Why we struggle to make progress in obesity prevention and how we might overcome policy inertia: Lessons from the complexity and political sciences

Luc L. Hagenaars*, Laura A. Schmidt, Joost Oude Groeniger, Marleen P.M. Bekker, Fleur ter Ellen, Evelyne de Leeuw, Frank J. van Lenthe, Karen M. Oude Hengel, Karien Stronks

*Corresponding author for this work

Research output: Contribution to journalReview articleAcademic

1 Citation (Scopus)
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Abstract

Despite evidence for the effectiveness of policies that target obesogenic environments, their adoption remains deficient. Using methods and concepts from complexity and political science (Stock-and-Flow analysis and Punctuated Equilibrium Theory) and a qualitative literature review, we developed system maps to identify feedback loops that hinder policymaking on mitigating obesogenic environments and feedback loops that could trigger and sustain policy change. We found numerous self-reinforcing feedback loops that buttress the assumption that obesity is an individual problem, strengthening the biomedical and commercial weight-loss sectors' claim to “ownership” over solutions. That is, improvements in therapies for individuals with obesity reinforces policymakers' reluctance to target obesogenic environments. Random events that focus attention on obesity (e.g., celebrities dismissing soda) could disrupt this cycle, when actors from outside the medical and weight-loss sector (e.g., anti-weight stigma activists) successfully reframe obesity as a societal problem, which requires robust and politically relevant engagement with affected communities prior to such events taking place. Sustained prioritization of policies targeting obesogenic environments requires shared problem ownership of affected communities and nonhealth government sectors, by emphasizing cobenefits of policies that target obesogenic environments (e.g., ultraprocessed food taxation for raising revenue) and solutions that are meaningful for affected communities.

Original languageEnglish
Article numbere13705
JournalObesity Reviews
Volume25
Issue number5
Early online date29 Feb 2024
DOIs
Publication statusPublished - May 2024

Bibliographical note

Publisher Copyright:
© 2024 The Authors. Obesity Reviews published by John Wiley & Sons Ltd on behalf of World Obesity Federation.

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