Online Gaming and Healthy Lifestyles: A Qualitative Study of Gamers in Saudi Arabia

Abstract

Gamers and esports players encounter distinct health challenges that can affect their well-being and performance. Recognising these needs is crucial for developing effective health interventions. This study explored the barriers and facilitators to adopting a healthy lifestyle among gamers and their views on behaviour change interventions. We conducted semi-structured interviews with esports competitors and gamers, using the COM-B model to explore their perceptions. Participants discussed definitions of a healthy lifestyle, emphasising diet and physical activity. There was no consensus on its attainability, as personal, social, and environmental factors influenced perceptions of ease or difficulty. Participants identified key aspects for effective behaviour change interventions, including where, how, and when to implement them, considering these components can help in the design of interventions that are more effective, accessible, and engaging for the target population. This study highlights the importance of a comprehensive approach that considers the unique traits of gamers and their lifestyle. By tailoring health promotion efforts, policymakers can more effectively support this community in reaching its health and wellness objectives.

1. Introduction

Esports has gained increasing popularity worldwide. The global esports market was valued at USD 1.72 billion in 2023 and is projected to grow from USD 2.06 billion in 2024 to USD 9.29 billion by 2032, reflecting a significant growth trajectory in the industry [1]. The terms esports and video gaming are often used interchangeably, but they refer to different concepts within the gaming world. Video gaming involves playing electronic games on various platforms, such as computers, mobile devices, and consoles. Esports, or electronic sports, is a subset of video gaming that involves players or teams participating in a competition [2].

It has been reported that the average playing time for esports players ranges from 20 to 25 h per week [3]. Prolonged gaming and training sessions often result in extended periods of sitting, which contributes to a sedentary lifestyle [3,4]. Sedentary behaviours are increasingly recognised as a significant health concern [5,6,7]. Research has shown that these behaviours are associated with an increased risk of various non-communicable diseases (NCDs), such as diabetes and heart disease [8,9], in addition to experiencing muscular pain in the neck, shoulders, and lower back [10]. Lack of physical activity can lead to weight gain and an increased body mass index (BMI) [11]. Research has shown an association between gaming and a higher BMI [12,13], with a notable correlation (r > −0.31) between BMI and electronic gaming among male teens in Saudi Arabia [14]. Studies have also shown that problematic adolescent gamers were more likely to be overweight or obese compared to non-gamers, with poorer dietary choices such as eating less fruit and vegetables and consuming sugary drinks [4,15]. A correlation between sedentary behaviour and abdominal obesity was also observed [16,17]. In addition to weight gain and sedentary behaviour, esports players report higher levels of anxiety and insomnia compared with non-esports players (p < 0.05) [18]. Furthermore, psychological burnout is increasingly reported by esports players [19] and has been associated with reduced performance and depression among esports players [20]. The majority of evidence in esports has been obtained from observational studies; therefore, the evidence of the impact of gaming on health is limited by the nature of these studies [21,22].

The gaming and esports market in Saudi Arabia is rapidly expanding and is driven by a passionate and growing consumer base. This growth is evident, as 48% of gamers are female, reflecting a nearly even gender split in the gaming community, while 44% of gamers are between the ages of 18 and 35 [23]. Revenue from esports and gaming in Saudi Arabia has surged from SAR 2.2 billion in 2020 to SAR 4.9 billion in 2023, reflecting a significant growth trend that highlights the increasing popularity and investment potential of the sector [23].

The Saudi government recognises esports as a vital part of its Vision 2030 initiative, which aims to diversify the economy and promote entertainment and sports as key sectors [24]. Saudi Arabia is actively positioning itself as an international hub for esports players and the broader gaming community, driving innovation and entrepreneurship in the region. It has significantly advanced local gaming developments by implementing various initiatives, including gaming competitions and financial incentives, such as hosting the Esports World Cup in 2024 [25].

The increasing interest in esports and gaming in Saudi Arabia is reflected in the scientific community as researchers explore various dimensions of this growing phenomenon [14,18,26,27,28]. These studies have concentrated primarily on younger demographics, examining aspects such as gaming habits and mental health issues among adolescents and young adults. While this demographic is significant, it overlooks older age groups that also engage in gaming and esports. Furthermore, little is known about the players’ lifestyle habits and health needs.

