The six reasons why overweight is a wicked problem

No quick fixes and simple solutions. That is the case with the current overweight and obesity epidemic. You can read this important message in the recently published book 'Tegenwicht. Feiten en fabels over overgewicht', written by Jaap Seidell and Jutka Halbertstadt. The translation of this Dutch title would be something like 'Counterweight. Facts and myths about overweight'.

I really liked reading this book, because it describes in easy-to-read and understandable language the current state of the scientific knowledge on overweight and obesity. What struck me most was that science has not yet come that far in understanding how various factors interact in creating the overweight problem and providing effective solutions. A key reason for that, Seidell argues, is that overweight is a wicked problem. This term was first mentioned in relation to the highly complex problems of social planning, but it can also be applied to overweight and obesity.

Basically, there are six reasons why overweight is a wicked problem:

Reason 1: You know what the problem is, when you have the solution. Since it is hard to define what exactly the problem is, it is difficult to find a solution. This definitely applies to overweight. For example, experts often disagree what the major causes are of overweight: lack of physical activity or overeating? Bad genes or bad eating habits?

Reason 2: The solution process does not have a clear end-point. As Seidell wonders; it is not exactly clear what the purpose is of preventing overweight: halting the rising trends or reducing the number of people with overweight to zero?

Reason 3: Solutions are not right or wrong. All involved stakeholders (such as food companies, authorities, consumers, health professionals) have an opinion about the problem and often disagree. For example, last week we had the No Diet Day (or 'Anti-Diet-day' in the Netherlands). Although the day aims at body weight acceptance, it led to debates about the usefulness of particular diets and the risks of overweight. 

Reason 4: Each wicked problem is unique and new. The involved actors and concrete situations are different. The causes and potential solutions are similarly not the same for different groups of overweight individuals.

Reason 5:  There is no room to experiment. It is impossible to check beforehand whether a particular solution will be effective. Essentially, it is often a matter of critically informed trial and error.

Reason 6: There is no clear set of solutions and there can be many solutions or only one. Solutions are hard to find. As a result, Seidell argues that the overweight and obesity problem requires a holistic solution. For example, schools, food industry, health authorities and consumers should work together in exploring solutions that seem promising. After all, there is a lot at stake: overweight is not just a medical problem, but also a social one. 

Trish Groves likewise argues in the British Medical Journal that obesity seems to be the classic example of a wicked problem. Consequently, we need more innovative and collaborative approaches. I completely agree. Acknowledging that overweight is a wicked problem might help getting a more realistic overview of the problem instead of over-simplistic and one-sided analyses and claims for solutions. It also shows that as researchers we should look across the boundaries of traditional research fields and become more creative in contributing to the search for solutions.

Nudging consumers to eat healthier: guidance without being told how to live

Nudging consumers towards healthier choices has been a hot topic for some time. Nudges are simple, low-cost interventions to move consumers towards healthier choices without banning food products or telling them how to live. There is a lot of attention for nudging since Thaler and Sunstein published their influential book 'Nudge' in 2008. The authors explain how to subtly redesign choice environments (such as canteens, stores), the so-called 'choice architecture', in such a way that consumers are gently pushed in a more responsible direction without limiting their freedom of choice. The concept is based on behavioural economics and psychological theories on how people are biased in their decision making. People tend to act automatically, often triggered by the environment. Despite knowing we should eat more fruit, we tend to buy a chocolate bar while waiting in line for the checkout. By redesigning the choice context, we can be nudged into buying something more healthful. For example David Just and Brian Wansink illustrate how simply moving the salad bar to a more central position in the school lunch room led to increased sales of salads.

Not everyone is enthusiastic and there is a growing debate about the value of nudging. The British Medical Journal recently published two papers that debated the question: 'Are nudges really an effective public health strategy to tackle obesity?'. Geof Rayner and Tim Lang worry that governments are only interested because of self-promotion motives. It also allows them to back away from taking strong (and often unpopular) actions, such as higher taxes and stricter regulation. In contrast, Adam Oliver believes that nudges may help people to make healthier choices. He argues that nudges should be seen as additional tools to move society in a more beneficial direction. In the Netherlands, Henriette Prast argued in the 'Groene Amsterdammer' that the private sector takes advantage of human weaknesses and that it is time for the government to develop some counterforce.

I believe that the concept of nudging is a refreshing way to look at creative, inexpensive and new ways to help consumers eat healthier. But indeed, evidence so far on how nudging helps improving food choices is limited, so more research is needed to understand whether they work and how exactly. And if nudges work, will they have a sustained impact on consumer behaviour?