Sydney: If the obesity crisis continues on its current trajectory, almost
half of the world's adult population will be overweight or obese by
2030. Celebrity chefs and food bloggers are lining up to solve our
obesity epidemic, with one in particular calling on world governments to
legislate against obesity. But should we expect governments to address
our failure to shift the kilos when the key to weight loss - eat less
and move more - seems so simple?
The truth is that the challenge
is beyond any one player. To put it bleakly, we are trapped in an
obesogenic environment of our own making. We have designed a lifestyle
that meets our basic biological desires for minimal energy expenditure
and constant access to an inexhaustible variety of easily digestible,
safe, palatable foods. Our ancient biological programming to conserve
energy is at odds with our economy, our political structures, our
agricultural systems and our built environment. So it's not as simple as
just deciding to eat healthily and exercise more.
On the surface,
government-led action shows potential to solve a problem of this scale.
However, there is a growing body of research showing that community-led
interventions are the most likely to succeed. The science is clear: it
is simply too difficult to break our habits from the very top down, or
the very bottom up. Social ecology tells us that small communities can
solve problems in ways not possible in large groups or at the individual
level.
Modern society is the pinnacle of what scientists call a
complex adaptive system, in which complex outcomes emerge from simple
connections. Each person has a multitude of simple interactions at
different levels of society, which paints a very complicated picture of
what is driving obesity. The spaghetti map presented by the UK Foresight
Project to chart the network of influences on obesity is so intricate
that it has become a favourite of conference presenters pointing out the
near hopelessness of effecting change.
Complex systems theory
tells us that complex systems are resistant to change. Many
disturbances, even major coordinated attempts to shake the system, will
have no observable impact. However, if you get the intervention right,
complex systems have a brighter side. They can rapidly self-organise
into a different, potentially healthier, stable state. Think of tobacco
in Australia - it took many decades of interventions at individual,
community and government levels to shift the system into a state where
it flipped, driven by a contagion of public opinion.
Science also
gives us a clue as to how we might create change. Human society evolved
around social units numbering in the tens or hundreds - not in the
millions. Once groups of people exceed several hundred members, they
require governance. If they have fewer than several hundred members,
they become self-supporting, self-organising and self-controlling. The
village effect prevails. Communities have a voice, will take ownership
of issues, and know their own business.
A significant benefit of
acting at community level is that it becomes possible to implement
multiple interventions at once. The holy grail of an holistic approach
to health is within reach because it's easier to see and act on the big
picture.
Take Broken Hill, where the Charles Perkins Centre has
opened a regional hub to tackle obesity, diabetes, cardiovascular
disease and related conditions: its obesity levels rank among the very
worst in the country, and yet it represents an ideal opportunity for
intervention. It encompasses the mix of socioeconomic, educational and
ethnic diversity that we see on a national level; has a strong sense of
itself with longstanding and trusting relationships between community
and University of Sydney researchers; and the extent of the community
can be defined geographically without merging into larger conurbations.
The
community of Brimbank, a resilient, cohesive local government area in
the western suburbs of Melbourne, is another example. It is a culturally
diverse community in one of the largest industrial areas of Melbourne,
and is in the midst of strong residential, industrial and community
development. It has higher than average rates of obesity, twice the
prevalence of diabetes as in Melbourne and Australia, and lower than
average rates of engagement in physical activity. The Brimbank City
Council, the Mitchell Institute for Health and Education and Victoria
University have launched the Brimbank Collaboration to lift health and
education outcomes in the Brimbank community through community-based and
supported initiatives.
Community-level, community-led
interventions such as these hold the key to breaking our complex
systems. If we can improve the health and habits of communities, there
is a real chance we could disrupt the larger complex systems that
operate around them, sparking a domino effect across the nation.