Dave Taylor always knew his lust for playing Fallout and Total Annihilation bordered on the pathological. The video games would hold the software programmer in such a vicelike grip that he often would play for 24-hour stretches, forestalling sleep, skipping meals and twisting himself in knots to delay bathroom breaks.
"It's super unhealthy," he said. "But man, I'm just so swept away in another world and so focused on my goals that I don't care. It hurts to be away from the game."
Now some doctors are lobbying to give his condition a formal medical diagnosis: video-game addiction.
The American Medical Association is scheduled to vote this week in Chicago on such a proposal.
The video-game addiction response was spearheaded by a Maryland psychiatrist and endorsed by MedChi, the state medical society.
Dr. Martin Wasserman, MedChi's executive director, said one of the group's former presidents, Dr. Thomas Allen, became concerned by the case of a young male patient who was so consumed by games that he was losing the ability to lead a normal life.
"This is not a trivial issue, because people become that dysfunctional," Wasserman said. And since MedChi helped put the issue on the AMA's agenda, the response has been overwhelming.
"I'm spending more time on the telephone regarding this than we did when we sued the tobacco industry," he said, referring to his time as Maryland's Secretary of Health and Mental Hygiene.
The proposal advocates that the Diagnostic and Statistical Manual of Mental Disorders, considered by many psychiatrists to be the final word for assessing mental illness, include video-game addiction.
The proposal also would have doctors exhort parents to limit their children's use of the Internet, television and video games to two hours a day. In addition, it would have the AMA, which has 250,000 members, lobby the Federal Trade Commission to improve the system for rating video-game content.
Getting the AMA to deem video-game addiction worthy of its own psychiatric disorder is the first step in a process required to create a mental health diagnosis. The ultimate arbiter is the American Psychiatric Association, which publishes the authoritative DSM guide, currently in its fourth version. Getting APA approval could take years.
Game industry executives say the measures are unsupported by scientific evidence.
"The American Medical Association is making premature conclusions without the benefit of complete and thorough data," said Michael Gallagher, president of the Entertainment Software Association, a trade group that represents video-game publishers.
But doctors in favor of the proposal say the condition needs to be recognized by the medical establishment so it can be properly treated.
U.S. physicians are concerned about the exposure children have to media violence, particularly in a medium as engaging as games.
But addiction also can be triggered by casual games that don't involve anything more frightening than a "game over" message, said Maressa Hecht Orzack, director of the Addiction Studies Center at McLean Hospital in Belmont, Mass., and an assistant clinical professor at Harvard Medical School.
Game industry representatives say the games themselves might not be to blame, that the addiction might be related to an addictive personality or major life stressors.
"The causation question is not particularly well supported," said Jamil Moledina, executive director of the Game Developers Conference, an annual event for professional game creators.
The proposal before the AMA also points out the inadequacies of current studies, saying there is "insufficient research to definitively conclude that video-game overuse is an addiction."
Meanwhile, MedChi's Wasserman said youngsters need adult guidance in dealing with video games.
If the AMA approves the measure, it would present its case to the APA, which plans to begin discussing revisions to its mental disorders manual next month.
"We want to be careful not to harm the process by rushing things," said Dr. Carolyn Robinowitz, president of the Arlington, Va.-based APA. "If you have a diagnosis, it should be reliable, clear and accurate. Otherwise, people may get overtreated, undertreated or badly treated."
Taylor, however, doesn't want treatment.
"I am sure it should be treated like pathological gambling," Taylor said. "But I don't want to be cured."
Alex Pham writes for the Los Angeles Times. Sun reporter Mike Himowitz contributed to this story.