Application of system dynamics approach in developing health interventions to strengthen health systems to combat obesity: a systematic literature review and critical analysis

Abstract

Background: Obesity is an escalating global public health challenge that is expected to impact a significant portion of the world's population in the coming decades. It leads to severe health conditions such as diabetes, cardiovascular diseases, and cancer, imposing significant economic burdens on health systems. Traditional intervention strategies, which emphasize individual lifestyle changes, fail to address the complex, systemic nature of obesity. This study aims to systematically review the application of system dynamics modelling (SDM) in obesity control, focusing on analyzing modelling methodologies and conducting a quality assessment of the included studies.

Methods: Employing a comprehensive systematic literature retrieval, we explored terms pertinent to overweight/obesity and system dynamics across three databases, including PubMed, Web of Science, and Scopus. This search culminated in identifying peer-reviewed studies published from the inception of these databases until July 2024. Quality assessment was used to evaluate the SDM for obesity control. The protocol of this systematic review has been registered on PROSPERO (CRD42024554520).

Results: Thirty studies were identified through a systematic review. These studies primarily focus on the effects of SD approaches, such as individual lifestyle changes, policy interventions within populations, and socio-economic and environmental improvements on obesity control. Among them, eleven studies completed the entire SDM process. Twenty-seven studies presented conceptual models, of which twenty-five developed casual loop diagrams (CLD). Seventeen studies conducted computational system dynamics modelling, with thirteen constructing stock-flow diagrams (SFD). Additionally, fourteen studies performed simulation analyses. These models facilitated multi-level strategies to reduce obesity prevalence.

Conclusions: Using SDM approaches has significant potential to enhance the effectiveness of obesity interventions and optimize resource allocation. Our study into the application of SDM in the design of obesity health interventions revealed its ability to promote multi-level, cross-sectoral cooperation and coordination, thereby enhancing the effectiveness of interventions. Further exploration and optimization of obesity health interventions can significantly advance health systems and welfare.

Keywords: Health interventions; Health systems; Obesity; System dynamics modeling.

Fig. 1

PRISM diagram of identification and selection of studies for the systematic review