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In the past, research into the negative health impact of spending too many hours each day glued to a TV set, video game console or computer screen has focused on “tweens” and adolescents, generally between the ages of 8-18. While this age group certainly earns their reputation as gamers—with 59–73% manning the controller on an average day—new research published in the October issue of the American Journal of Preventive Medicine turns the microscope on a different class of video game enthusiasts, adults.

In a study of 562 people between the ages of 19–90 living in the Seattle-Tacoma area, 45.1% said they played video games regularly. The concentration of gamers didn’t surprise researchers too much, considering that the hub of Microsoft and Amazon is the country’s 13th largest media market, and has its highest level of internet use. Yet, what was illuminating for researchers led by James B. Weaver from the National Center for Health Marketing at the Centers for Disease Control, was the strong correlation between regular gaming and internet use, and increased risk for depression, higher body mass index (BMI), and other negative physical and mental health issues.

Women who regularly played video games had both higher levels of depression and lower overall health status compared with women who didn’t play, and men who concentrated time on the console were more likely to have elevated BMI and report more time spent on the internet than men who weren’t gamers. Overall there were more male than female video game devotees (55.9% of those who reported playing regularly in this survey were men), but for both men and women, regular gaming was strongly correlated with a higher dependence on the internet for social interaction.

While this is among the first major studies to analyze the adverse effects of excessive gaming among adults, its findings are consistent with previous research in adolescents, which also found a significant correlation between hours spent logged on and elevated BMI, higher numbers of “poor mental health days,” and lower levels of sociability and assertiveness. The factors driving those negative physical and mental health outcomes may have to do with the real world activities gamers forgo in order to spend more time in the virtual world. “Internet community support and time spent online also distinguished adult video-game players from non-players, a finding consistent with previous research pointing to the willingness of adult video-game enthusiasts to sacrifice real-world social activities to play video games,” the researchers write.

In an accompanying editorial, Dr. Brian A. Primack, a professor of medicine and pediatrics at the University of Pittsburgh School of Medicine, applauds the efforts to shine light on the apparently growing phenomenon of adult gamers, highlighting the statistic that the average age of video game enthusiasts is actually 35. He also laments the growing prevalence of “playlike activities”—that is, things that stimulate similar parts of the brain as old fashioned running around does, but with out all of the sweating and, you know, being outside. Yet he doesn’t pan gaming altogether, suggesting it may be beneficial in helping develop hand-eye coordination, and that games like Wii Fit, which simulate sports and actually get you moving may be better than just sitting around. But Primack does raise offer a word of caution: With video games now being developed for everything from pure entertainment to surgical training and street safety, he says, it may not be too long before the virtual world starts to eclipse the real one. “[W]ho will be left to remind us that—for children and adults alike—Hide-And-Seek and Freeze Tag are still probably what we need most?”