A Pilot Study of a Gamified CBT‐Based Digital Approach for Body Image Distress and Appearance‐Related Concerns

Body image concerns related to perceived flaws in appearance represent a significant mental health challenge affecting a broad population. While Cognitive Behavioral Therapy (CBT) is an effective approach, stigma, financial costs, and limited access to trained professionals prevent many from seeking help. Digital interventions, particularly gamified approaches, offer an alternative by making support more engaging and accessible. To reflect the exploratory nature of this work, we developed a pilot-scale serious game that integrates CBT techniques with AI-driven analysis to provide interactive and personalized guidance. This pilot study provides preliminary indications of user-reported improvements in engagement and emotional reflection following gameplay. Compared to traditional approaches, the game′s adaptive feedback system, informed by real-time emotional assessment, provides more personalized support during gameplay. The AI model used for analyzing user input achieved an accuracy of 97.15% on held-out test data, outperforming a BERT-based baseline classifier. While promising, these results are not intended to establish clinical efficacy; rather, they suggest that digital gamification may offer a scalable and accessible approach for supporting individuals experiencing body image distress. Future work will require larger samples, validated assessment tools, and multisite randomized controlled trials to evaluate effectiveness before potential clinical application, as well as exploration of augmented and virtual reality to further enhance user experience and supportive interaction outcomes.