Baltimore’s Games For Health conference saw exergaming crop up as a recurring theme, from game designer and Gamasutra/Game Developer contributor Noah Falstein’s previously reported review of its history, to XRtainment Zone co-founder and CEO Ernie Medina, Jr., DrPH, CHFI presenting his experiences launching a company dedicated to bringing exergaming to the masses.

Medina – who claimed his parents wouldn’t let him play games as a kid which led him to open his own gaming facilities – has been considering the idea of a gaming-themed fitness center for years, and first experimented with that R&D at the ESPN Zone sports restaurants. When conceiving his own exergaming facility, however, he wanted to bring his degrees in public health to bear in creating something more medically-informed.

Medina quoted former U.S. Surgeon General Richard Carmona, who said “the greatest threat to national security is pediatric obesity,” adding that most students fail their fitness exams, with blame often laid on “recreational screen time.” Medina saw a way for exergaming to make exercise more attractive for those who are receptive to gaming, while still fulfilling the government’s recommended daily hour of exercise.

After opening in Redlands, California and conducting a local advertizing campaign, the XRtainment Zone facility was successful, but Medina explained that the concept still has challenges. For one thing, it can be tough marketing the center as a “family fitness and wellness center” and maintaining a reputation as a serious establishment. “We don’t want to be seen as a fat gym,” he said.

Often when parents entered the center and saw numerous video games, Medina said, they were immediately dubious about its legitimacy. Medina described two approaches that helped circumvent the issue: classes for specific regimens such as swimming and dancing, which eventually transition into full-scale memberships, and the introduction of more traditional exercise equipment alongside the exergaming machines.

That second approach has the secondary benefit of making the video game exercise games look more attractive in comparison, which in turn helps elsewhere. “The games are fun and exciting and all, but once the newness wears off, the excitement can go away,” said Medina, stressing the importance of new programs as well as incentives.

According to Medina, children have lost from 7-17 pounds in seven-week courses. “Some exergaming facilities don’t even measure outcomes,” he said, cautioning against tracking participant progress. Leaderboards, a common feature of traditional multiplayer gaming, have proven encouraging among customers as well.

He remains a strong advocate of traditional exercise and, like those who claim Harry Potter is bringing new long-term readers into the world, believes that this kind of gaming facility is a “gateway gym” to more traditional exercise. One 12-year-old told Medina, “I don’t like to exercise, but playing here I get a great workout and it doesn’t feel like exercise.”

Looking forward, Medina believes the field needs more research in order to convince insurance partners and non-profit organizations that exergaming is not simply intended as entertainment but is true medical intervention. Specialized, more durable hardware is also needed – most gaming equipment is manufactured for simple consumer use.

“If the gaming industry can see the excitement and potential market in the fitness and the casual market, it would be exciting if they’ll start developing for it,” he said. He floated potential ideas such as tying exercise equipment to online worlds such as Webkinz, with players’ avatars reflecting their real-life fitness. Even professional exergaming was thrown out as one avenue for greater visibility.

On a personal note, Medina pointed to his own father, who suffered from a stroke. The only thing that was able to get his dad exercising in the aftermath? The Wii.