Using Systems Thinking to Understand the Dynamics of Obesity in Low and Middle Income Countries

The current chapter applies a systems thinking approach to define and study the dynamics underlying increased rates of obesity in Low and Middle Income Countries (LMICs). Systems thinking and dynamics modeling belong to the rapidly evolving, interdisciplinary field of system science research. This field adds value to more traditional public health research methods by contributing to the design and testing of integrated models of change, to examine how key factors interact with each other and with health status. We frame the problem of obesity for LMICs as an aggregate, chronic energy imbalance of the population as a whole, due in large part to increased consumption of highly processed foods. To begin to explore the dynamically complex nature of global obesity, we develop a causal loop diagram, supported by the extant literature, showing a comprehensive qualitative model of the dynamics underlying increased rates of obesity in LMICs. Eighteen endogenous factors, or constructs, make up these seven distinct loops. In addition, selected exogenous factors are shown, representing the effect of policies by foreign governments, global corporate entities, and other institutions that explain obesity dynamics in LMICs. We suggest that there are two major points of intervention to curb current increasing obesity rates: the first is to sustain or grow healthy food production capacity and the second is public health education.

Keywords: Complex public health problems, exercise, fitness, global health, low and middle income countries, nutrition, obesity, overweight, processed foods, risk, systems thinking, wellness.