vol. 0 • no.

0 American Journal of Lifestyle Medicine

Andrew Lepp, PhD , Bryan Dowdell, PhD, Brian Yim, PhD,

and Jacob E. Barkley, PhD

Esports Gamers, Recreational

Gamers, and the Active Couch
Potato Lifestyle
Abstract: Esports gamers compete
in sanctioned tournaments whereas
recreational gamers play video
games casually for fun. Research
suggests exercise might benefit
esports performance. Regular
exercise combined with prolonged
sitting while gaming may lead
esports gamers to be “Active Couch
Potatoes,” (highly sedentary
individuals who meet physical
activity guidelines). This research
investigated the relationship
between esports gamers (n = 304),
recreational gamers (n = 229), and
the Active Couch Potato lifestyle.
Participants reported time spent
playing video games, esports
participation, physical activity, and
sedentary behavior. Using
established guidelines, participants
were categorized as Active
(sufficient exercise, not sedentary),
Not Active (insufficient exercise), or
Active Couch Potato (sufficient
exercise, highly sedentary). ANOVA
revealed no difference in time spent
gaming across physical activity
groups (P = .332). Logistic regression
examined relationships between
physical activity groups, esports
participation, sex, and age. Esports
participation was the only
significant predictor (P < .001).
Crosstabs with Chi-square then
described this relationship in detail:
in the Not Active group, 64.7% were
recreational gamers, 35.3% esports
gamers; in the Active group, 28.9%
were recreational gamers, 71.1%
esports gamers; among Active Couch
Potatoes, 61.2% were recreational
gamers, 38.8% esports gamers (χ2 =
65.52, Sig.<.001). Relative to
‘“Our data suggests that the
sedentary, physically inactive lifestyle
may be more typical of recreational
gamers.”
recreational gamers, a significantly
greater proportion of esports gamers
exceeded exercise guidelines and
minimized sitting.
Keywords: physical activity;
sedentary behavior; esports; video
games; exercise
Introduction
The number of American adults
who play video games is at an all-
time high and expected to increase.
Currently, about 54% of adults play
video games and interest is greatest
among younger generations such as
Gen Z (i.e., those born between
1997-2012) and Millennials (i.e.,
those born between 1981-1996). In
2022, young adults from these 2
generations spent more time playing
video games than they did using any
other type of media, including
’
watching television.1 Because video
games are most often played while
sitting, playing video games (i.e.,
gaming) is typically considered
a sedentary behavior.2 The negative
health consequences associated
with increased sedentary behavior
are well researched and include
disruption of lipid metabolism,
insulin resistance and type 2
diabetes, cardiovascular disease,
and greater mortality risk from all
causes.3-9 Increased daily sitting also
takes time away from physical

DOI: 10.1177/15598276231184159. College of Education, Health and Human Services, Kent State University, Kent, OH, USA; Department of Exercise and Nutrition Sciences,
Weber State University, Ogden, UT, USA; and College of Education, Health and Human Services, Kent State University, Kent, OH, USA. Address correspondence to: Andrew Lepp,
PhD, College of Education, Health and Human Services, Kent State University, PO Box 5190, 263 MACC Annex, Kent, OH 44242-000, USA. e-mail: alepp1@kent.edu.
For reprints and permissions queries, please visit SAGE’s Web site at http://www.sagepub.com/journalsPermissions.nav.
Copyright © 2023 The Author(s).

