Systems science and obesity policy: a novel framework for analyzing and rethinking population-level planning.
OBJECTIVE
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.
Lee M. Johnston is with the Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada. Carrie L. Matteson and Diane T. Finegood are with the Chronic Disease Systems Modeling Laboratory, Department of Biomedical Physiology and Kinesiology, Simon Fraser University.
Lee M
LM
Johnston
Carrie L
CL
Matteson
Diane T
DT
Finegood
D002170:Canada; D004032:Diet; D002149:Energy Intake; D004734:Energy Metabolism; D015444:Exercise; D006040:Goals; D006293:Health Promotion / Q000458:organization & administration*; D006801:Humans; D009765:Obesity / Q000517:prevention & control*; D057766:Policy; D013598:Systems Theory; D014481:United States