Numerous behaviour change theories contribute to our understanding of the factors that lead individuals to adopt or resist health behaviours. The Theory of Planned Behaviour posits that attitudes, subjective norms, and perceived control significantly influence intentions and actions [29]. The theory has been applied to explore and influence health behaviours in different populations [30]. Social Cognitive Theory is another theory used to examine health behaviours by emphasising the significance of observational learning, self-efficacy, and reinforcement in the behaviour change process [31]. The theory was used to explain healthy lifestyle behaviours, such as dietary habits and physical activity [32,33]. There are numerous theories of behaviour change, each with limitations. This presents a challenge for researchers when selecting the most appropriate theory to investigate and influence health behaviours. Therefore, to integrate various behaviour change theories and create an all-encompassing model, Michie and Atkins devised the Capability, Opportunity, Motivation–Behaviour (COM-B) model of behaviour change [34]. This model posits that behaviour is determined by at least one of the following factors: the individual’s ability to perform the behaviour, the circumstances that allow the behaviour to take place, and the drive to engage in the behaviour [34].

Gamers and esports players face health challenges similar to the general population [3], but the rise in esports introduces unique risks that can negatively impact their health and performance, such as prolonged gaming, physical inactivity, unhealthy eating, stress, and injuries. Addressing these areas through tailored interventions can enhance their quality of life and performance. However, there is a lack of research on effective strategies for this community. Understanding players’ needs and preferences is crucial for developing relevant and engaging interventions. These findings can guide future research and the creation of interventions designed to improve performance and potentially reduce health risks within this population. Doing so can help further improve the gaming sector and create more jobs and opportunities in Saudi Arabia, which aligns with Vision 2030. This study aimed to explore barriers and facilitators to engaging in a healthy lifestyle among gamers and esports players to inform behaviour change strategies that improve their well-being and performance.

2. Materials and Methods

2.1. Study Design

Our research project utilised a qualitative approach, conducting semi-structured interviews with esports players and video gamers. The objective was to examine the obstacles and enablers to adopting a healthy lifestyle and to gather their experiences in creating behaviour change interventions. Due to the growing popularity of esports and video gaming, there is increased attention to exploring gamers’ experiences in following healthy lifestyles and health behaviours. A qualitative approach is particularly well suited to examine these experiences, as it allows for an in-depth exploration of participants’ lived experiences, attitudes, and motivations [35]. Qualitative research designs have been used previously to explore different aspects of health behaviours in the target group [36,37,38].

We employed a methodology similar to that of a prior study that investigated the barriers and facilitators to healthy lifestyles among women from economically disadvantaged backgrounds [39]. In this project, our emphasis was on the gaming community, and we conducted semi-structured interviews to facilitate a personal exploration of their experiences.

Our focus was on healthy eating and physical activity as fundamental components of a healthy lifestyle; however, participants were encouraged to expand on their personal definitions of what a “healthy lifestyle” signifies for them.

2.2. Sampling and Recruitment

Participants for the interviews were recruited through various channels, including social media platforms, such as X (previously Twitter), WhatsApp, and Telegram, as part of a larger study. Utilising multiple social media platforms aimed to reduce selection bias and engage a broader and more representative audience of the gaming community. Those interested in participating completed an electronic informed consent form and provided their preferred method of contact. The study team then reached out to interested participants using their chosen communication method, either via email or phone, to schedule the interviews. No compensation was offered to the study participants.

A purposive sampling approach was employed to ensure a diverse group of male and female individuals with various experiences in esports and video gaming, as well as from different age groups. Our goal was to recruit participants aged 18 and older who reside in Saudi Arabia.

2.3. Data Collection

A demographic questionnaire was administered to each participant prior to the interview to collect descriptive data. This questionnaire captured information on participants’ gender, age, education, and employment status. The interviews were held online via Zoom. The primary investigator (YA) conducted the interviews. YA is a Saudi female researcher with experience in health behaviour change and nutrition. Before the interview, all participants provided informed consent to take part in the study. Participants also consented to have the interviews audio recorded.

All interviews were conducted in Arabic, and only the quotes were translated into English by the authors. The interviews occurred between February and June 2024 and ranged in duration from 20 to 45 min. The interviews continued until thematic saturation was achieved.

2.4. Interview Guide

The guide for the interview was created based on the existing literature and theories related to health behaviour change. We applied the COM-B model to investigate the lifestyles of participants and their views on the barriers and facilitators related to healthy eating and physical activity, including social factors. We also engaged in discussions about perspectives on potential future health promotion initiatives.

Table 1. Interview questions in accordance with the COM-B model.

