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.

BACKGROUND: Virtual reality (VR) can deliver standardized, ecologically valid assessments while capturing nuanced psychological and behavioral outcomes. Sensitivity of VR assessments to pharmacological interventions, however, has seldom been tested. METHODS: We conducted a secondary analysis of a randomized, double-blind, placebo-controlled, crossover study evaluating a growth hormone secretagogue receptor (GHSR, the ghrelin receptor) blocker (PF-5190457) in people (N = 29) with alcohol use disorder. The previously reported primary study results demonstrated that the GHSR blocker did not reduce alcohol cue-elicited craving but did reduce the number of calories selected in a VR buffet food choice assessment. Here, we investigated the impact of the drug on experiences and behavior in the VR buffet. RESULTS: Participants reported higher levels of liking the VR, more typicality, and more satisfaction with their food choices under the GHSR blocker than the placebo. We also found that participants who were given the placebo first took longer to make a decision about the food they should eat and were also more likely to go up for a second serving of food when on the placebo. This was significantly less likely for participants who were given the GHSR blocker. CONCLUSIONS: The present results suggest that the GHSR blocker influenced experiences and behavior in the VR buffet in ways that are conceptually consistent with the known real-world effects of blocking the ghrelin system. These findings support the validity of using VR buffets as proxies for real-world measurements in pharmacology contexts.