Regular practice of video games, especially when the player is immersed in a three-dimensional environment, could have positive impact on the dexterity of surgeons. This is particularly true for the laparoscopic surgery (surgical technique using a laparoscope [optic cable system] to view the affected area and haptic grippers to perform the surgery). In this case, the 3D real environment (body of the patient) is projected on a screen in 2D, video games help the surgeons to evaluate distances and perspectives in this particular environment. It is interesting to note that the correlation between the video game performance and laparoscopic skills was significant and positive, but not between video game performance and traditional surgical skills scores (Millard et al. 2014). Based on those studies, laparoscopic simulators have been developed to prepare surgeons before their surgeries (Willis et al. 2014). Some researchers have also highlighted that performing some warm-up with serious games before the surgery was beneficial for the patients (Jalink et al. 2015).

It has also been demonstrated that playing action video games could increase oculomotor performance of the players (West et al. 2013).

Many games are based on strategy and management. Here are some examples of role-playing and strategy games; players must build and manage a city in SimCity, an airport in Airport Simulator, a farm in Farmy Simulator, etc. Therefore, some researchers have proposed that video games could develop good learning principles and may promote problem-solving skills. A positive correlation has been found between strategic video game play and the self-reported problem-solving skills with adolescents (Adachi and Willoughby 2013). These authors concluded that strategic video games promote self-reported problem-solving skills and indirectly predict academic grades. Those points are important considering that millions of adolescents play video games every day.

Mental training is an exercise of the mind in order to reach a desired physical result². This approach is used by a lot of sportsman to prepare a race or train a particular movement (e.g., the skiers who is mimicking the course before starting, eyes closed, with his arms). There are different techniques in the mental training: the goal setting, the positive self-talk, and the imagery (Arvinen-Barrow et al. 2015). A regular training with simulator games, sports game but also flight or train simulator, is beneficial for goal setting and mental imagery. Those simulators are used by the students to practice before the real-world situation. Since a few years, race car simulators have been even used to detect new talents. The winner of the virtual competition receives indeed a professional training and is competing in the real championship the following year. This is the best example of how to transfer virtual ability to reality³.

Playing video games could also have a positive effect on speed reaction time. Action video games (i.e., first person shooter games) require the players to develop the ability to quickly analyze situation, monitor fast moving (enemies) and inhibit erroneous action (don’t shoot on your allies). Current research seems to support that action video games are associated with enhanced flexible updating of task-relevant information without affecting impulsivity of the players (Colzato et al. 2013).

Playing video games could also be beneficial for the brain and the cognitive function in particular with elderly subjects: games appear to offset declines in age-sensitive cognitive function (Whitbourne et al. 2013). As any kind of repeated activity (e.g., sport training, rehabilitation), regular video games playing/training induce brain spasticity in adolescents (Kühn et al. 2011) but also in adults (Kühn and Gallinat 2014). There is a positive correlation between the amount of video gaming and the increase of gray matter volume of the brain.

It is important to mention here that all games do not have positive effect on the cognitive function. There is, currently, no consensus in the scientific community to determine the best kind of video games to develop cognitive function.

For some authors, the entorhinal cortex volume (part of the brain involved in memory and olfaction) can be predicted by the kind of video game played. Logic/puzzle games and platform games seem to contribute positively and action-based role-playing games contribute negatively (Kühn et al. 2011). On the other hand a meta-analysis concluded that shooter video game improved spatial skills and these improvements were similar to the effects of lectures (high school or university level). A very interesting point is that the authors also concluded that the skills acquired during the games can be transferred to activity of daily living (Granic et al. 2014).

The famous games “Dr Kawashima’s Brain Training: How Old Is Your Brain®” could therefore really be positive for the brain, but not only this kind of games. Actually, it seems that playing shooter games is even more efficient to enhance cognitive function than puzzle or role-playing game (Green and Bavelier 2012).

This point will also be discussed more in detail in the Chap. 4 because it is mainly considered as a negative outcome of the games.

However some people, surprisingly, mainly elderly and aged players, explained that playing video games is a good way to stay socially active (Whitbourne et al. 2013). There have been major modifications in the last 20 years in the way of playing video games, and currently the average gamer is not socially isolated. Approximately, 70% of the gamers play with friends online or directly together.⁴

The different kinds of social interactions related to the type of games are presented in Fig. 3.1.