COM-B	Questions
Capability	- What does a “healthy lifestyle” mean to you? - Describe your understanding of healthy eating. - What is your understanding of physical activity?
Opportunity	- In general, as a video gamer, what factors make it easier or more difficult to adopt a healthy lifestyle? - Are your diet and health-related decisions influenced by advice or guidance from others? - What obstacles do you face when trying to improve your diet and increase your physical activity? For example: Time? Cost? Knowledge? Influence of others?
Motivation	- How satisfied are you with your diet? - How satisfied are you with your physical activity? - What solutions would you like to use to help improve your healthy lifestyle?

provides examples of the interview questions in accordance with the COM-B model. Additionally, participants had the opportunity to talk about any pertinent topics that were not included in the guide. The topic guide underwent a pilot test with one participant and was revised prior to the commencement of data collection.

2.5. Data Analysis

The interviews were recorded in audio format and transcribed word for word, followed by thematic analysis [40]. The analysis proceeds through several phases, starting with familiarisation with the data to gain an overview before moving to the initial coding to systematically label the data before searching for themes, reviewing themes, and defining and naming themes.

During the familiarisation phase, two authors (YA and SA) thoroughly reviewed the transcripts prior to coding, generating initial impressions and potential themes. SA, a Saudi female public health researcher, has extensive experience in qualitative research. Both YA and SA independently coded the interviews, after which they compared the codes, made revisions, discussed them, and implemented any necessary changes until they reached complete consensus. When coding disagreements arose between the authors, they addressed the issues by reviewing the codes, merging similar categories, and redefining specific codes based on insights gained from their discussions. An inductive approach to coding was utilised, where codes and themes emerged directly from the data. A codebook was created, and the connections between codes were investigated. Codes were then organised into categories to form preliminary themes. Initial themes were then reviewed in relation to the whole dataset to ensure they reflected participants’ accounts accurately. The research team then refined the specifics of each theme and overall narrative and interpretations to enhance the rigour and reliability of the study’s findings [35]. All quotes presented in the findings were independently translated from Arabic to English by the authors to ensure translation accuracy.

3. Results

Twenty participants took part in this study. Most of the sample was male and included a wide range of age groups, from 18 to almost 40. Most of the sample participants were either amateur players or gamers, with two participants being professional players. The characteristics of the study participants are detailed in

Table 2. Study participants’ characteristics.

Characteristics	n
Gender
Male	14
Female	6
Age group
18–24 years	4
25–31 years	12
32–38 years	4
Marital status
Single	17
Married	2
Divorced	1
Employment
Full-time employment	12
Seeking employment	3
Student	3
Unemployed	2
Type of esports
Professional player	2
Amateur player	10
Gamer	8

.

Three themes were developed from the data, namely the concept of a “healthy lifestyle”, a healthy lifestyle is “difficult but not impossible”, and behaviour change interventions are needed. Themes are linked with the theoretical framework throughout the results and are displayed in Figure 1.

3.1. Theme 1: The Concept of a “Healthy Lifestyle”

According to the COM-B model, participants’ perception of a healthy lifestyle influences their capability to perform it. Participants discussed several definitions of a healthy lifestyle. However, the focus was on diet and physical activity. Many participants defined a healthy lifestyle as having a balanced life. A balanced life was viewed as striving to satisfy all aspects of life and balancing time spent on work/studies with time spent with family and friends and engaging in fun activities and hobbies. Many participants also highlighted the need for a healthy sleep schedule as an essential part of a healthy lifestyle.

“Healthy lifestyle? I think a healthy lifestyle, since I am an employee and married, is a balanced life between work, home, health, and proper nutrition.”

(P6, male, 32–28 years)

“Having a good sleep would reflect on the rest of your day.”

(P19, male, 25–31 years)

Mental health was also discussed as a central aspect of a healthy lifestyle. Participants emphasised the need to promote emotional stability and a positive mindset as part of living a healthy life and not focusing only on the physical aspect of health.

“The concept of a healthy life is a life free of psychological issues, a productive life, a life with inner happiness, even if there are problems, solutions are available … A life free from stress and anxiety, this what a good healthy life means to me.”

(P9, female, 32–38 years)

Some participants also discussed a key aspect of a healthy lifestyle that is especially challenging for gamers. Developing and maintaining good social relationships is key to an overall healthy lifestyle. Participants explained that they find it challenging to develop meaningful relationships because they spend a large proportion of time online and, therefore, struggle with real-life relationships. The dynamic of their relationship with other gamers is limited to discussing playing techniques and lacks social connectivity.

“I was antisocial before, but now I am trying to fix this, and I have improved a lot. I think if someone is social, it has a great impact on the person’s mental health, instead of not being in contact with people and sitting in the same place, or even depending on communicating with people on social media or other things, which is a different experience from what it actually is in reality … We must return to meeting face-to-face … it could help a person’s mentality, way of thinking, or psychological health.”

