Purpose <p>Obesity is a major health challenge, requiring the development of more effective interventions. Setting realistic goals and developing detailed plans that anticipate potential challenges can be helpful strategies for bridging the intention–behavior gap. Immersive technologies, such as virtual reality (VR), are considered to further support closing this gap by reducing the distance to one's future self.</p> Methods <p>This study investigates a novel VR-supported reflection exercise as an additional treatment module within a conservative obesity treatment regime. It examines its feasibility, acceptance and short- and medium-term effects on participants' therapy motivation, body dissatisfaction, self-esteem, depressive symptoms, and eating behavior. 23 participants (BMI: <i>M</i> = 43.44&#xa0;kg/m², <i>SD</i> = 4.42) were presented with a real-time animated body avatar that had the average body shape for their individual height, initial weight, and realistic target weight (−&#xa0;10%), and standard appearance matched in terms of hair and skin color. The avatar could be viewed from first-person and mirror perspectives. The exercise included reflective questions about their experience, well-being, daily life, and eating and movement behavior.</p> Results <p>Participation and dropout rates of the VR-supported reflection exercise, user experience ratings, assessments on general discomfort and qualitative feedback demonstrated good feasibility and acceptance of the VR exercise. There were no measurable effects of a single session on clinical outcomes, including motivation to change, eating disorder psychopathology, self-esteem and depressive symptoms.</p> Conclusions <p>The VR-based reflection exercise was feasible and well-accepted. The sample was highly burdened with multimorbidity, severe obesity (grade III), and psychological stress. A clinical trial with sufficient dosage would be required to infer about clinical effects.</p> Level of evidence <p>Level 4.</p>