Usefulness of a virtual reality programme for body self-image in obese and overweight patients: a focus on gender differences – a randomised trial

Abstract Background Excess weight significantly impacts body image perception. While research on body satisfaction in overweight and obese individuals is extensive, most studies report high dissatisfaction, especially among women. This study aimed to evaluate the utility of a virtual reality (VR) intervention for improving body image perception among overweight and obese individuals and to examine gender differences. Methods A total of 102 overweight and obese adults were recruited from the general community (Alicante, Spain) and randomized to the experimental (EG, n = 50) or control (CG, n = 52) group. The nutritional, anthropometric, body composition, clinical parameters and body self-image questionnaire (MBRSQ) scores were collected at baseline (Time 1) and postintervention (Time 2). Both groups received nutritional recommendations based on the Mediterranean diet (DM). Only the EG went through the 4D modelling machine, which showed the morphological changes of each participant over time through immersive VR. Results The results revealed that the EG improved in all the MBRSQ dimensions after the intervention, particularly in terms of the subjective importance of corporeality (SIC), physical fitness behaviors (BAMPF), and self-assessed physical attractiveness (SAPA). Significant gender differences emerged, with women exhibiting greater body dissatisfaction, greater body image concerns, and lower engagement in health-oriented behaviors. Conclusion This study provides evidence of VR’s usefulness in improving body self-image perception and promoting healthier behaviors. Additionally, it emphasizes the importance of addressing gender-based differences, as women experience greater societal pressures regarding body image. These findings highlight VR’s potential as a transformative tool for managing body image issues in individuals with excess weight. Trial registration The study was retrospectively registered at ClinicalTrials.gov (Identifier: NCT07205029, registered on 30 September 2025).