(P20, male, 25–31 years)

3.1.1. Definition of “Healthy Diet”

Most participants explained a healthy diet in terms of the amount of macronutrients needed daily. A healthy diet was often identified as one that includes high levels of protein and fibre and low levels of fats and carbohydrates. Some participants even went beyond general definitions of a healthy diet to explain the need to calculate nutritional needs and calories.

“P12: It will be a healthy diet with high protein and low carbohydrates.”

Interviewer: Besides proteins and carbohydrates, is there anything else that would make a specific food or food product healthy?”

“P12: It has to be low in fat.”

(P12, female, 25–31 years)

“What is healthy food for me? Food that contains suitable calories, meaning that it is balanced according to the food pyramid, so the percentage of proteins is high and a quarter of the meal is carbohydrates, and fruits and vegetables are also part of the meal.”

(P9, female, 32–38 years old)

Many participants defined a healthy diet as a balanced diet containing various food types. Some participants emphasised the importance of flexibility and avoiding strict dieting. They attributed their ability to sustain a healthy diet to their ability to take breaks and enjoy unhealthy foods occasionally. Strict dieting was often viewed as only acceptable when undertaken for a short period of time or for people with medical conditions. Healthy individuals do not need to follow a special diet.

“I see the value of dieting only when needed. I mean, like a diet, it is a commitment. It should be done only if you need it if your health depends on it, or if you have a chronic disease, like diabetes or those who have severe obesity, they are the only ones who need to follow a specific dietary pattern. But disease-free people don’t need a strict diet; they only need a balanced diet.”

(P5, Male, 25–31 years)

3.1.2. Definition of “Physical Activity”

Physical activity was mainly viewed as any bodily movement that keeps muscles active. Walking was often discussed as an ideal physical activity. Movement indoors, such as taking the stairs, was also linked to being active.

“Physical activity is not only going to the gym; no, you may not necessarily participate in any exercise, but you can take a walk, walk in your house, on the street, walk in the street, any form of activity… I think physical activity is any bodily movement.”

(P13, female, 32–38 years)

Many participants also linked the definition of physical activity to going to a gym and engaging in resistance training and cardio exercises. Others used sports, such as tennis and padel, as examples of physical activity.

“It is not necessary exercises, for example, barbell exercises or other things. I think that the most important thing is that one should be able to move, even if, for example, in the week you play a certain sport, such as padel or tennis, or some people like to walk. What I am trying to do is if there is an elevator or there are stairs, I try not to always rely on the elevator. My body gets used to movement. I find that this can help. It means that the body gets used to movement, not laziness.”

(P20, male, 25–31 years)

Participants were especially concerned with gamers’ sitting time, emphasising the need for posture training tools. Some participants were concerned with the health impacts of prolonged sitting while gaming.

“We need to learn how to properly sit, what is the best way for sitting while playing. Most people sit in a chair for long periods. Too much sitting can be harmful.”

(P2, Male, 25–31 years)

3.2. Theme 2: A Healthy Lifestyle Is “Difficult but Not Impossible”

Participants discussed the ease or difficulty of following a healthy lifestyle, mainly related to having a healthy diet and being physically active. This was influenced by the three components of the COM-B model, namely their capability to perform a healthy lifestyle and the opportunity and motivation to perform healthy behaviours. There was a lack of consensus on whether following a healthy lifestyle was challenging. While some participants viewed it as easy, others discussed the challenge of maintaining a healthy lifestyle. The difficulty and ease are often attributed to factors associated with multiple levels, including personal, social, and environmental factors.

3.2.1. Personal Factors

Participants linked the ability to follow a healthy lifestyle with having strong willpower and determination. Therefore, people would need discipline to maintain a healthy lifestyle. Based on this assumption, laziness was linked to the inability to engage in a healthy lifestyle.

“Frankly, laziness plays a big role; it is supposed to be easy, but one should be able to motivate oneself and always have a strong will.”

(P5, male, 25–31 years)

Participants discussed factors that motivate them to maintain healthy lifestyles, including experiencing physical health benefits, mental health improvements, and positive physical appearance. Some participants explained the concept of “investing in health” as motivating to follow a healthy lifestyle and overcome obstacles. They explained the health gains they envision for themselves in the future, including reduced susceptibility to diseases and improved quality of life. Others also linked the health benefits to current outcomes, including improved health lab results, weight loss, and sleep quality. Some participants were motivated by their experiences of mental health gains, such as feeling happy and having a positive energy following engaging in physical activity or improving the quality of their diet. Other participants were motivated by the improvement in body image, including losing weight.

“Interviewer: What encourages you to follow a healthy lifestyle? What are your reasons?