1
 American Journal of Lifestyle Medicine
activity and therefore limits
opportunities to receive the health
benefits of exercise.10 Given the
widespread and increasing
popularity of gaming in our society,
there is concern that individuals who
spend long periods of time playing
video games (i.e., gamers) may be an
at-risk population for a sedentary,
physically inactive lifestyle.11
Gamers have often been
stereotyped as sedentary, physically
inactive, and even socially
awkward.12,13 But these stereotypes
are increasingly challenged and
debunked.13,14 Particularly with the
rise of esports. Esports are officially
sanctioned gaming competitions
between amateur or professional
players and their teams. Amateur
esports gamers may play for high
school or university teams; while
professional esports gamers
compete for cash prizes, lucrative
endorsement deals, and have tens-
of-thousands (even millions) of fans
who follow their exploits across
multiple social media platforms.15
Given what is at stake in esports
(e.g., college scholarships, cash
prizes), esports gamers may make
different lifestyle choices than
gamers who play only for casual
recreation. For example, emerging
research suggests that moderate and
vigorous-intensity physical exercise
may benefit esports
performance.16,17 Potential
performance benefits might
motivate esports gamers to be more
physically active than their
recreational gamer peers. Yet,
research investigating the lifestyle
behaviors associated with frequent
video game playing does not often
distinguish esports gamers from
recreational gamers.18 This tendency
to conflate esports and recreational
gamers might be why a recent
systematic review of gamers’ lifestyle
behaviors such as physical activity
and sedentary behavior produced
equivocal results.19
Despite emerging evidence that
physical exercise might benefit
2
esports performance, esports gamers
must still spend many hours a day
practicing (i.e., playing video
games). For example, a study of
collegiate esports players found that
many sit up to 10 hours per day
while playing video games.20 If
esports gamers are physically active,
yet also sit for many hours each day
practicing, they may be “Active
Couch Potatoes.” The Active Couch
Potato is an individual who meets
established guidelines for daily
physical activity (such as those
established by the American College
of Sports Medicine) but is also highly
sedentary (i.e., more than 8 h per
day).21 Because research suggests
that the negative health effects of too
much sitting are independent of the
benefits of regular physical activity,
Active Couch Potatoes are at greater
risk for negative health outcomes
associated with sedentary behavior
compared to a person who is
similarly physically active yet
engages in much less sitting.3,4,6,22,23
Given the research identifying
potential benefits of physical activity
on gaming performance, individuals
who spend large amounts of time
playing video games for recreational
purposes may have different lifestyle
behaviors than individuals who
spend similar amounts of time
playing video games for esports. As
such, we hypothesized that esports
gamers would be more likely than
recreational gamers to meet
established guidelines for physical
activity, but that esports gamers
would also still be highly sedentary
making them more likely to qualify
as Active Couch Potatoes (i.e.,
sufficiently physically active but
simultaneously highly sedentary).
Guided by this hypothesis, the
purpose of this research was to
investigate the relationship between
esports gamers, recreational gamers,
and the Active Couch Potato
lifestyle. Because gaming
behavior24,25 as well as physical
activity behavior26 has been shown
to interact with age and gender,
nn–nn 2023
these variables were included in the
initial analysis. Identifying
populations of Active Couch
Potatoes is important as they may
inaccurately feel protected from the
deleterious health effects of too
much sitting as a result of meeting
established physical activity
guidelines.
Methods
Data Collection
Amazon Mechanical Turk (MTurk),
a crowd-sourcing web service, was
used to recruit experienced gamers
to participate in an online survey.
Participants were limited to the
United States by IP address. The
recruitment script explained that
“only gamers can participate in this
study. Non-gamers will be filtered
out through a screening process.”
After reading the informed consent
document and agreeing to
participate, 2 filtering questions were
presented. These read: “What are the
common keys for character
movement (backwards, forwards,
side to side) on a PC keyboard while
gaming?” and “What is the most
popular messaging app amongst
gamers?” A total of 1416
individuals initiated the survey
and through the filtering
procedure and removing the data
with systematic missing values, the
final number of participants was
532 (n = 360 males; n = 172
females). After the filtering
questions, the survey was divided
in 2 parts and required about 10
minutes to complete. Part 1
assessed social and psychological
aspects of the gamer lifestyle and
is published here.18 Part 2 used the
valid and reliable International
Physical Activity Questionnaire
(IPAQ) to assess physical activity
and sedentary behavior. 27 The
survey also assessed time spent
playing video games (min/day)
and esports team membership
(dichotomous variable: yes/no). In
this sample of experienced
 vol. 0 • no. 0
