Part 1: Introduction
Strand 4: Evidence for a Whole Systems Approach to Obesity
Video
Learning Objectives
After watching this section, you should be able to:
- Describe the aims of the rapid evidence synthesis on whole systems approaches to obesity
- Define a whole systems approach using the Public Health England definition
- Identify the range of terms used to describe whole systems approaches and explain why terminology varies
Key Points
- The rapid evidence synthesis was funded by the Institute for Public Health to inform obesity strategy development in Northern Ireland, with a focus on existing review evidence and case studies
- Public Health England defines a local whole systems approach as an ongoing, dynamic, and flexible way of working that enables local stakeholders — including communities — to share an understanding of the challenge, identify opportunities for change, and agree integrated actions for sustainable, long-term systems change
- Bagnall (2019) defines a whole systems approach as “a collection of integrated and comprehensive levers, procedures or mechanisms that aim to change community systems by targeting individuals, groups and community level environments and policies”
- Multiple overlapping terms are used interchangeably — holistic, cross-sectoral, systems-based, healthy cities, multi-partnership, multi-strategy, healthy community — reflecting the breadth of the approach
- A whole systems approach requires a psychological shift away from event-based or campaign-based thinking; it is a new way of working, not just a new type of intervention
Further Reading
- A whole systems approach to obesity prevention: a rapid synthesis of evidence — the full IPH report underpinning this strand; covers the evidence base, case studies, and policy recommendations for Northern Ireland (Breslin et al., 2023)
- Bagnall AM et al. (2019). Whole systems approaches to obesity and other complex public health challenges: a systematic review. BMC Public Health, 19, 8. — the foundational systematic review cited throughout this strand, including the Bagnall definition of WSA used in this video
- Whole systems approach to obesity: a guide to support local approaches (Public Health England, 2019) — the PHE/Leeds Beckett practical guide referenced in the evaluations; sets out the six-phase approach to implementing a local WSA
- Language Matters: Obesity (Obesity UK, 2020) — guidance on using non-stigmatising language when discussing obesity; important for practitioners working in this area
- Reframing how we talk about children’s health and food (Impact on Urban Health) — a framing toolkit to help public health practitioners communicate about child health and food in ways that support rather than stigmatise
Knowledge Check
Complete the questions below before moving on.
According to Public Health England, what is the primary purpose of a local whole systems approach to obesity?
The correct answer is To enable local stakeholders to come together, share understanding of the challenge, and agree on actions for sustainable, long-term systems change. Public Health England defines a local whole systems approach as an ongoing, dynamic, and flexible way of working that enables local stakeholders — including communities — to share an understanding of the reality of the challenge, consider how the local system operates, identify the greatest opportunities for change, and agree on integrated actions to bring about sustainable, long-term systems change.
- False — a whole systems approach is explicitly a new way of working across the whole system, not a single regional intervention.
- True
- False — setting fixed national BMI targets is contrary to the dynamic, flexible nature of whole systems approaches.
- False — while evidence informs WSA, the approach is about changing systems and practices, not commissioning biological research.