May 03, 2013
By Greg Peters
New research shows the virtual reality world of avatars created in Second Life can help people keep weight off once they lose it.
A study led by Debra Sullivan, Ph.D., professor and chair of the University of Kansas Department of Dietetics and Nutrition, used Second Life's three-dimensional, virtual reality environment to study both weight loss and maintenance.
"I saw a presentation by a faculty member in occupational therapy who was teaching a class in Second Life, and I thought that it was crazy," Sullivan says. "But my next immediate thought was that it would be crazy not to use it for weight management."
As a result, Lycopene — Sullivan's red-headed avatar — was born, as were those of the 20 participants in the research project.
Sullivan's research team studied the 20 overweight and obese people in a program that involved either real-life or virtual reality meetings every week for three months. At the end of that period, all the subjects took part in a weight-maintenance program using Second Life, which is used in everything from gaming to education to the arts.
Sullivan found that while virtual reality compares favorably with face-to-face interactions in controlling weight loss, its true benefits can be seen more readily in weight maintenance. The results are published in the May/June 2013 "Journal of Nutrition Education and Behavior."
"For weight loss, if you do the program as we suggest, then you are successful," says Sullivan. "Maintenance is when real-life behavior change really makes a difference. You have to make more decisions on your own. I think being able to practice those behaviors in Second Life led to better adoption of behavior changes in real life."
In the study, participants created avatars that could interact with the other cyber-dwellers in the group. Training and education took place on island space in Second Life that was owned by KU Medical Center and controlled by Sullivan's researchers. Participants used headsets and microphones to communicate with others within the group.
To access the island, participants logged in to Second Life software that had to be installed on the computer they were using to gain secured access to the island. Second Life can automatically work with websites like YouTube to pull in content to use within the simulation.
During meetings of the avatars in a virtual conference room, group leaders could show videos or present other materials.
Sonny Painter, an educational technology liaison, and Tennille Fincham, an eLearning support specialist, were tasked with making the original KU Medical Center island come to life from the reaches of KU Medical Center's Teaching and Learning Technologies offices. This was familiar ground for the pair since they had helped other departments use Second Life for a variety of projects.
Second Life has a variety of preset island templates that can be customized. KU Medical Center's original island environment included a conference room, house, gymnasium, grocery store, restaurant and buffet. Each room provided the avatars with a setting to interact with each other as well as to check on calorie counts in food items, calories burned during exercise and other helpful information.
Sullivan says by using the role-playing scenario of Second Life, participants can simulate real-life situations without many of the consequences and repercussions. For example, the avatars can practice meal planning complete with calorie counts for trips to the grocery store, dining out or attending holiday parties, all in the anonymity of cyberspace. The goal of the simulation is to create a friendly environment where people can spend time researching healthier lifestyles without the fear of being judged.
As a result of her preliminary research, Sullivan's team has received a grant from the National Institutes of Health to continue the research. Painter and Fincham are now hard at work at their electronic workbenches creating KUMC Healthy U, a new island that will be used when the research starts again in July 2013 with 202 new subjects, who will take part in an 18-month study.
The new island will expand opportunities for the participants. On KUMC Healthy U, avatars will be able to take advantage of restaurants with cashiers that total the amount of calories on customers' trays as they check out. A kiosk, known as Fast Food Frenzy, will link avatars to the websites of various restaurants, so that they can calculate the calories in their meals.
The new island also includes a more elaborate gymnasium, complete with a swimming pool where avatars can register the calories burned as they swim, tread water or take part in activities in the water. Trainers in the gym will be able to help the research subjects by answering basic fitness questions. Avatars can also access fitness videos while doing their simulated running on treadmills.
One of the highlights of the new island will be trails where avatars can walk, run or bike while Second Life keeps tabs on the calories burned.
"All participants will receive the same weight-loss program for six months and then be randomized to either virtual reality or remain with a traditional method for 12 months of weight-loss maintenance," Sullivan says. "We aim to compare the difference in weight loss maintenance between the two groups at the end of the 12-month maintenance phase."
Her team also hopes to assess factors that might influence weight change, such as physical activity, calorie intake, and the consumption of fat, protein, carbohydrates and micronutrients and food groups. They also plan to monitor how closely subjects obey the study protocol to see if that influences the outcomes, as well as how often participants attend meetings, turn in behavior-tracking data, log in to Second Life and what they do once they get there.
Researchers also plan to collect data on any changes in a subject's ability to set and obtain goals and problem-solving skills, Sullivan says.
So what began as a whim sparked by a colleague's presentation in the use of Second Life has blossomed into research into weight loss and maintenance that could help dietitians and other health professionals find better ways to address obesity and its associated problems that burden today's society.
Sullivan is the lead author on the study. Other KU Medical Center authors include Joseph Donnelly, Ed.D.; Jeannine Goetz, Ph.D., RD; Cheryl Gibson, Ph.D.; Richard Washburn, Ph.D.; and Tennille Fincham. Other co-authors include Jaehoon Lee, Ph.D., from the University of Kansas; and two former KU Medical Center faculty and staff, Bryan Smith, Ph.D., and Stephanie Gerald.