As technology and healthcare become increasingly intertwined, so too does the advent and acceptance of innovative behavioral health intervention approaches. Not the least of which of these is wellness gamification—a paradigm defined as “the application of a ‘game system’ in a non-game context” with “frequently incorporated components including points, leadership, levels and achievements.”
A Brown University Warren Alpert Medical School report underscores research detailing why gamification is proven to work, noting, “The most prominent categories of persuasive feedback involve goal setting, overcoming challenges, providing feedback on performance, reinforcement of positive behaviors, comparing progress and social connectivity.” A Research Dive report adds even more clarity, citing that “gamification technologies help people to adhere to the path of attaining their goals by tapping into their instincts and strengths. Gamification in healthcare apps serves as a good cop and bad cop at the same time, keeping up high enthusiasm as well as loyalty among people.”
As further case in point, newly published findings from the new JAMA Network “Financial Incentives for Weight Reduction” clinical trial proves that paying obese people cash for weight-loss is highly effective, even doubling fat loss rates. Related reports underscore the key finding that “paying cash to people with obesity for losing a specific amount of weight or completing weight-reducing activities works better than offering stand-alone free tools, such as weight-loss programs, diet books and wearable fitness trackers.” This amid throngs of other behavioral science studies validating the power of gamifying weight-loss efforts: money-motivated obesity intervention and prevention.
With the efficacy of healthcare gamification consistently proven, the category has skyrocketed, and hugely sustained growth is forecasted throughout the years ahead. In fact, another Research Dive’s report reveals the global healthcare gamification market is anticipated to rise at a stunning 11% CAGR, garnering a revenue of nearly $9.5 million by 2031 (up from $3,260 million in 2021). This amid “the gradual shift of the medical sector to preventive healthcare expected to help the prevention application sub-segment to become the most profitable one.”
Prime Players Embody Approach
A Global Market Insights report is more specific, stating that fitness-oriented games will “increasingly influence the demand for gamification in the market.” To that point, there is a wide array of noteworthy, gamified exercise examples. This includes the Nike Run Club app, billed as providing what is needed to start running, keep running and enjoy running more. CARROT is a free app that rewards you financially for walking. By achieving individualized activity goals, users earn virtual currencies that can be used to play games, compete in challenges, bid on an auction and earn rewards. For fun-seekers who enjoy engagement, Fitocracy is an app offering online games and social networks to help users stay motivated and improve their fitness.
While these, and throngs of other healthcare companies and applications, have added gamification strategy to their solution suite—or have otherwise appeared on the scene in recent years—some visionaries have been pioneering the diet and fitness gamification space for well over a decade. Case in point is HealthyWage, which was founded in 2009 with wellness gamification as its entire business model. Unlike the glut of exercise-oriented apps that dominate this gamification sub-category, HealthyWage is instead championing—and financially rewarding—the results of one’s fitness and nutrition efforts relative to resulting healthy weight-loss and management.
The brainchild of two former healthcare consultants, the company was the very first in the United States to offer cash-based diet incentives directly to consumers. Today, this weight-loss wagering company offers numerous types of contests and challenges for both individual and team dieters, all fueled by cash incentives; social- and expert-based support; and goal-setting and tracking technologies among other tools and resources. Since its inception, HealthyWage has reportedly paid nearly a half a million women and men more than $52 million in cash rewards collectively for a combined 3.7 million pounds lost—and with over 523 participants having lost 100 pounds or more with the program. Also driving gamification in the enterprise and corporate wellness space, the company has formally created competitive, cash-fueled diet gamification programs for more than 90 Fortune 500 and other companies, hospitals, health systems, insurers, school systems, municipal governments and other organizations throughout the U.S. In addition, their program has been more informally run at more than 3,000 companies and organizations.
Given the multitude of studies and reports upholding the efficacy of gamified health and wellness for both prevention and intervention, credentialed field authorities advocate the benefits of this approach—both related to general healthcare and diet and fitness in particular.
“Studies continue to show that monetary incentives serve to enhance the effectiveness of, and duly complement, weight loss programs of any and all sorts, especially when paid out quickly like our various programs,” said weight-loss gamification pioneer David Rodenberry, Co-Founder of HealthyWage—the world’s leading purveyor of money-driven diet contests and challenges for individuals, teams and corporate wellness groups. “Loss aversion is a powerful dynamic and the reality of having ‘skin in the game’ can propel the results of a gamified weight-loss initiative. A key element for the success of a gamification program is giving participants something to lose if they fail to meet their goal—whether tangible or intangible—in our case large cash prizes—for losing weight and getting more active in the program.”
According to Board Certified Sports Dietitian Tara Collingwood, MS, RDN, LD/N, “Losing weight and keeping it off is one of the most difficult behaviors to change. Making a game of increasing exercise and making healthier nutrition choices can be a powerful way to provide additional motivation. People with a competitive streak love to have a way to play a game, but also get health benefits at the same time. Having a financial investment or incentive adds another layer of motivation. No one likes to lose money or waste money with no return, either financially or with health rewards.”