Patients suffering from phobia (arachnophobia, fear of flying, aerophobia, claustrophobia, etc.) can be helped by video games (Malbos et al. 2008; Rus-Calafell et al. 2013). The games slowly recreate the patient’s fear in the virtual environment step by step.

Another important health-related issue that could be potentially treated by video games is the Post-Traumatic Stress Disorder (PTSD). Lots of studies have been done with war veterans; virtual reality treatment is associated with a reduction of PTSD (Rothbaum et al. 2014).

Games could also be used by patient with autism spectrum disorders in order to reduce fear, anxiety level, and to increase social skills (Maskey et al. 2014).

Virtual reality could also be used as a diagnostic tool for PTSD patients; it seems indeed that players’ physiological measurements (heart rate, respiratory rate, skin conductance, etc.) and reaction during games could be used to detect people with higher risk of suffering from PTS (Costanzo et al. 2014).

The U.S. Supreme Court ruled that video games enjoy full free speech protections and that the regulation of violent game sales to minors is unconstitutional. The Supreme Court also referred to psychological research on violent video games as “unpersuasive” and noted that such research contains many methodological flaws. Recent reviews in many scholarly journals have come to similar conclusions although much debate continues (Ferguson 2013).

This is indeed an old debate and, despite the fact that the U.S. Supreme Court held that the studies linking violence and video games presented methodological flaws, there are much more studies highlighting an increase of violence due to frequent use of violent video games than the opposite.

Actually the problem of violence is broader and should not be limited to video games only but also include movies, video-media-televisions, music clips, games, the Internet, and social media become the primary model for transmitting aggressiveness to children (Cardwell 2013).

Different theories have been developed to explain the link between violent video games and the level of aggressiveness of the players. One of the most popular theories is that violent video games are stressful (e.g., explosions, enemies trying to kill you) and it has been demonstrated that the stress increases the aggressivity. A group of researchers has compared the level of stress and aggressiveness when playing violent and nonviolent games. As expected, violent video game players had higher stress level and aggression level than nonviolent game players (Hasan et al. 2013).

Yet, as mentioned above, authors did not all agree on this relationship. After testing several kinds of games (violent, nonviolent, or prosocial), researchers failed to prove that playing any kind of video games affects prosocial behavior (Tear and Nielsen 2013).

Another popular theory is that some players, people with pre-existing mental health problem, could be affected more by the violent games. A population of 377 children presenting attention deficit or depressive symptoms was included in a study to test this hypothesis. Results did not support the hypothesis that children with elevated mental health symptoms constitute a “vulnerable” population for video game violence effects (Ferguson and Olson 2014).

In conclusion, it seems not possible to have a final stance on the issue but it is important to be aware that increased aggressivity can be linked to several sources of media, not only video games, and affects various people with different conditions in a variety of ways (Hoffman 2014).

Due to the evolution of games controllers, a distinction needs to be done between active and sedentary (passive) video games. First, we are going to discuss the sedentary video games because there are still, currently, the more popular and used compared to active ones.

It is obvious that watching television and playing video games seated in a sofa—eventually drinking soda and eating chips—is an, almost perfect, example of sedentary behavior that increases the risk of overweight, hypertension, and diabetes. The total screen time for adolescents (11–17 years old) is 4.5 ± 2.4 h/day (Baer et al. 2012). Once again a distinction must be done between the different kinds of games played. A study has been done to compare three different conditions: violent video games, competitive nonviolent game, or watching TV. The studied variables were: blood pressure, appetite perception, and food preferences. Violent video game playing was associated with a significant increase in diastolic blood pressure compared with the other two groups. Subjects playing violent video games felt less full and reported a tendency towards sweet food consumption. Video games involving violence appear to be associated with significant effects on blood pressure, food preference, and appetite perceptions compared with nonviolent gaming or watching TV (Siervo et al. 2013).

As expected, there is a positive association between the Body Mass Index (BMI) and the time spent on the Internet or video games by boys. There is also a greater proportion of obese boys spending more than 2 h daily in front of the screen. The time spent playing outside after school is negatively associated with BMI. Note that these observations are not true for girls (Gates et al. 2013).

