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Hard to initiate, resource, and sustain cross-boundary action
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⌅
Tackling obesity in the UK
Tackling obesity in the UK☜With concern growing that the Foresight analysis—that 50% of the UK population could be obese by 2050, at an annual cost to the nation of around £50 billion per year [2]—substantially underestimates the scale of the unfolding obesity crisis, the College of Contemporary Health is working with the wider policy community to develop a whole systems map of the obesity crisis and the potential responses.☜F1CEB7
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Barriers to change
Barriers to change☜What are the barriers to tackling obesity?☜FF4888
⌃
Policy process struggles to address multi-factor, systemic problems
Policy process struggles to address multi-factor, systemic problems☜☜FF4888
■
Hard to initiate, resource, and sustain cross-boundary action
Hard to initiate, resource, and sustain cross-boundary action☜☜FF4888
⇥
Appoint an obesity champion or tsar
Appoint an obesity champion or tsar☜Appoint a government obesity champion to drive a coordinated obesity strategy between and across central government departments which include Health, the Treasury, Sport, Education, Agriculture, the Department of Work and Pensions, and local government for the local environment. This person should have a strong but politically independent status (e.g. a member of the House of Lords) with the skills and authority to address issues which need multiple government departmental involvement.☜FFFACD
⇥
Multidisciplinary teams to cover severe and complex obesity across UK
Multidisciplinary teams to cover severe and complex obesity across UK☜Commissioning of specialist obesity services should be for multidisciplinary care of ‘severe and complex obesity’ and not directly for rather than just bariatric surgical treatment. Need multidisciplinary teams (MDTs) available to cover severe and complex obesity throughout the UK.☜FFFACD
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Definitive evidence is often difficult to obtain
Definitive evidence is often difficult to obtain☜When dealing with complex systems it is rarely possible to obtain the sort of evidence that would be required in science, engineering or clinical trials. As things stand, the overall evidence base on how to tackle obesity is limited, and what evidence there is on effective approaches is skewed towards short ‘visible’ interventions at an individual and consumer level. [1]☜FF4888
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Need to appreciate and incorporate multiple perspectives
Need to appreciate and incorporate multiple perspectives☜A second dimension of complexity requires an appreciation of the different perspectives used by agents and agencies within the system (pluralism). Most of the population, including many experts and scientists, are not able to dis-identify from their own perspective sufficiently to be able to appreciate other peoples perspectives fully. Until all the key perspectives are incorporated into a study then any analysis will be partial and any intervention likely to fail. [1]☜FF4888
□
Relational complexity of problems makes them hard to grasp as a whole
Relational complexity of problems makes them hard to grasp as a whole☜Obesity is a complex, systemic issue with no single or simple solution. Within complex systems it is normal for there to exist a complex network of causes that frequently feeds back on itself. The systems that have been modelled mathematically indicate that the overall behaviour of the system is determined by the structure of these interactions (in particular feedback loops and delays) rather than the values of any particular variables or parameters. [1]☜FF4888
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Short-term pressures and incentives undermine long term plans
Short-term pressures and incentives undermine long term plans☜☜FF4888
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Desire for solutions undervalues real improvements
Desire for solutions undervalues real improvements☜When dealing with complex human systems it is necessary to focus on improvements, not solutions. Sustainable change takes place slowly and as the result of co-operative action by large numbers of agents and agencies within the system. [1]☜FF4888
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Desire to prioritise options becomes a barrier to action
Desire to prioritise options becomes a barrier to action☜A search for the “best” interventions or a single solution could delay action and displace responsibility. Given the seriousness of the obesity issue, the aim should be to do as much as possible as soon as possible. [1]☜FF4888
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Government obesity efforts are too fragmented to be effective
Government obesity efforts are too fragmented to be effective☜Government efforts to tackle the obesity issue seem too fragmented to be effective. In the United Kingdom, 15 central government departments; all local authorities with responsibility for health, education, and local planning; 16 EU directorates-general; and a wide range of nongovernmental organizations all have a significant impact on the major intervention areas. [1]☜FF4888
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Polarization and obfuscation are used as tactics in resisting change
Polarization and obfuscation are used as tactics in resisting change☜☜FF4888
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Graph of this discussion
Graph of this discussion☜Click this to see the whole debate, excluding comments, in graphical form☜dcdcdc
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