6. Strengths and Limitations
food-specific disgust, anorexia, eating disorder
ANOREXIA
This study has two main strengths. First, to the best of our knowledge, this is the first study to examine the correlation between food-disgust sensitivity and eating disorder symptom severity in people with AN. Second, the VR paradigm enabled aspects of attention and approaches towards food to be measured.There are some limitations in the present study to acknowledge. The first limitation is the lack of a healthy control group. Including a healthy control group would be valuable for supporting the hypothesis that food-specific disgust is critical to target in the treatment of anorexia and when investigating aberrant patterns in food-related eye gaze and touch. The second is the smaller number of participants from ethnic minority backgrounds, limiting the generalisability. Possible explanations could be that young White females, the majority of the participants, have more cultural pressure on body image, greater awareness of the illness, or access to better medical care [The current experimental paradigm also has limitations. For example, food-specific trait and state disgust were measured at different time points. Only one question was utilised to measure disgust reactions to a group of high-calorie foods that were shown in the virtual kitchen. Food-specific state disgust responses collected before and after the virtual kitchen exposure via VR would help to evaluate the effects of different virtual kitchen scenarios. Exposure to a virtual kitchen with a wider range of foods (e.g., decaying melon, wrinkled tomato, chocolate with chocolate bloom, snails, oysters, and grasshoppers) might be more likely to elicit disgust, especially in people with a greater level of food disgust sensitivity. To further increase the sense of presence in VR and to make the user experience even more immersive, it might be useful to include more sensory modalities that occur during interaction with food, such as tactile feedback and smell. With regards to food interaction measures, it might be useful to analyse them specifically in relation to the calorie content of virtual food items. In addition to the VR touch feature, other measures of food avoidance could be tested in a larger sample to draw firm conclusions regarding the link between food-related touch and food-specific disgust.