Governmentality, Playbor, and Peak Performance: Critiques and Concerns of Health and Wellness Gamification

Introduction

Few would challenge the notion that play is an intrinsically rewarding experience. Play motivates individuals to invest substantial time, energy, and capital into their leisure activities—paradoxically exerting great effort during periods of rest (Bowman, 2018a) but intrinsically enjoying the experience of this exertion (Inzlicht, Shenhav, & Olivola, 2018). The cultural and economic dominance of video games as a form of engrossing, immersive, and interactive play (Grodal, 2000; see also Sherry, 2006; Vorderer, Hartmann, & Klimmt, 2003) is easily demonstrated by their economic influence. Games are a popular form of leisure across various age, gender, and racial demographics (Scharkow, Festl, Vogelgesang, & Quandt, 2015; Williams, Yee, & Caplan, 2008). Using the United States as an example, as many as 65% of adults play video games, with a rather even gender split and an average age of 33 (Entertainment Software Association, 2019). As recently as 2018, global video gaming revenues were more than $43 billion (Shieber, 2019), and the overall video games industry has been valued at over $100 billion (Statistica, 2019). Such figures suggest gaming to be a form of leisure that has taken a global role in shaping the form and function of play.

As video games become increasingly common-place, even mundane (Bogost, 2011), elements of video games have seeped into uses and applications beyond merely leisure and play. Myriad daily activities have become gamified—transformed into systems that are intentionally designed to make use of game design elements in decidedly non-gaming contexts (Deterding, Khaled, Nacke, & Dixon, 2011). Such efforts are intended to encourage participation in activities that are normally considered laborious, tedious, or otherwise non-autotelic, and they are increasingly popular. Anderson and Rainie (2012) surveyed over 1000 different technology stakeholders and critics regarding gamification and reported that gamification efforts were on the rise and should be expected to substantially increase. A cursory browse of smartphone app markets seven years after that paper bears this conclusion out (Wasil, Venturo-Conerly, Shingleton, & Weisz, 2019).

A popular and growing segment of gamified activities includes health and wellness activities (Periera, Duarte, Rebelo, & Noriega, 2014; Sardi, Idri, & Fernández-Alemán, 2017). Largely in response to global concerns with otherwise-preventable health and wellness deficiencies, such as staggering obesity rates in many developed and developing nations (Imes & Burke, 2014) and increases in depression rates on a global scale (World Health Organization, 2017). Gamification schemes are designed to compel compliance with and participation in activities aimed at improving mental and physical health, but the seemingly and singularly prosocial aims of these programs do not suggest that they are beyond reproach (see Kim & Werbach, 2016). That said, the preponderance of academic work into health and wellness gamification tends to focus on the relative success or failure of these programs in terms of whether they achieve their focal health outcomes. As a result, more critical discussions of those platforms and their broader consequences tend to be eschewed. To this end, the current chapter achieves three goals. First, it reviews current perspectives on and research into gamification (broadly and in the context of health and wellness). Then, it recognizes the success of gamification-based health interventions in terms of encouraging the formation of healthy habits and improving health literacy. Finally, the chapter problematizes health and wellness gamification by highlighting dangerous and exploitative practices that can stem from their uncritical adoption.