gamers, those who answered “yes”
will be referred to as “esports
gamers” (n = 304) and those who
answered “no” will be referred to
as “recreational gamers” (n = 229).
The minimum age for participating
in the study was 18 years. The
mean age of participants was
35.4 years (±10.1) and in that
respect this sample is comparable
to the larger population of US
gamers where 80% of video game
players are adults aged 18 or older
with an average age of 31 years. 28
Physical Activity Group
Definitions
We used the physical activity and
sedentary behavior data to identify
Active Couch Potatoes. The method
for doing so was developed in
a previous paper.29 Briefly,
established physical activity
guidelines developed by the
American College of Sports Medicine
(ACSM) recommend that adults
should do at least 150 min a week of
moderate-intensity, or 75 min
a week of vigorous-intensity
physical activity, or an equivalent
combination of both.30 Additionally,
research suggests that sitting more
than 8 hours per day increases risk
for all-cause mortality.21-23
Therefore, we identified any
participant who sat 8 or more hours
per day while also meeting the
ACSM recommendations for
physical activity as an “Active Couch
Potato.” Similarly, individuals who
did not meet the recommendations
for physical activity were
categorized as “Not Active.” Finally,
individuals who met the physical
activity guidelines and sat less than
8 h per day were categorized as
“Active.” To summarize, established
guidelines were used to create an
activity variable with 3 physical
activity groups: Not Active, Active,
and Active Couch Potato.
Data Analysis
First, an ANOVA with Bonferroni
post hoc tests compared mean
values of time spent playing video
games, moderate-intensity physical
activity, vigorous-intensity physical
activity, and sedentary behavior
between the 3 physical activity
groups (i.e., Not Active, Active,
Active Couch Potato). The intent was
to illustrate similarities and
differences in time spent gaming,
participating in physical activity, and
sitting between these groups.
Second, a multinomial logistic
regression was used to examine the
relationship between potential
predictor variables (i.e., esports
membership, sex, age) and the
physical activity group variable.
Multinomial logistic regressions are
commonly used to model categorical
dependent variables as is the case
here.31 Potential interactions
between the regression’s predictor
variables (i.e., esports sex, esports
age) were examined using crosstabs
with a Chi-Square test of statistical
significance and independent
samples T-tests. Finally, a crosstabs
with a Chi-Square test of statistical
significance was used to provide
additional description of the
relationship identified in the logistic
regression. Data were analyzed
using SPSS version 26 with α ≤ .05.
Results
This sample of experienced video
game players averaged 211 ± 120 min
per day (i.e., over 3.5 h) of game play.
The sample was divided into 3
physical activity groups using
established physical activity
guidelines: 133 (25%) were not
sufficiently active, 315 (59%) were
sufficiently active and not highly
sedentary, and 85 (16%) were
sufficiently active and highly
sedentary (i.e., Active Couch
Potatoes). The complete results from
the group comparisons are presented
in Table 1. In summary, ANOVA
revealed no significant difference in
the time these groups spent playing
video games (F = 1.105, P = .332). As
was expected, ANOVA revealed
American Journal of Lifestyle Medicine
significant differences in moderate
and vigorous physical activity
(F ≥83.26, P < .001). The Not Active
group participated in significantly less
moderate physical activity than the
Active group (P < .001, 95% C.I. =
[ 443.66, 304.20]) and Active
Couch Potatoes (P < .001, 95% C.I. =
[ 383.42, 196.15]). Likewise, the
Not Active group participated in
significantly less vigorous physical
activity than the Active group (P <
.001, 95% C.I. = [ 454.00, 313.68])
and Active Couch Potatoes (P < .001,
95% C.I. = [ 376.50, 188.07]). Also,
the Active Couch Potatoes spent
significantly less time participating in
moderate (P = .044, 95% C.I. =
[ 166.56, 1.72]) and vigorous
physical activity (P = .010, 95% C.I. =
[ 184.49, 18.64]) in comparison to
the Active group. There were also
significant differences in sedentary
behavior across groups (F = 221.99,
P < .001). The Active Couch Potatoes
were significantly more sedentary
than the Not Active group (P < .001,
95% C.I. = [1254.86, 2075.04]) and the
Active group (P < .001, 95% C.I. =
[2678.40, 3400.30]). The Not Active
group was also significantly more
sedentary than the Active group (P <
.001, 95% C.I. = [ 2075.04,
1254.86]).
The potential relationship between
physical activity group and the
predictor variables (i.e., esports
membership, age, sex) was assessed
using a multinomial logistic
regression. Accordingly, the
likelihood ratio test was used to
assess the importance of each
predictor.31 This test compares the
strength of the model with the
variable of interest to the strength of
the model without the variable of
interest. Using this approach, sex did
not contribute to the model (χ 2 =
3.13, df = 2, P = .209); age did not
contribute to the model (χ 2 = 4.51,
df = 2, P = .105); however, esports
membership did contribute to the
model (χ 2 = 58.98, df = 2, P < .001).
Next, a crosstabs with Chi-Square
identified a significant interaction
3
 American Journal of Lifestyle Medicine nn–nn 2023