P12: When I see the results. The results include health, skin, and weight loss.”

(P12, female, 25–31 years)

Long hours of esports training were highlighted as having a negative impact on participants’ mental health, self-esteem, and overall performance. They noted that excessive gaming hindered their ability to form social connections, which in turn affected their engagement in healthy lifestyles.

“If someone is not used to meeting people and wants to succeed in this matter [esport], if he is a professional and wants to succeed, focusing on his training means not meeting a lot of people, which affects his performance. I mean, mentally, he won’t be confident in himself and anxious. It’s all affected.”

(P20)

Time was discussed as a significant barrier to engaging in a healthy lifestyle. Many participants explained the need for a clear schedule and time management skills to maintain a healthy routine, especially for the target group, who spend much of their time on video gaming.

“Video games and PlayStation are factors. Many people waste time playing video games instead of going to the gym. But I have good time management skills. I really value my time.”

(P13, female, 32–38 years old)

3.2.2. Social Factors

Participants indicated that social support is a key factor in maintaining healthy lifestyles. Family and friends can either facilitate or hinder healthy lifestyles. Many participants highlighted the crucial role of family members in supporting lifestyle changes, emphasising that having friends or family to encourage these changes is essential. This includes verbal encouragement or participating in the behaviour change process, such as walking or exercising with them. A few participants also explained that their gym instructor is a source of support in their journey toward a healthy lifestyle.

“Honestly, if a friend joins as well, for example, then I would commit to the gym. So, each one will encourage the other. I see that a friend or a companion is a motivating factor.”

(P13, female, 32–38 years old)

Social factors can also hinder the progress of lifestyle changes. Many participants explained that family members could force them to adopt specific dietary habits that are difficult to change. Others also explained that colleagues could have a negative influence on nutritional habits in the workplace. Going out with friends and social gatherings could also make it challenging to maintain dietary behaviours. Social obligations also mean having limited time to engage in physical activity.

“Interviewer: What is the biggest challenge [in following a healthy lifestyle]?

P4: I mean, there are many temptations, many temptations, many restaurants, many new things, many trends, yes, my whole community, there are always gatherings, so I am affected by that.”

(P4, male, 25–31 years)

Social media was also discussed as a source of support for engaging in a healthy lifestyle. Some participants explained that they were motivated by people they follow to be more physically active and have a healthy diet. Some participants explained that social media could also make following a healthy diet difficult due to constant advertisements for unhealthy food.

“P3: To me, I am honestly affected by social media. I try to ignore it, but I visually enjoy the content (laughs). The number of advertisements and the way they are presented. It is usually unhealthy food, full of bad food.”

Interviewer: If you saw these pictures or videos, would you order them?

P3: Probably I will.”

(P3, male, 32–38 years)

3.2.3. Environmental Factors

Participants also explained factors impacting lifestyle behaviour change beyond their control. Cost was often discussed as a barrier to physical activity or following a healthy diet. Some participants explained that the costs of gyms, especially for women, create barriers for those intending to engage in physical activity. This also applied to following a healthy diet, where some participants explained that healthy alternatives are usually more expensive than unhealthy products.

“Also, there is the cost issue because there are ready-made meals. For example, you only need a microwave, which is available in supermarkets, but it is a little expensive, so this is another factor in terms of cost.”

(P10, male, 25–31 years)

Access to healthy lifestyles also plays a role in facilitating or hindering behaviour change. Participants explained that difficulties with transportation or traffic could discourage physical activity. The lack of suitably located gyms adds an additional barrier.

“Interviewer: What obstacles make it difficult for you to engage in a healthy lifestyle?

P2: The distance, gym distance. Most of the gyms are far away from my home. So far away that I cannot go. If I could go to the gym on foot, I would. I would have walked.”

(P2, male, 25–31 years)

Easy access to unhealthy food was also discussed. Some participants referred to food delivery applications and easing access to unhealthy fast food.

“Currently, with the pressures of life, with work … the presence of family obligations at home… the fast-paced lifestyle that means a person is not able to cook healthy food, so we are forced to order food. With the ease of use of food delivery applications, we eat junk food.”

(P9, female, 32–38 years)

3.3. Theme 3: Behaviour Change Interventions Needed

Participants suggested three main aspects of needed behaviour change interventions, namely where, how, and when. Considering these components, the intervention can be designed and tailored to be more effective, accessible, and engaging for the target population. As explained by the COM-B model, behaviour change interventions are focused on influencing people’s opportunity and motivation to follow a healthy lifestyle.

