Effects of active video games on physical activity, psychological distress, exercise motivation, and body composition among overweight and obese college students in China

Active video game training has been extensively studied in children, adolescents, and older adults. However, its benefits for college students with overweight and obesity remain unclear. This study evaluated the effects of 12 weeks of active video game training on physical activity, psychological distress, motivation, and body composition in Chinese college students with overweight and obesity. This is a true pre-test and post-test experimental design study, where the cluster randomised controlled trial was conducted in Jining City, Shandong Province, China. Two districts were randomly selected from the nine districts of Jining City and one university was randomly selected within each district. One university was randomly set as the experimental group (active video game training) and the other as the control group (standard training). The study screened college students based on the criteria for overweight and obesity in adults set by the World Health Organisation. Body mass index was used as the screening criterion, with BMI ≥25 kg/m² defined as overweight and BMI ≥30 kg/m² defined as obesity. All college students who met this criterion were eligible to participate in this study. Eventually, 63 college students (age range: 18-22 years) participated in the study. Each group participated in three weekly training sessions for twelve weeks (36 sessions). These training sessions were conducted during physical education lessons in both universities. In addition, those test protocols measured changes in the dependent variables at baseline, week 6, and week 12. Generalised estimating equations (GEE) were used to analyse between and within group differences, and the significance level was fixed at p<0.05. Results showed no statistically significant differences (p>0.05) between groups for baseline physical activity, psychological distress, exercise motivation and body composition. Betweengroup comparisons at week 12 showed significant differences in all variables except external regulation, introjected regulation, and lean body mass, which were not significantly different (p>0.05). In physical activity, step counts increased significantly (χ2=53.92, p<0.001). In psychological distress, depression (χ2=16.00, p<0.001), anxiety (χ2=33.53, p<0.001), stress (χ2=76.93, p<0.001) and overall psychological distress (χ2=116.76, p<0.001) were significantly reduced. In exercise motivation, amotivation was reduced considerably (χ2=10.41, p=0.005). Identified regulation (χ2=26.83, p<0.001) and intrinsic regulation (χ2=19.35, p<0.001) were significantly increased. In body composition, body mass index (χ2=89.81, p<0.001), body fat percentage (χ2=31.59, p<0.001), and waist-to-hip ratio (χ2=16.03, p<0.001) were significantly reduced. Active video game training has a large effect size on physical activity (d=0.94). Among psychological distress, stress had the most significant effect size (d=1.64). In addition, for exercise motivation, identified regulation had the largest effect size (d=1.17). Meanwhile, for body composition, the waist-to-hip ratio demonstrated the largest effect size (d=0.81). The results showed that active video game training could benefit both physical and mental health in Chinese college students with overweight and obesity. Active video game training uses its rich content to continually increase physical activity in college students with overweight and obesity while improving mental health. This increases exercise motivation and ultimately enhances body composition. It is recommended that active video games be included as part of physical education activities in college, especially for the overweight and obese group, because it can effectively help them physically and psychologically. Future studies should further explore the effects of gender differences and active video game training time on exercise motivation and explore the optimal training dosage applicable to Chinese college students with overweight and obesity to improve long-term participation and intervention outcomes.

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