The more we learn about obesity, the more obvious it is that the brain plays a huge role. Some scientists trying to stop obesity in its tracks are already targeting the brain through hormone treatments. But one team of scientists, which recently published their work in the Journal of Behavioral Medicine, is taking a very different approach. You might call it “gamified dieting.”
Using video games for brain training to improve cognition may sound too good to be true — and it was in the past— but as the team shows in the paper, there’s evidence that games can be used to combat obesity. Their version, a game called Diet DASH developed by Drexel University psychology professor Evan Forman, Ph.D., is based on the idea of inhibitory control training (ICT), which helps people regain control of insatiable urges to eat. Previous research has shown that a lack of inhibitory control, or the inability to resist food, is often a contributor to obesity.
Forman tells Inverse that the value of a video game is that it allows people to practice exercising that control in a virtual setting, which can pay off in real life.
“By practicing inhibitory control over and over again, people’s ability improves,” Forman says. “We also know the effect is specific, so practicing inhibitory control with sweet foods helps improve inhibitory control to sweet foods specifically.”
In his experiment, Forman had his participants first adhere to a low-sugar diet, so people in all groups did lose small amounts of weight over the course of the trial. But the real point of his trial was to evaluate two different types of “brain training” for sweets-related impulse control: one that was “gamified” and one that was, to use Forman’s words, “less gamified.” Both tasks are essentially computer games, but one was far more fun than the other.
Diet DASH players raced through a virtual grocery store as both healthy and unhealthy food options appeared at random on the screen.
“This condition added a story element, background graphics, feedback sounds, music, points, levels, and badges,” says Forman. Within milliseconds, the participants had to reject the unhealthy items and choose the healthy ones instead.
The less-gamified condition was similar (participants had to think quickly and select healthy choices), but it was significantly pared down. There were less fancy graphics, no background music, and no fun story.
Forman found that his participants enjoyed both versions of the ICT tasks enough to keep playing them over the course of eight weeks — he had a staggeringly high 88.8 percent compliance rate. And overall, those who played both types of games and had low impulse control for sweets ended up losing 3.1 percent of their body weight, about one percent more than those who played non-ICT “sham games.” That group lost 2.2 percent of their body weight.
But interestingly, those who played the flashy, gamified condition actually lost less weight than those who played the bare-bones version. In fact, Forman says there was a “marginally significant” effect showing that the bells and whistles actually reduced the game’s efficacy:
“What we saw is that adding those game elements described above made the training more interesting, but it is also made the training less effective,” he says. “We speculated that certain types of game elements may be distracting from the core training.”
Forman adds that his study is a “caution” about how we develop brain-training methods for obesity. He was able to show that these treatments really do work as long as designers don’t get too carried away with making slick games. The future of a brain-based impulse training, he explains, lies in simplicity. That’s the focus of his next project — which is actively recruiting.
He thinks that one day there will be a useful video game that helps people control their impulses, but first we have to get the design right.
“Certain kinds of computerized, brain training appear to offer a method of improving diet and achieving weight loss, especially for people who are attracted to high-calorie foods like sweets,” he adds. “I do think that those sorts of combinations will become popular in the future, especially as we learn more about how to make these successful.”
Nearly 70% of Americans are overweight, in large part because of overconsumption of high-calorie foods such as sweets. Reducing sweets is difficult because powerful drives toward reward overwhelm inhibitory control (i.e., the ability to withhold a prepotent response) capacities. Computerized inhibitory control trainings (ICTs) have shown positive outcomes, but impact on real-world health behavior has been variable, potentially because of limitations inherent in existing paradigms, e.g., low in frequency, intrinsic enjoyment, personalization, and ability to adapt to increasing ability. The present study aimed to assess the feasibility, acceptability, and efficacy of a gamified and non-gamified, daily, personalized, and adaptive ICT designed to facilitate weight loss by targeting consumption of sweets. Participants (N = 106) were randomized to one of four conditions in a 2 (gamified vs. non-gamified) by 2 (ICT vs. sham) factorial design. Participants were prescribed a no-added-sugar diet and completed 42 daily, at-home trainings, followed by two weekly booster trainings. Results indicated that the ICTs were feasible and acceptable. Surprisingly, compliance to the 44 trainings was excellent (88.8%) and equivalent across both gamified and non-gamified conditions. As hypothesized, the impact of ICT on weight loss was moderated by implicit preference for sweet foods [F(1,95) = 6.17, p = .02] such that only those with higher-than-average implicit preference benefited (8-week weight losses for ICT were 3.1% vs. 2.2% for sham). A marginally significant effect was observed for gamification to reduce the impact of ICT. Implications of findings for continued development of ICTs to impact health behavior are discussed.