Table 1.
ANOVA With Bonferroni Post Hoc Comparisons.

Group N Mean Std Dev df F Sig

Not active 133 213.51 115.44 2 1.105 .332

Playing timea Active 315 205.65 122.30

ACPa 85 227.12 119.44

Not activeb 133 2999.00 1886.16 2 221.99 <.001

a b
Sitting Active 315 1624.60 849.95

ACPb 85 4663.95 1117.79

Not activeb 133 15.04 31.43 2 83.26 <.001

Moderate physical activitya Activec 315 388.97 323.90

ACPc 85 304.82 322.03

Not activeb 133 2.71 9.50 2 86.39 <.001

Vigorous physical activitya Actived 315 386.55 332.27

d
ACP 85 284.99 301.15
a
Playing time, minutes per day spent playing video games; Sitting, moderate and vigorous physical activity measured in minutes per week; ACP, active couch
potato.
b
Significant difference between each group (P < .001).
c
Significant difference with “not active” group (P < .001) and between active and ACP groups (P = .044).
d
Significant difference with “not active” group (P < .001) and between Active and ACP groups (P = .010).

between sex and esports
membership (χ 2 = 19.73, df = 1, P <
.001). Specifically, 70% of females in
the sample (122/172) participated in
esports vs 51% of the males (182/
360). Also, independent samples T-
tests identified a significant
interaction between age and esports
membership (t = 3.43, df = 530, P <
.001). Specifically, the mean age of
esports gamers was 36.65 years
compared to a mean age of 33.72
years for recreational gamers.
Therefore, 2 interaction terms were
added to the model (esports sex,
esports age). The interaction terms
did not make significant
contributions to the model (χ 2 ≤
1.031, df = 2, P ≥ .597) while the
significance of the original predictors
remained unchanged. Thus, esports
membership was the only significant
predictor of physical activity group.
Regression results highlighting the
relationship between activity group
and esports membership are
presented in Table 2. Logistic
regression estimates are best
interpreted as a comparison of
odds.31 Looking at Table 2, row 1
presents the odds of a respondent
being categorized as Active
compared to the odds of being
categorized as Not Active given
differences in gaming style (i.e.,
recreational vs esports). This
comparison was statistically
significant (Wald = 47.41, df = 1, P <
.001) and shows that esports gamers
were 4.55 times more likely than
recreational gamers to be in the
Active group compared to the Not
Active group. The second row of
Table 2 presents the odds of
a respondent being categorized as
an Active Couch Potato compared to
the odds of being categorized as Not
Active given differences in gaming
style. This comparison was not
statistically significant (Wald = .27,
df = 1, P = .603).
Finally, crosstabs provided
additional descriptive details of the
relationship between the physical
activity groups and esports
participation. Complete results are
presented in Table 3. In the Not
Active group, 64.7% were
recreational gamers and 35.3%
were esports gamers. In the Active
group, 28.9% were recreational
gamers and 71.1% were esports
gamers. And in the Active Couch
Potato group, 61.2% were
recreational gamers and 38.8%
were esports gamers. Looked at
another way, 73.7% of all
participants identified as esports
gamers were in the Active group

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 vol. 0 • no. 0 American Journal of Lifestyle Medicine

Table 2.
Logistic Regression of Physical Activity Groupa and Esports Membership.

