Among video game developers, it’s called “crunch”: a sudden spike in work hours, as many as 20 a day, that can last for days or weeks on end. During this time, they sleep at work, limit bathroom breaks and cut out anything that pulls their attention away from their screens, including family and even food. Crunch makes the industry roll — but it’s taking a serious toll on its workers.

In late 2011, as he was finishing up production on the role-playing game The Elder Scrolls V: Skyrim, the programmer Jean Simonet started feeling severe stomach pains. At first, doctors were perplexed. But on his third emergency room visit, he revealed that he’d been regularly staying at the office late and coming in on weekends to fix bugs and add features that he thought would take Skyrim from good to great, no matter how much sleep he lost along the way.

He took his doctor’s advice and took the next few weeks off work, trying to relax and acclimate to a normal sleep schedule. With this hiatus from crunch, “eventually the pain just disappeared,” he said.

Anecdotes like this are common in the video game industry, which generated $30.4 billion in the United States last year but has a human cost that can’t be calculated. The designer Clint Hocking described suffering memory loss as a result of the stress and anxiety of crunching on a game. Brett Douville, a veteran game programmer, said he once worked so long and for so hard that he found himself temporarily unable to step out of his car.