Obesity and overweight among young adults are becoming public health concerns. Active video games (AVGs) have been demonstrated by previous studies as a healthy and enjoyable exercise, which may assist young people in weight management (WM). This review aims to critically assess the literature on the effects of AVGs on young adults in terms of energy expenditure (EE) and WM. Five international databases (PubMed, Scopus, ScienceDirect, Cochrane, and Web of Science) were searched with keywords up to 2025. A systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, and randomized controlled trial (RCT) studies investigating the effects of AVGs on EE and WM in young adults aged 18–25 were included. Data from all studies were extracted using a preprepared structured form, and pre- and postintervention differences were compared between the AVG intervention groups and the control/comparison groups. Thousand one hundred twenty-nine articles were retrieved, of which 14 RCT studies (n = 668, 47.5% female) met the inclusion criteria. Ten studies measured EE while playing AVGs, and nine of these found that playing AVGs could achieve moderate physical activity. Four parallel-design RCTs measured body weight or body mass index (BMI), with only one of these found a significant reduction (−0.29 kg/m2, P = 0.043) in BMI in the AVG group. The differences in study design and methodological quality among the included literature make it challenging to simply summarize the results, and the findings need to be interpreted with caution. Overall, AVGs could achieve moderate physical activity and serve as an effective alternative to traditional exercise. However, the results related to WM are mixed. Future research should adhere to more rigorous methodological standards, such as larger sample sizes and stricter dietary controls, to investigate the long-term effects of AVGs on body composition.
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