Kimberly Gomer, MS, RD, LD/N sees the many opportunities gamification presents in the nutrition and weight-loss space. “So many people rely on their smart phones and apps to provide them with information around how to get healthier and lose weight,” she says. “Any app that offers both support and accountability is a huge asset to a program for those who enjoy that type of connection … Apps that offer fitness support and accountability are extremely helpful for those that want to include fitness in their lifestyle.” She also believes it is critical not to rely on an app, alone, when it comes to nutrition and diet. “Each person has their own individual challenges around health and creating the pathway to reach their health and weight-loss goals,” Gomer continues. “But any support system strengthens the resolve and may make the experience more beneficial and more fun.” She also says that gaming as it relates to diet and exercise can be particularly helpful for certain personality types. “The ‘Type A’ person who loves to compete will love participating in weight loss and exercise gaming challenges.”
Nutrition expert William Toro, BHSC, appreciates the many ways that technology is spurring participation and success with wellness gamification, assuredly factoring into escalating category demand. “People find it easy to track their health issues, improvement, tasks to be set and reminders,” he says. Specific to dieting, he further notes that people can set a diet plan, reminders not to take high calorie foods, watch videos to do complex exercise postures that are difficult to remember as well as contact and consult diet and fitness experts for any issue.
Beyond tech tools that can bolster game play, Registered Dietitian and Nutrition Coach Emily Tills, MS, RDN highlights the motivational benefits of gamifying wellness endeavors. “Most individuals cannot mind the motivation within themselves to do a certain task, build a habit or try to work out consistently,” she says. “They don’t find it fun enough or make excuses as to why they can be too busy to fit some of these things in. With the gamification of health and nutrition and apps, this can be a convenient way to challenge someone—especially when paired against their friends—to build a better habit. The game can add a layer of fun to things that they would usually find mundane or not worth doing. We also enjoy things that give us positive feedback; by beating a friend or leveling up with habits or exercise, we are constantly challenged mentally and physically to keep going and do more.”
Health and Wellbeing Behavioral Science expert Casey Hughes, MA, MCHES, NBC-HWC, notes, “Gamification is increasingly popular in healthcare due to its ability to make redundant or anxiety-provoking experiences more dynamic and exciting.” She clarifies that, while gamification can positively impact motivation, the focus should be on “progress, not perfection,” explaining that “gamification for weight-loss is most effective when it creates an engaging environment for building healthy habits that encourages experimentation and iteration.”
Specific to the weight loss wagering approach HealthyWage undertakes, Registered Dietitian Julianna Coughlin, MS, RD, LD/N, applauds the company’s approach, citing that it is “a great way to incentivize and gamify weight-loss by bringing in outside stimulants, rewards and a community to help motivate those involved. Lack of motivation is one of the most common reason weight-loss efforts fail because people become disinterested and bored. I think HealthyWage is doing a good job of keeping the proverbial ‘carrot in front of the horse’ and the goal at the front of the participant’s mind.”
Registered and Licensed Dietitian Nutritionist Suzanne Fisher, MS, RD, LD/N, cites, “One of the most significant effects of gamification apps is providing a jumpstart to a healthy lifestyle and possible weight-loss. Changing one’s behaviors can be difficult and often monotonous. Gamification motivates participants toward behavioral change using camaraderie in a fun and approachable way.”
Kellie K. Middleton, MD/MPH, an Orthopedic Surgeon who places great emphasis on providing advanced orthopedic and sports medicine care, emphasizes how gamification is a powerful tool for engaging and motivating her patients toward their fitness ambitions. “It can help to keep people motivated and on track with their health and weight-loss pursuits,” she says. “Some of the most popular apps for health and wellness, like Nike Run Club, CARROT and HealthyWage, are perfect examples of how effective gamification techniques can be in helping users achieve their fitness goals.”
Losers Win Big
As Research Dive aptly points out, “acquiring healthy habits is not always an enjoyable journey but, with the help of gamification, the entire process can be a little more fun, stress-free, motivating and enjoyable. Nowadays, gamification is widely used in healthcare for encouraging people to stick to their diet, sleep better, exercise regularly or keep up with their mental well-being.”
Implementing lasting and meaningful self-care behavioral changes can prove challenging, if not seemingly impossible, for some. Gamifying the process—especially that related to enhanced fitness and weight-loss with elements of fun, competition and having some form of “skin in the game,” and financially rewarding the achievements in kind—is now well-proven to be a powerful catalyst. Gamification is an effective way to level up efforts to lose those unwanted lbs.
The author, Merilee Kern, MBA is an internationally regarded brand strategist and analyst who reports on noteworthy industry change makers, movers, shakers, and innovators across all B2B and B2C categories.