Expert Opinion

The importance of using a whole systems approach to obesity

In the last of our posts to mark National Obesity Awareness Week, Dr Duncan Radley, Matt Butler and Joanna Saunders from Leeds Beckett University discuss why we need to use a whole systems approach to tackle obesity.

Photo credit (c) World Obesity

Obesity is the product of a highly complex system which is a collection of parts that are interdependent and unpredictable. If something happens to one part of the system, other parts of the system will be affected and it is not always possible to tell what the outcomes will be. As such, more traditional approaches, where individual parts of the system are acted on in isolation are unlikely to be effective at a population level. Consequently, a different approach is required which addresses the constantly interacting and shifting drivers that create the obesogenic environment.

A whole systems approach recognises that social challenges like obesity exist in a complex system and that unless we can make a change in the system, we will keep getting the same result. It provides a framework by which stakeholders can come together, share an understanding of the reality of their challenge(s), consider how the system is operating, where it might be feasible to intervene, agree what actions they will take and how as a network they will move forward to bring about change.

Whole systems working requires a different mind-set and different ways of working to more traditional approaches. Stakeholders need to work as equals, focusing on shared goals and aligning actions in the joint drive to make shifts in the system.

From ….

To….

Silo working

Integrated approach

Generalised solutions

Solutions that are tailored to the local context, which reflect what matters locally

Individual, isolated initiatives, whose combined impact is unpredictable

Considering different potential scenarios and looking at how the system works as a whole, and how each action can contribute

Linear cause and effect

Keeping up with the changes and flexing the system to keep actions relevant

Top down control

Providing support and guidance through an adaptive and facilitative leadership style

One of the most important elements of whole systems thinking is time. As any system is susceptible to change, it is important for the players in the system to communicate frequently and to jointly monitor progress. They need to share intelligence and data about what is happening so that actions can be adapted if necessary. This coming together of stakeholders is an on-going process otherwise actions become fixed and static, less able to respond to new information, and ultimately lose purpose.

There are a number of significant benefits to adopting a whole systems methodology when tackling obesity. Whole system working:

  • Creates a framework so stakeholders can discuss and agree the way ahead.
  • Reflects the complex nature of obesity.
  • Enables all to understand the system and their role in it.
  • Shows it is more than just the responsibility of the health sector.
  • Identifies where best to disrupt the system.
  • Maximises all the assets in the system.
  • Mobilises and aligns resources more effectively.

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