In 1963, Jean Nidetch invited some friends to meet weekly at her house in Queens, New York, to talk about how they could lose weight. They had variously tried pills, hypnosis and myriad diets, but the collaborative sharing of ideas, group accountability and peer recognition appeared to make all the difference for those involved – and, thus, the concept of Weight Watchers was born.
Slimming World was formed six years later, and, over subsequent decades, many more organisations and initiatives have built their own track records of helping people to lose weight and keep it off. And yet, over that time, the average level of obesity within the populations in which all those interventions operate has risen inexorably.
It’s not that those interventions don’t work. They do: Weight Watchers has a comprehensive evidence base to prove it. But the obesity challenge they are facing is more complex, more widespread and growing far faster than individual interventions can hope to match. Which is why, in local authority areas where weight-loss programmes are socially prescribed, it’s perfectly possible for targets to be hit and for hundreds of people to collectively shed thousands of excess kilos of weight, while the local level of overall obesity continues to climb.
If the five-and-a-half decades of weight-watching experience in every major economy in the world has shown us anything, it’s that the population-level problem of obesity will not be solved by individual interventions, however robustly proven they might be. The problem at a societal level is fundamentally different from the problem at an individual level, and the solutions must be too.
Across the charity sector there are plenty of similar examples. Many non-profits do sterling work helping marginalised and disadvantaged groups get into employment. Some have robust evidence proving their interventions, and even those that don’t have no shortage of success stories. And yet, in the decades they’ve all been working on it, most of the population-level indicators, such as the percentage of disabled people in full-time employment for example, have hardly changed at all.
It’s clear that any charity whose vision is one of population-level change ("The end of…"; "A world where…"; and so on) needs to start taking these insights seriously.
This might not be an issue for Weight Watchers, in that the ongoing obesity epidemic will continue to provide it with many more new recruits, but mission-led charities need to step back at some point from constantly pulling beneficiaries out of the metaphorical rivers of unemployment, addiction, prison, depression and so forth, and look upstream to ask why our beneficiaries are the ones who are disproportionately falling in, and how we can change things to stop it happening.
Invariably, these situations are created by many interrelated factors: from policy and legislation to social attitudes and local behavioural norms, alongside a multitude of practical and environmental issues.
These factors combine to create highly complex "systems", from which emerge the problems with which local services then have to deal.
Changing the systems to prevent the issues arising in the first place is a mammoth task, and not one that a single charity or agency can resolve alone, which is why we are seeing a surge in place-based initiatives, where national and local, public, private and third-sector organisations are coming together, trying to take a much more collaborative and holistic approach to sustainable change.
This is a good thing, but for most of the participants it’s fair to say that these collaborations are still a very small part of their operations: a footnote in the annual reach and impact report, their strategic goals primarily focused on their own interventions, of how many people they’ve pulled out of the water.
That’s understandable. We like to set achievable goals, so we set them around the things we can control, which are in our gift and not reliant on big, complex, unproven ambitions in which we are merely one of many players.
So long as that’s the case, however, these collaborations, these attempts to shift the system, to prevent beneficiaries falling into the river in the first place, will always be an add-on.
The change that needs to happen for these collaborations to move from the periphery to the core of non-profit strategies, is to start setting goals for those system-level changes: goals the charity knows full well it can’t achieve on its own; goals that create the immediate necessity for collaboration and innovation if they’re to have a hope of being realised.
I’m just coming to the end of an engagement with a major charity in which we’ve developed the outline of a ten-year strategy based on exactly that principle, and I was delighted to see that the British Red Cross appears to be doing exactly the same. It’s a brave move, but one that’s prerequisite for achieving any genuine population-level goal.
Those women in Jean Nidetch’s house back in the 1960s came together for ideas, accountability, mutual support and recognition, precisely because they had set goals they knew, from years of experience, they couldn’t achieve alone.
Necessity might be the mother of invention, but she also had a second child, and she named it collaboration.
Martyn Drake is founder of the management consultancy firm Binley Drake Consulting