We now know that obesity is the result of a complex web of contributing social factors; including things like energy density of food, self-esteem and walkability of living environment amongst many others. These myriad influences have been identified in the Foresight Obesity Systems Map (PDF).
The Whole Systems Obesity project is in the process of examining these factors, assisting local authorities to identify the most likely and productive places in the system that they can intervene, aligning their resources to maximum effect.
The study has now reached the half-way mark. Our researchers are currently developing and testing a process with a number of pilot authorities, applying learning from other countries and sectors to answer the key question:
“How can a local authorities use its levers, leadership, evidence and relationships with stakeholders and communities to create a more effective, sustainable, system-wide approach to tackling obesity?”
Paul Gately, Professor of Exercise & Obesity in the Carnegie School of Sport explained: “The approach recognises that the obesogenic environment is the result of a complex social system of changing influences and drivers. This system needs to be disrupted if we are to make a significant change.”
Key learning so far
Work to date by the researchers suggests that creating and sustaining a whole systems approach to obesity has five main elements, bearing in mind that by its nature it is about long-term, continuing improvement rather than a set end point:
- Creating the environment for change: building a local understanding of the reality of obesity and its impact on local prosperity and wellbeing
- Understanding causes and current actions
- Identifying leverage points
- Building and aligning actions around these points
- Creating and maintaining a flexible and dynamic system
Other points include
- Whole systems working enables all those with a contribution to understand that obesity exists in a highly complex, moving system, that encompasses a wide range of sectors and issues – it is not just about health
- It enables stakeholders to see their role in the system, and for the system to mobilise and align its resources in the most effective way
- Senior leadership is crucial to getting partners involved and staying involved
- An adaptive style of leadership is key
- Preparation or “pre-systems working” is essential, to lay robust foundations
- Stakeholders, including local communities need to be involved in creating the approach so that they own it
Pinki Sahota, Professor of Nutrition & Childhood Obesity at Leeds Beckett, said: “Given its scale and complexity, taking a whole systems approach is not easy or straightforward and we have to be realistic about what is possible. However, it does appear that this sort of process has a range of positive benefits in short and medium terms, and the process may be transferrable to other challenging issues.”
The study has been commissioned by Public Health England, the Local Government Association and the Association of Directors of Public Health, and is being carried out in collaboration with local government. More information about the Whole Systems Obesity Programme and the Community of Learning can be found at www.leedsbeckett.ac.uk/wholesystemsobesity.