Activity Group Predictor B Std. Error Wald df Sig Exp(B) 95% CI for Exp(B)

Intercept .045 .151 .091 1 .763

Active
Esports 1.516 .220 47.41 1 <.001 4.55 2.96 7.01

Intercept .503 .176 8.20 1 .004

Active couch potato
Esports .149 .287 .27 1 .603 1.16 .66 2.04
a
“Not active” is the reference group for the comparison.

Table 3.
Crosstabsa Comparing Esports Participation With Physical Activity Group.

Esports Participation

Physical Activity Group No Yes Total

Frequency 86 47 133

Not active % within phy. activity group 64.7% 35.3% 100%

% within esports participation 37.6% 15.5%

Frequency 91 224 315

Active % within phy. activity group 28.9% 71.1% 100%

% within esports participation 39.7% 73.7%

Frequency 52 33 85

Active couch potato % within phy. activity group 61.2% 38.8% 100%

% within esports participation 22.7% 10.9%

Frequency 229 304 533

Total
100% 100%
a
Chi-square = 62.52 (df = 2, sig. < .001) indicating a relationship between esports athletes and physical activity group.

while only 39.7% of all participants
identified as recreational gamers
were in the Active group. In
contrast, recreational gamers were
more likely than esports gamers to
be categorized as Not Active or as
Active Couch Potatoes. These
differences were significant (χ 2 =
62.52, df = 2, Sig. < .001) providing
additional support for the
relationship between esports
participation and physical activity
group.
Discussion
Our hypothesis that esports gamers
would be more likely than
recreational gamers to meet
established physical activity
guidelines was supported. However,
our hypothesis that esports gamers
would be more likely than
recreational gamers to be Active
Couch Potatoes was not supported.
To briefly summarize, a logistic
regression suggested that esports
gamers were significantly more
likely than recreational gamers to be
categorized as Active compared to
Not Active. Age, sex, and the
interaction terms (i.e., age esports,
sex esports) were not significant

5
 American Journal of Lifestyle Medicine
predictors of physical activity group.
The relationship between activity
group and esports membership was
further described using a crosstabs
analysis. Crosstabs suggested that
esports gamers were significantly
more likely than recreational gamers
to be in the Active group which met
physical activity guidelines and was
not highly sedentary; conversely,
recreational gamers were
significantly more likely to be either
in the Not Active group or Active
Couch Potato group. Interestingly,
there was no relationship between
physical activity groups and time
spent playing video games meaning
that differences in sedentary
behavior between groups came from
activities other than gaming. Our
survey did not assess what those
activities might be and perhaps this
is an area of interest for future
research.
Taken together, this study
suggests that not all experienced
gamers adopt the same
stereotypical sedentary, physically
inactive lifestyle.12,13 Our data
suggests that the sedentary,
physically inactive lifestyle may be
more typical of recreational gamers.
Esports gamers, on the other hand,
appear to be breaking that
stereotype. Indeed, esports gamers
are more likely than their
recreational gamer peers to be
sufficiently active and not highly
sedentary. Perhaps esports gamers
are motivated by the esports
performance benefits that research
suggests result from regular
moderate and vigorous physical
activity.16,17 Research examining
esports gamers’ motivations for
physical activity is an area for future
research. Considering recreational
gamers, this appears to be an at-risk
population for the negative health
consequences of sedentary
behavior and physical inactivity.
Health awareness messages which
describe the importance of being
both physically active and reducing
sedentary time to prevent negative
6
health consequences should target
this population. Popular esports
personalities, who according to our
data may be more likely to engage
in a healthy active lifestyle, may
represent ideal messengers for
promoting healthy behavior among
the recreational gaming community.
Declaration of Conflicting
Interests
The author(s) declared no potential conflicts of interest
with respect to the research, authorship, and/or
publication of this article.
Funding
The author(s) received no financial support for the
research, authorship, and/or publication of this article.
Ethical Approval
All procedures were approved by the university
institutional review board.
ORCID iD
Andrew Lepp  https://orcid.org/0000-0002-1077-
083X
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