Carrie L. Matteson

Systems Science and Obesity Policy: A Novel Framework for Analyzing and Rethinking Population-Level Planning

OBJECTIVES We demonstrate the use of a systems-based framework to assess solutions to complex health problems such as obesity. METHODS We coded 12 documents published between 2004 and 2013 aimed at influencing obesity planning for complex systems design (9 reports from US and Canadian governmental or health authorities, 1 Cochrane review, and 2 Institute of Medicine reports). We sorted data using the intervention-level framework (ILF), a novel solutions-oriented approach to complex problems. An in-depth comparison of 3 documents provides further insight into complexity and systems design in obesity policy. RESULTS The majority of strategies focused mainly on changing the determinants of energy imbalance (food intake and physical activity). ILF analysis brings to the surface actions aimed at higher levels of system function and points to a need for more innovative policy design. CONCLUSIONS Although many policymakers acknowledge obesity as a complex problem, many strategies stem from the paradigm of individual choice and are limited in scope. The ILF provides a template to encourage natural systems thinking and more strategic policy design grounded in complexity science.

Obesity, Complexity, and the Role of the Health System

As obesity continues to increase throughout the world, there is still no well-defined solution to the issue. Reducing obesity poses a significant challenge for the health care system because it is a complex problem with numerous interconnections and elements. The complexity of obesity challenges traditional primary care practices that have been structured to address simple or less complicated conditions. Systems thinking provides a way forward for clinicians that are discouraged or overwhelmed by the complexity of obesity. At any given level, individuals matter and system functioning is optimized when our capacity is well matched to the complexity of our tasks. Shifting paradigms around the causes of obesity is essential for creating a health care system that promotes innovative and collaborative practice for healthcare practitioners and individuals dealing with obesity.

Join the Conversation! The Development and Preliminary Application of Conversation Cards in Pediatric Weight Management

of children treated for obesity. The idea for the cards stemmed from a United Kingdom–based project in which a deck of cards was created for adults living with diabetes. The cards contained phrases representing common challenges experienced by patients, and were used before clinic visits to help patients prioritize issues they wished to discuss with their health care professional. 4