Digital public health interventions using gamification to prevent or reduce overweight and obesity in children and adolescents: a scoping review

Abstract Background Childhood overweight and obesity are a growing global public health concern due to their long-term physical and mental health consequences. Digital public health interventions (DPHIs) can help promote healthy behaviors in children and adolescents, and gamification, which uses rewards, challenges, and social interaction, may further increase motivation and sustain engagement with these tools. Aim This scoping review provides an overview of studies on digital public interventions that used gamification to prevent or reduce overweight and obesity in children and adolescents and assesses their reported effectiveness. Methods Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) framework, two reviewers independently searched OVID MEDLINE ® and Web of Science for English or German studies from January 2005 until July 2025. Eligible studies targeted children and adolescents (< 18 years), examined the effects of gamification elements in interventions, and reported outcomes related to overweight/obesity. Data were extracted using a structured form and synthesized narratively. Results Of 249 records, six studies met the inclusion criteria. The studies were conducted across six countries and reported differing study designs, durations, and technologies incorporated in health behavior change interventions. Most interventions (66%) used exercise-based games or apps promoting physical activity; others involved school-based gamified systems or integrated digital ecosystems combining education and behavior tracking. Common gamification elements included points, rewards, leaderboards, and team challenges. Most interventions improved physical activity and engagement, but only one study showed a sustained weight reduction. Motivation and adherence generally declined over time. Conclusions DPHIs that used gamification can help promote health behaviors, particularly physical activity, in children and adolescents, but evidence for lasting weight reduction is limited. Future interventions should focus on personalization, social engagement, and strategies and evaluate whether these elements can support maintenance of long-term weight reductions.