3.3.1. Where

This component refers to the physical or environmental context in which the behaviour change intervention occurs. Participants suggested that workplaces are the ideal intervention venue, justifying their choice based on convenience.

“If I had, I could go in the middle of work at break time, right!”

(P9, female, 32–38 years)

Participants also suggested alternative venues, such as schools and universities, for implementing behaviour change interventions. Targeting young people in educational settings is recommended to enhance the effectiveness of these programmes. This approach is justified because intervention programmes are more effective when introduced at a younger age, and educational institutions serve as a central hub for gamers.

“In schools and universities, I think they have the largest group of gamers there. For example, a lot of things start after university. For example, with work, the concentration and interest in games diminishes, although in many cases, I follow gamers and adults sometimes, meaning the ages of 30 and 40 continue to play, but I see that schools and universities are good places.”

(P18, male, 18–24 years)

Other participants suggested community spaces like malls and parks because they are accessible to the community, which was crucial in fostering engagement and participation.

“Malls, because this is where if we want to have fun, we and our family go out there”.

(P6, male, 32–38 years)

“For me, workplaces are not suitable for this type of activity. It could be delivered in parks and complexes that people visit for recreation. It can stimulate them, meaning it will be their free time, and it encourages them to do something.”

(P14, female, 25–31 years)

3.3.2. How

This aspect focuses on the mode of delivery used in behaviour change interventions. Participants’ preferences varied between face-to-face and remote delivery or a combination of approaches. Most participants favoured face-to-face interventions, which often provide a more focused and engaging experience than virtual formats. Distractions from mobile phones can hinder engagement in virtually delivered interventions.

“Because face-to-face may be somewhat obligatory, and you must be engaged. But when it is given virtually, you may be less interested. For example, you would turn on the program and be distracted by your phone. When it’s face-to-face, you can be more focused.”

(P18, male, 18–24 years)

Despite this, some participants identified transportation and traffic as barriers to attending face-to-face sessions. This concern highlights the importance of accessibility in the design of behaviour change interventions. Online sessions offer flexibility, making it easier to accommodate different schedules.

“It doesn’t make a difference. Even if it was provided through Zoom, it might even become easier. Considering traffic and the crowded streets. I mean, let’s be honest, all you have to do is log in to a Zoom call.”

(P13, female, 32–38 years old)

Participants also suggested using social media and communication platforms, such as YouTube, TikTok, and Zoom, to disseminate health information as part of virtual communication strategies for behaviour change interventions.

“YouTube and TikTok … of course, give short messages quickly. You see, it is really important to add it to TikTok. You can start with TikTok, and then you can add longer clips (videos) on YouTube.”

(P5, male, 25–31 years)

Some participants suggested the inclusion of both one-to-one and group session formats. Many participants preferred one-to-one format sessions, as they could help express themselves freely without fear of judgement. One participant emphasised the importance of privacy in his preference for one-to-one sessions:

“I also expect privacy to play a big role. If someone cares about privacy or wants to ask private questions.”

(P5, male, 25–31 years)

One-to-one sessions offer a greater focus on the individual and allow for a personalised approach, while group sessions can introduce a unique element of excitement and liveliness.

“I think groups are best so people can get more excited and motivated.”

(P3, male, 32–38 years)

One participant highlighted the benefit of conducting sessions in small groups, recommending a maximum of 10 participants. This format can foster a more interactive and supportive environment, allowing for personalised attention and discussion.

“It is a group that if a person is not paying attention, they will be noticed… let’s say, for example, that there are ten of us sitting like this, in front of you at a meeting table. It makes it very difficult for you not to pay attention.”

(P19, male, 25–31 years)

Participants suggested combining one-to-one and group session formats, which can create a well-rounded experience. One participant suggested starting the intervention programme with one-to-one sessions, as this can help build self-awareness and confidence among participants before transitioning to group settings.

“The program can start individually so I can understand my situation better, but I don’t like to be alone all the time. I like groups, and having competition is also nice. Yes, the group spirit is nice, but I would like to understand my situation individually.”

(P9, female, 32–38 years)

Some participants suggested involving groups other than gamers and esports players in the target group. They also emphasised the importance of including parents in intervention programmes. This approach could raise awareness about the health risks of prolonged gaming and encourage healthier habits in children and adolescents.

“I think these programs would have better value at a younger age… that’s why educating parents is also very important. They need to take part in these programs.”

(P18, male, 18–24 years)

A participant proposed offering rewards, such as gym memberships. Incentives can motivate individuals to engage in healthier behaviours and participate in the programme.

