According to recent research, “gamifying” exercise can improve motivation and make fitness more effective at all levels. Here’s what you need to know. Share on Pinterest Illustration by Brittany England In May, Leah Jewer, 34, of Montreal, made the decision to exercise more often. However, this time, she wanted to find a fresh way to motivate her newfound fitness goals. Jewer purchased a Fitbit. She also downloaded the Lifesum Health App (a fitness app that allows users to personalize diet plans with healthy recipes and nutrition advice) and the 5K Runner app (designed to train runners). Jewer was serious about “gamifying” her fitness routine, thinking that if she set a “sort of achievement system” to her exercise regimen, she’d be more likely to stick with it. What is gamification? It’s the process of taking something that already exists – such as a workout regimen – and integrating game mechanics into it with the intent to motivate, improve engagement, and increase loyalty. In other words, it’s a way of turning an activity into a game. Jewer is no stranger to gaming. In addition to her job as a senior product manager for iHeartRadio Canada, she is the co-founder and co-editor-in-chief of Girls on Games, a blog dedicated to video game news and reviews. So she knows how the need to complete a quest can help push a player to excel. With her apps and gadgets on hand, Jewer began her new approach to diet and fitness, and soon discovered it worked. “I found that trying to reach my steps and exercise goals on Fitbit, while trying to eat the right food and calorie count with Lifesum and earning the badges in 5K, to be a fairly easy [way] to keep consistent,” she said. “I do find these apps and the Fitbit itself very helpful because the notifications they all give remind me to keep with the program.” For Jewer, transforming exercise into a game has motivated her unlike anything else — and she’s not alone. A quick Google search finds many people sharing their stories of success after using a range of fitness apps, gadgets, or video games aimed at getting people to embrace exercise through gaming. In other words, “gamifying” your workout works.

Leveling up Today, Americans appear to be more unmotivated than ever before to get up and move. A June report from the Centers for Disease Control and Prevention reveals that just about 23 percent of U.S. adults are able to meet the recommended guidelines for muscle-strengthening and aerobic exercises. According to “The State of Obesity,” an annual report from the Trust for America’s Health and the Robert Wood Johnson Foundation, 45 percent of American adults aren’t sufficiently active to achieve necessary health benefits, with a massive $117 billion in healthcare costs tied to inadequate physical activity. Bradley Prigge, a wellness exercise specialist at the Mayo Clinic Healthy Living Program, said getting people to embrace healthy physical activity can be a challenge. He pointed out that thought of embracing exercise — not to mention heading into a gym — can be intimidating for many people who haven’t always been active. “In our programs here [at Mayo Clinic], it’s really about finding things that are relevant to each individual. It’s about what allows them to find that connection to activity,” Prigge told Healthline. “Gaming can be a way of doing that. In our classes we [have] here, we do have a gaming component where we introduce people to fitness gaming, and there are some people who are jazzed about that.” Recent research has looked at the phenomenon of gamifying workouts and its effectiveness on fitness. A July study in the Journal of the American Heart Association divided 146 people — sedentary office workers, ages 21 to 65, who sit at least 75 percent of their workdays — into two groups over 10 weeks. In both groups, participants were given Fitbits, but only one group used the wearable along with MapTrek, a web-based game that moves a person’s digital avatar along Google Maps based on their number of steps. The group using the game competed against each other in weekly walking challenges. The results? The group playing the map-based game walked 2,092 more steps each day and finished 11 more active minutes per day compared to the group with just the Fitbits. Lucas J. Carr, PhD, assistant professor in the department of health and human physiology at the University of Iowa, was one of the lead researchers behind the pilot study. Carr told Healthline that the most surprising finding of the research was how many people reported the game motivated them to wear their Fitbit more often. “This is important, as wearing a Fitbit is a great way to self-monitor daily physical activity levels,” Carr said. “Self-monitoring has been shown as a good way to maintain physical activity and prevent declines in activity.” However, after the study, people didn’t maintain their new activity levels. By the end of the study’s 10 weeks, both groups failed to maintain their overall spikes in activity, but the MapTrek gaming group still averaged more steps than their Fitbit-only counterparts. “It’s difficult to say without testing these hypotheses, but if I had to speculate, I would say we need to continue to modify the game in a way that maintains high levels of engagement. Introducing new and fresh game features periodically is something we’ve discussed and plan to do in future studies,” he said. “We’ve also discussed combining the game with health coaches who can provide continued motivational and educational support to participants.” Getting people to adopt new behaviors over a longer period of time is one of the biggest obstacles in the world of fitness. In a 2017 study in the journal JAMA Internal Medicine, researchers conducted a clinical trial among adults who were enrolled in the Framingham Heart Study. The study involved a 12-week intervention period and 12-week follow-up of 200 adults from 94 families in the long-term study. Each person tracked their daily step counts with either wearables or smartphone apps and was given feedback on their step count performance by email or text over 24 weeks. Once this baseline was established, half of the participants were put into a game with their family where they each worked to earn points as they moved through levels to see who could surpass each other in their steps. By the end, people in the “gamified” group reported 1,661 daily steps compared to their baseline of 636. That being said, as with the other study, new behaviors are hard to maintain. In the 12-week follow-up period, physical activity dropped in both groups. But the group that played the game still had a significantly greater number of steps compared the control group.

The challenge of maintaining fitness levels So why is it so hard to adopt new fitness practices — game or no game? Yuri Quintana, PhD, director of Global Health Informatics at the Division of Clinical Informatics at Beth Israel Deaconess Medical Center in Boston Massachusetts, has made a career looking at the ways games can impact people’s health. An assistant professor of medicine at Harvard Medical School, Quintana has looked at “serious games for health,” seeing ways in which games applied to healthcare practices can impact everything from mental health to pediatric cancer. When it comes to the difficulty of maintaining lifestyle changes brought about by games, he says that “creating sustained changes in health behaviors is one of the most challenging aspects of healthcare.” “Mobile apps that are complemented with other support services such as counseling and follow-up care visits have better long-term outcomes,” he told Healthline. “Traditional forms of education and communication have shown limited results. Gamification shows promise, but long-term studies are needed to find the optimal blend of education and communication methods.” The phrase “long-term” is key. The two recent gamification studies were both short-term looks at how technology can potentially shift people’s fitness behaviors. Carr, the researcher from the MapTrek game study, said that moving forward, he would love to test the game with a wider range of populations, including people with chronic diseases, older adults, and veterans. “We know enough about human behavior to say that people are much more likely to do the things that they enjoy,” he added. “Lots of people enjoy playing games, but few genuinely like to exercise. Adding a gaming component to fitness is exciting to me because it’s shown to help some people be more active simply because they like to play games. If that is what motivates them to be active, more power to them.”