feeling present in a 3D space. How do you drive performance outcomes using a 3D environment? One of the longstanding theories is that greater presence will lead to greater performance. We've been studying that question for three years. In this pilot study, I did the behavioral assessment for the 3D participants of how much presence they were feeling in the 3D space using the scales we've been developing. I'm seeing positive indicators that the more the virtual club participants felt present in the 3D space, the higher their performance outcomes were. There's a positive relationship between presence and biometric and behavioral outcomes. When you think about designing a 3D environment, if this is true, the more I can design the environment to drive presence, the more the presence will drive outcomes. This is tying into research I've been doing.

Image, top: Club One Island

Photo, bottom: Anne Massey

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Christina Hernandez Sherwood

Contributing Writer

Contributing Writer Christina Hernandez Sherwood has written for the Los Angeles Times, Newsday, the Philadelphia Inquirer, Diverse: Issues in Higher Education and Columbia Journalism Review. She holds degrees from the University of Delaware and Columbia University's Graduate School of Journalism. She is based in New Jersey. Follow her on Twitter. Disclosure