A virtual reality buffet on a ghrelin receptor blocker
Does a drug that blocks the hunger hormone ghrelin change how people with alcohol use disorder feel about, and choose from, a virtual buffet? I ran the buffet in a randomized, double-blind crossover trial.
My role
First author
Status
Published, Journal of Medical Extended Reality, 2026
Leitao, M. R., Farokhnia, M., Leggio, L., & Persky, S. (2026). Experiences and behavior during a virtual reality buffet simulation: A secondary analysis of a ghrelin-related pharmacology randomized controlled trial in people with alcohol use disorder. Journal of Medical Extended Reality. doi:10.1177/29941520261484294
29 adults who finished both visits, of 42 enrolled. 8 women, mean age 51.3.
Design
Randomized, double-blind crossover. Each person ate the buffet once on the blocker and once on placebo.
Data
Available on request only. These figures are redrawn from the printed paper.
Main findings
On the blocker, the virtual meal felt more typical, more liked and more satisfying
Twenty-nine adults with alcohol use disorder ate a buffet in virtual reality twice, once on a ghrelin receptor blocker and once on a placebo. Neither they nor the staff knew which was which.
The blocker went with higher ratings of liking (ηp² = .144), typicality (.244) and satisfaction (.153). By common benchmarks, .06 is a medium effect and .14 a large one.
ηp² = .244
drug effect on how typical the meal felt
The largest of the five experience ratings.
Feeling of being there depended on which visit came first
The blocker alone did not change presence (ηp² = .016) or realism (.018). Presence did change with the drug and the order together (ηp² = .291).
People who got the blocker first rated presence 3.83 on the blocker and 3.47 on placebo. People who got placebo first rated it 3.83 on the blocker and 4.09 on placebo. The direction of the drug gap depended on the visit order.
ηp² = .291
drug by order effect on presence
Order of the two visits mattered more than the drug.
Eating choices were mixed and depended on order
Time to the first food order showed a drug effect (ηp² = .138) and a drug by order effect (.224). Food variety and the other eating measure were not reliably different.
Whether people went back for a second plate also depended on order. The sample was small, so I treat these as leads to follow up, not settled results.
29 people
completed both visits
Of 42 enrolled. The study fell short of its planned sample.
The evidence
Size of each effect
What to look for. Dots to the right of the dashed lines are larger effects. Experience ratings sit mostly past the medium line. Presence needs the drug and order together.
Table 1. Experience ratings (ηp², with F in brackets)
What to look for. Three ratings change with the drug. Presence changes only with drug and order together.
Rating
Drug effect
Drug by order
Liking
.144* (4.375)
Not significant
Typicality
.244** (8.381)
Not significant
Satisfaction
.153* (4.680)
Not significant
Presence
.016 (not significant)
.291** (10.697)
Realism
.018 (not significant)
Not significant
* p < .05, ** p < .01. From the paper's Table 1. Weight-status models also showed drug by weight effects for presence (ηp² = .219) and realism (.206).
Ratings at each visit, by order
What to look for. In the top block the blocker dot sits to the right for liking, typicality and satisfaction. In the bottom block the two dots are close.
Ghrelin receptor blocker
Placebo
View as a table
Row
Ghrelin receptor blocker
Placebo
Presence
3.83
3.47
Realism
5.13
5.07
Liking
5.91
5.57
Typicality
5.27
4.71
Satisfaction
5.73
5.21
Presence
3.83
4.09
Realism
5.50
5.29
Liking
6.04
6.00
Typicality
5.64
5.07
Satisfaction
5.71
5.57
Ratings by perceived weight
What to look for. Gaps between the dots are wider in the higher perceived weight group, especially for realism and typicality.
Ghrelin receptor blocker
Placebo
View as a table
Row
Ghrelin receptor blocker
Placebo
Presence
3.88
4.13
Realism
5.33
5.86
Liking
6.10
6.20
Typicality
5.67
5.29
Satisfaction
5.87
5.79
Presence
3.77
3.43
Realism
5.29
4.50
Liking
5.83
5.37
Typicality
5.21
4.50
Satisfaction
5.57
5.00
Eating measures
What to look for. Time to the first food order flips direction between the two order groups. Food variety barely moves.
Ghrelin receptor blocker
Placebo
View as a table
Row
Ghrelin receptor blocker
Placebo
Time to first food order
20.5
14.9
Food variety
7.5
7.9
Time to first food order
19.0
31.7
Food variety
7.9
7.8
Went back for a second plate
Ghrelin receptor blocker
Placebo
View as a table
Row
Ghrelin receptor blocker
Placebo
Blocker visit first
26.6%
13.3%
Placebo visit first
28.5%
41.8%
Table 2. Eating behavior (ηp²)
What to look for. Only time to the first food order shows a clear effect.
Measure
Result
Time to first food order
Drug ηp² = .138*, drug by order ηp² = .224**
Second plate (logit model)
Drug b = 9.241 (SE 4.537), order b = 8.441, drug by order b = −12.039
SSC and food variety
Not significant
* p < .05, ** p < .01. From the paper's Table 2.
What this means
The blocker changed how the meal felt. Liking, typicality and satisfaction were higher on the blocker, with large effects by common benchmarks.
Order complicates the eating results. Time to the first order and the second plate depended on which visit came first. With 29 people I cannot separate a drug effect from carryover.
Limits. The study fell short of its planned sample because of COVID, and these analyses were exploratory. The abstract and the Results text describe the second plate differently: the abstract says it was less likely on the blocker for the placebo-first group, and the Results say the blocker made it more likely in the drug-first group. Both can be true, since they describe different groups, and the chart above shows each.
How this page was made
The data are available on request, so I have not released any. Every number here is taken from the printed paper and redrawn. I did not recompute anything from raw data.