The same relation is found with adults; it is striking to note that playing only more than once a week is sufficient to increase the risk of being overweight. Contrariwise, no significant association was found between the Internet use and overweight (Melchior et al. 2014).

In addition to the overweight problem, spending too much time in front of a screen (Internet, TV, video games) is associated with a lot of other troubles such as bullying, being bullied, decreased physical activity level, skipping school, alcohol use, and unhealthy eating habits. Compulsive and excessive screen times are associated with several psychosocial problems (Busch et al. 2013).

Most children and youth around the world do not meet current physical activity guidelines and are considered to be inactive by WHO (2010). According to those guidelines, the minimum daily physical activity duration is 60 min of moderate-to-vigorous intensity activities (Spinks et al. 2007).

In order to fight against the sedentary lifestyle of young people and especially frequent video players, video games companies have introduced new games controllers to turn the players more active (e.g., The Nintendo Wii™ and the Microsoft Xbox Kinect™).

Is it working and is it enough to fight against sedentary lifestyle? Playing active video games induce indeed a significant increase of energy expenditure compared to a rest situation (i.e., sitting in the sofa playing sedentary games). But the level of energy expenditure is rather low and there is no significant difference between playing video games and walking. The amount of energy expenditure is depending on the games but, unfortunately, active video games are not intense enough to contribute towards the 60 min daily moderate-to-vigorous physical activity that is recommended for children by WHO (White et al. 2011).

Unfortunately, the ratio between active and passive video games is still in favor of the passive one. It is estimated that 24% of adults and 41% of children are playing active video games. Adults spend playing 33% of their time in active video games and nearly 20% of children in video games(Fullerton et al. 2014).

Note that the use of commercial and serious games to fight against overweight and obesity is discussed in Sect. 4.​3.

One last point that needs to be addressed is whether or not the use of these games is associated with an increase of energy intake in which case the benefit associated with these games would be null or even negative! This is not the case and there is no difference in terms of “snacking” between active and sedentary games. However, it should be noted that the energy intake while playing video games, active or passive, is 166% more than the calories required during resting conditions (Mellecker et al. 2010). Therefore, the balance between energy intake and expenditure while playing video games is not in favor of the players.

We have seen that 97% of children and adolescents in the States play video games at least 1 h per day (Granic et al. 2014). When the players were asked what sacrifices they are ready to make to play computer games; 25% responded “another hobby,” 20% “socializing with friends, family and/or partner” or “sleep” and less than 10% said “work and/or education” (Griffiths et al. 2004).

Currently, majority of the games are being played online in cooperative or competitive mode. The Massive Multiplayer Online Role-Playing Games (MMORPG) are becoming more and more popular and this kind of games require social cooperation and communication, at least virtually; this could be a positive point. But it is interesting to note that this social support, through the Internet, is done at the expense of real physical contacts. Indeed, video game players reported that they received less social support from family members and friends and that they perceived the Internet community as a positive social support (Weaver et al. 2009).

Another potential negative effect is the fact that playing video games induces sleep perturbation and affects negatively the quality of sleep (Exelmans and Van den Bulck 2015).

Turning the player into a more active person is beneficial for the energy expenditure but it could have adverse effects. Like regular sport training, an intensive “training” in active video games can induce some injuries. Several accidents, mainly case-reports, have been published in the literature. Most of the complaints concern minor musculoskeletal disorders (e.g., tendinitis). On the other side, several accidents have been reported such as a patient who presented an acute strangulation of a pre-existing asymptomatic paraumbilical hernia after completing a series of aerobic exercises on the Wii Fit (Khan et al. 2013), the case of a self-inflicted penetrating eye injury, late retinal detachment, and vision loss in a 7-year-old boy resulting from the use of a Wii Remote (Razavi and Lam 2011), a case of arm swelling with associated rise in serum creatine kinase to over 8000 U/L in a man, following unaccustomed and sustained strenuous muscle exertion through the use of the Nintendo Wii (Baxter and Madhok 2011), a case of forehead laceration (Wells 2008), a case of a severe thumb bone injury (Galanopoulos et al. 2012), a patellar dislocation (Hirpara and Abouazza 2008), a traumatic hemothorax (Peek et al. 2008), and an acute tendinitis of shoulder muscle (Bonis 2007).