A path for transforming esports into a health and performance domain.

The health and wellbeing of young people (10-24 years old) is a global public health priority, with evidence that many of these individuals have poor physical, mental, and social health. Adding to the growing concerns is the rise in overall digital media usage and the popularity of video gaming as a leisure activity. Developing from video gaming is a competitive form known as esport, which has now reached a level where it is starting to mirror the traditional sporting landscape in terms of professionalism. Given the competitive focus of esports and players striving to gain an edge over opponents, many have adopted a training approach characterised by long hours of repetitive practice, colloquially referred to as "grinding". These high levels of engagement, often totalling over 20 h per week, mean players may sacrifice their physical, mental, and social wellbeing, as they do not have time to engage in healthy behaviours. With the growing visibility and mainstream status, we argue that esports is at a crossroads where failing to address the grinding culture could negatively impact players' long-term health. Rather than seeing performance and health as a dichotomy, we propose a Performance through Health approach that raises the potential for the two to co-exist. We suggest leveraging systems thinking, socio-ecological models, and co-creation methodologies to design, develop, and implement strategies and interventions that are appropriately tailored to the needs of the industry while acknowledging the multiple interacting layers that can impact implementation and success.