Written by Hannah Harp
Spoon Feed
Active video games, or exergames, show promise in increasing physical activity and positively affecting BMI in children with overweight and obesity, though studies are limited in number and have heterogeneous designs and outcomes.
More screen time? Really?
We live in a world where pediatric obesity is on the rise, screen time is way up, and total minutes of physical activity per day are lower than they were 25 years ago. Physical activity took a giant nosedive during the COVID-19 pandemic, when children remained inside and missed out on in-school physical activity. Exergames look great on paper – physical activity disguised as video games?! But how effective are they at increasing minutes spent in sustained moderate-to-vigorous exercise or even at assisting with weight loss?
This systematic review examined whether exergaming interventions improve BMI and physical activity in children with obesity. Twelve studies (RCTs and non-RCTs) involving 29-445 participants over 2-48 weeks showed mixed but promising outcomes. Nine studies reported BMI or BMI z-score reductions, with statistically significant improvements in only three (e.g., ΔBMI −2.1; p < 0.05). Six studies showed increased physical activity, with one reporting an increase of +7.4 min/day in moderate-to-vigorous physical activity.
While exergaming may serve as a useful adjunct in pediatric obesity management, the data are limited, the study designs are heterogeneous, and the results are somewhat conflicting. However, it is promising enough to warrant more research. Many studies use delta BMI as an endpoint, which makes little sense to me since ideal BMI fluctuates throughout childhood.
How will this change my practice?
I will do pretty much anything to convince my patients to get moving (including inventing some pretty creative games involving inflated exam gloves). Many of my patients can’t play outside because of safety concerns, so some sort of indoor activity that means they can game as much as they want is the holy grail.
Source
The Effect of Exergaming on BMI and Fitness in Children and Adolescents With Obesity: A Systematic Review. Acta Paediatr. 2025 Mar 4. doi: 10.1111/apa.70048. Epub ahead of print. PMID: 40035397
