“I don’t study because it gets in the way of my video game time”

-15 year old patient.

Sorry mom and dad, video games are here to stay. In my clinic, this is a topic of discussion every day:

“How many hours of screen time does Mikey get every day?” I ask.
“Tell the truth”, Mom says looking at Mikey.
“brmfbr mbbrm,” says Mikey looking away.
Mother turns to me with the familiar look that telegraphs, “Please tell him something because he will listen to you!”

But what if we could turn the powers of video games for “good” rather than “evil”? How do we manipulate the seductive power of video games to get our kids (or even ourselves) to do things we know are good for us but somehow never gets done?

How about physical activity? We know the evidence. 1 in 3 children in the United States are overweight or obese. 60% of overweight children will be become overweight adults. Kids are spending vast amounts of time in front of a screen of some sort. And to make matters worse, gym classes are being eliminated across the country.

Enter exergaming, also called active gaming. A growing body of scientific evidence is showing that video games such as the Wii Fit or Just Dance is a legitimate form of exercise. Using a variety of measures including heart rate and energy expenditure, active gaming has been shown to facilitate mild to moderate activity. And when taking on the more difficult levels, they can provide vigorous levels of activity akin to jogging or jumping rope.

Now I should be very clear that there is no substitute for going outside and playing sports or going on a bike ride. As Shelly Pfohl of the Presidential Council on National Fitness so aptly stated, there should be “No Child Left Inside”. But for some children, just getting their gluteus extracted from the couch is a victory.

Video game based physical activity can be particularly helpful for kids who live in “recreation deserts”, areas that don’t have access to safe parks. Many children have parents who work long hours and can’t supervise them outdoors. It could be a fun activity for a rainy day in the San Francisco winter. Frankly, not everyone, including me, finds utter bliss in a 5 mile run. For some kids, virtually knocking out their friend on Wii boxing has an allure that can’t be found in traditional sports.

Remember all the fun you had running laps in gym class? Some schools have the entire class play dance games for rain days or just to keep the class interesting. Not surprisingly, in studies children report more fun when exergames are done in groups. Even the First Lady’s “Lets Move” campaign includes active gaming.

Most of the research have a study period of only a few months and so long term effects and actual weight loss haven’t been extensively studied. But predictably, one of the challenges is the loss of interest. Called the “Day After Christmas Effect” by Ernie “the exergaming evangelist” Medina, kids often lose interest a short while after the shine of a new toy wears off. The key is make it fun. The video game industry is a master of creating immersive captivating experiences. How else do they get the 13 year old teenager who is “bored” by everything to log in 1000 hours on World of Warcraft.

A few weeks ago I attended the “Games for Health” conference in Boston as a health consultant for Ubisoft. It was attended by an unconventional collection of game developers, gym teachers, researchers all with the aim of bringing the powers of gaming to improving health. Speakers and attendees spoke of health apps, health education games for museums, video games for use in fitness centers, and games to assist physical rehabilitation.

One of the intriguing questions left unanswered was whether or not active video games had a “gateway effect.” Can exergaming lead players to do more outdoor activities and lead a more active lifestyle? Stay tuned for more research.

At a time where apps and social media seems to devise creative solutions to old problems, how about a few more ideas for the future of active gaming:

• Video game boxing with a friend online, for when your friend can’t come over.
• Virtual dance competitions for which you can compete from home.
• Video games that fine tune your form and skills for when you play golf on a real course.
• An immersive hiking game that displays interactive views using real images of the world’s most remote and beautiful places.

Send me your ideas.

A week after the conference I had a follow up visit with C.M. in my clinic, an 11 year old girl who has been struggling with obesity. A very bright straight-A student, she shared her aspirations of becoming a pediatrician when she grew up. (She is clearly a genius.) Her vices are potato chips and ice cream. Over the years we have had many conversations about exercise and eating healthy. And like many overachievers, she gets frustrated when she fails on the first try. Her mother has been concerned and involved, but very busy during the day working in catering. But she bought a Wii along with every imaginable variation of the Just Dance series with the hopes that C.M. would exercise at home. C.M., who is very current on her Justin Bieber and Katy Perry, admitted she enjoy playing, though she only used it occasionally.

So I pulled out my prescription pad and wrote clear instructions: “1 hour of exercise everyday including Wii Just Dance, no refills”. She smiled. She said that she would post the prescription on her wall and promised to follow through with my instructions.

Ricky Y. Choi is a pediatrician who blogs at SFGate and reprinted with the author’s permission.

 

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