“If there are prizes that are not financial, but they were prizes, any incentive. For example… a gym would offer someone a one-week free membership if they showed health improvement. This would encourage someone to go, even if they were not interested. For example, they will try harder so that they would at least take the free membership.”

(P10, male, 25–31 years)

3.3.3. When

This subtheme refers to the timing of the intervention (e.g., time of day, day of the week). Participants expressed varying preferences for scheduling sessions, primarily based on their convenience. Some participants may prefer morning sessions when they feel energised and focused, while others find evening sessions more convenient after work commitments. Participants also suggested providing the programme during workdays, as people would have fewer social commitments.

“In the morning, I feel like my brain is more receptive than at night.”

(P11, female, 25–31 years)

“I mean, let it be in the middle of a week, meaning let us say any time from Sunday to Thursday, people have fewer social commitments during the week.”

(P9, female, 32–38 years)

4. Discussion

This study explored the facilitators and barriers to adopting a healthy lifestyle among esports players and gamers in Saudi Arabia. Understanding these factors is crucial for developing effective interventions that promote health within this community. Participants defined a healthy lifestyle as healthy nutrition, physical activity, and mental well-being. Participants identified several factors that may hinder or support their adoption of a healthy lifestyle, including personal, social, and environmental influences.

The high cost of gym memberships (particularly for women), lack of time, and limited accessibility to facilities and resources, in addition to easy accessibility to unhealthy foods via delivery applications, were reported as the main barriers to healthy lifestyles. A systematic review exploring the facilitators and barriers to a healthy lifestyle reported that a lack of time, the high cost of food, and limited availability and accessibility to facilities and resources act as barriers to a healthy lifestyle [41]. The facilitators for adopting and maintaining healthy behaviour included perceived health benefits and social support [41]. Several studies involving fitness club members and the general population demonstrate that a lack of time and motivation are the most common barriers to exercise adherence [42,43]. This is in accordance with the motivation and opportunity components of the COM-B model.

In our study, it was suggested that facilitators for adopting a healthy lifestyle included the desire for a positive physical appearance, the health benefits of healthy living, and improvements in mental well-being. This finding parallels previous research, which identified motivations associated with external outcomes, such as enhanced health and increased physical fitness, as the primary reasons for exercising [43,44].

Participants highlighted findings that were specific to the gaming community, including prolonged sitting during gameplay, extended training hours, and a lack of social connectivity among players. A systematic review indicated that prolonged gaming hours have been linked to social distress, social phobia, and interpersonal sensitivity [45]. In contrast, a recent study reported better friendship, social engagement, and teamwork skills among 38 esports college players [46]. The small sample size and the inclusion of two universities hinder the ability to draw broader conclusions about esports. Thus, future studies should explore both the risks and benefits of esports gaming. Furthermore, enhancing social connectivity can foster better communication, boost teamwork, and improve overall performance. This can be encouraged through tournaments and mentorship programmes.

Participants in this study cited key components of behaviour change interventions that should be considered during planning. Most participants suggested using in-person delivery, while others preferred remote interventions. The reason for preferring remote delivery was the elimination of time spent commuting to sessions. The advantages of face-to-face interventions outlined by participants included higher engagement and a more focused approach to learning. Blending in-person with online delivery can address the challenges and practicalities of each method, allowing them to complement one another effectively. Furthermore, focusing on a personalised approach can help increase engagement and produce positive outcomes [47].

Few participants suggested the incorporation of social media platforms as a means for delivering health information. Social media can be cost-effective for implementing behavioural change interventions [48]. While social media interventions hold promise for promoting behaviour change associated with physical activity and weight loss, evidence regarding their effectiveness is inconsistent [49]. More comprehensive research is necessary to determine which components or features of social media interventions have the most significant impact on behaviour change.

Participants identified social support from family and friends as facilitators and barriers to maintaining a healthy lifestyle. It has been suggested that increasing social support can effectively produce positive outcomes in behaviour change interventions, regardless of online or face-to-face delivery [47,50]. This highlights the importance of including social interaction as an essential feature when designing and executing behaviour change interventions [51].

Gamers reported that willpower and good discipline were linked to their ability to maintain healthy habits. Notably, a lack of willpower was the most frequently perceived barrier to healthy eating [52]. Evidence suggests that self-regulation plays a significant role in adopting different health behaviours [53]. For instance, research shows that individuals with high self-control skills are more likely to engage in healthy behaviours consistently and have fewer unhealthy habits [54]. In contrast, those with low self-control skills tend to be more prone to a range of unhealthy behaviours [55]. This highlights the significance of integrating self-regulation as a key component of behaviour change interventions. Alongside self-regulation, the self-monitoring of lifestyle behaviours, such as daily food intake, has been demonstrated to enhance adherence to the intervention programme [47]. Self-monitoring primarily aims to offer individuals feedback on their performance while providing opportunities for growth and self-reflection [56].

To the best of the authors’ knowledge, this study is the first to examine factors influencing healthy lifestyles among gamers in Saudi Arabia. A strength of this study is that it included men and women from different age groups, marital statuses, and employment statuses. This helped with assessing a comprehensive view of people’s experiences and factors that impact their lifestyles. Using the COM-B model may have led to participants discussing factors that may not be otherwise discussed. The model provides a comprehensive framework that includes different behavioural influences [57]. Additionally, two researchers independently coded interview transcripts, improving interpretation transparency and credibility [35].

This study is not without limitations. Qualitative interviews discussing healthy behaviour can produce social desirability bias, especially if conducted virtually [58]. We tried to reduce desirability bias by avoiding showing any emotional reactions toward participants’ responses and following a non-leading approach in interview questions. Additionally, online interviews have several limitations compared to face-to-face interviews, including a lack of control over the interview environment and technical difficulties [59]. These might have affected the depth of the interpretation of participants’ experiences and limited the ability to analyse non-verbal cues, such as body language.

Recruiting participants through social media platforms enables researchers to access a diverse audience across a wide geographical area [60]. However, it is important to acknowledge the limitations of this approach. Relying exclusively on social media for recruitment can introduce selection bias, which may lead to the underrepresentation of certain demographic groups in the sample. This could ultimately impact the overall diversity and representativeness of the study’s participants [60].

Given the increasing number of gamers, the diverse genres of players in Saudi Arabia, and the health challenges linked to gaming, it is essential to investigate the barriers they face in adopting a healthy lifestyle. Additionally, incorporating quantitative methods—such as questionnaires on diet, physical activity, stress, and sleep—would complement the interviews and offer a more comprehensive understanding. Addressing the barriers identified by participants requires a collaborative effort between the government and public sector rather than a one-size-fits-all solution.

This study provides a framework for the design, implementation, and evaluation of behaviour change interventions targeting gamers. Several elements must be considered when creating and delivering behaviour change interventions. A blended approach combining in-person and virtual formats and human support provides a comprehensive strategy. Delivering these intervention programmes across multiple sites, such as workplaces and community venues like malls and parks, offers a holistic approach. In addition to face-to-face interventions, the programme should be accessible on social media platforms to accommodate the community’s preference for timing. The programme content should encompass physical activity, nutrition education, psychological support, and education on other wellness components, e.g., mental health, sleeping, etc., that can enhance quality of life. It is essential to incorporate behaviour change techniques such as self-regulation, self-monitoring skills, and goal setting into these interventions. The significance of these factors lies in their ability to enhance engagement and effectiveness, ensuring that interventions are accessible and relevant to the target audience. Using visualisation or mental rehearsal can also help familiarise players with potential scenarios and enhance their performance [7,61]. Furthermore, encouraging participation in esports tournaments and events promotes social connectivity, inclusion, and interaction. By thoughtfully addressing these elements, stakeholders can better assist individuals in making sustainable changes to their health behaviours. It may be beneficial to use artificial intelligence-based personalised coaching tools that offer players customised training and health programmes, helping them monitor their performance and health status. Prior to its application, the acceptability of the use of digital health interventions can be evaluated by players through interviews and focus groups. These interventions can be offered by the Saudi Esports Federation, the driving force of change in the gaming community in Saudi Arabia, during training and official tournaments. Furthermore, the federation can collaborate with other organisations, such as The Saudi Sports for All, to promote healthy esports and gaming behaviours in multiple community sites, e.g., schools, malls, and workplaces. The federation can further team up with researchers to create lifestyle guidelines to obtain a good quality of life and optimise their performance.

5. Conclusions

This study has provided valuable insights into the facilitators and barriers that gamers encounter when attempting to adopt a healthy lifestyle. The findings indicate that while many gamers are motivated to improve their health, they face several obstacles that hinder this process. To promote healthy lifestyle changes within the gaming community, interventions should provide nutritional education and mental support, incorporate physical activity, and foster supportive social networks. These approaches can create an environment that encourages positive health behaviours and enhances the overall well-being of gamers.

This study underscores the need for a multifaceted approach that considers the unique characteristics of gamers and lifestyle factors that define the gaming community. By aligning health promotion efforts with these contexts, stakeholders can better support this community in achieving their health and wellness goals and optimising their performance. Future research should continue to explore these dynamics, ensuring that health initiatives are not only effective but also resonate with the gaming culture.