SMPSYSTH001 v2014 QCCI Part 1 1

Systems Thinking
Introduction
Session 1-
Part 1
Exclusive property of IBPAP. This material or any portions thereof, in this format, may not be copied,
reproduced or distributed in any manner and for any purpose without the prior written approval of IBPAP.
VIDEO PRESENTATION
As a class, develop on the board or manila paper a causal loop diagram, a chain of cause-effect
circular events that influence global warming.
OVERVIEW
From Wikipedia, the free encyclopedia
System
A schematic representation of a
closed system and its boundary
A system is a set of interacting or interdependent components forming an integrated whole or a set

of elements (often called 'components') and relationships which are different from relationships of
the set or its elements to other elements or sets.
Fields that study the general properties of systems include Systems science, systems theory,
cybernetics, dynamical systems, thermodynamics, and complex systems. They investigate the abstract
properties of systems' matter and organization, looking for concepts and principles that are
independent of domain, substance, type, or temporal scale. Some systems share common
characteristics, including:
A system has structure, it contains parts (or components) that are directly or indirectly related to each
other; A system has behavior, it contains processes that transform inputs into outputs (material,
energy or data).
A system has interconnectivity: the parts and processes are connected by structural and/or behavioral
relationships. A system's structure and behavior may be decomposed via subsystems and sub-
processes to elementary parts and process steps.
The term system may also refer to a set of rules that governs structure and/or behavior. Alternatively,
and usually in the context of complex social systems, the term institution is used to describe the set
of rules that govern structure and/or behavior.
Systems Thinking Teacher’s Guide Session 1

Introduction
Date Developed: 2013 page 1 SMPSYSTH001 v2014 QCCI
Etymology
The term is from the Latin word systēma, in turn from Greek σύστημα systēma, "whole
compounded of several parts or members, system", literary "composition", History
The word system in its meaning here, has a long history which can be traced back to Plato (Philebus),
Aristotle (Politics) and Euclid (Elements). It had meant "total", "crowd" or "union" in even more
ancient times, as it derives from the verb sunìstemi, uniting, putting together. "System" means
"something to look at". You must have a very high visual gradient to have systematization. In
philosophy, before Descartes, there was no "system". Plato had no "system". Aristotle had no
"system". (Marshall McLuhan in: McLuhan: Hot & Cool. Ed. by Gerald Emanuel Stearn. A Signet Book
published by The New American Library, New York, 1967, p. 288).
In the 19th century the first to develop the concept of a "system" in the natural sciences was the
French physicist Nicolas Léonard Sadi Carnot who studied thermodynamics. In 1824 he studied the
system which he called the working substance, i.e. typically a body of water vapor, in steam engines,
in regards to the system's ability to do work when heat is applied to it. The working substance could
be put in contact with either a boiler, a cold reservoir (a stream of cold water), or a piston (to which
the working body could do work by pushing on it). In 1850, the German physicist Rudolf Clausius
generalized this picture to include the concept of the surroundings and began to use the term
"working body" when referring to the system.
One of the pioneers of the general systems theory was the biologist Ludwig von Bertalanffy. In 1945
he introduced models, principles, and laws that apply to generalized systems or their subclasses,
irrespective of their particular kind, the nature of their component elements, and the relation or 'forces'
between them.
Significant development to the concept of a system was done by Norbert Wiener and Ross Ashby who
pioneered the use of mathematics to study systems.
In the 1980s the term complex adaptive system was coined at the interdisciplinary Santa Fe Institute
by John H. Holland, Murray Gell-Mann and others.
Systems thinking is the process of understanding how things, regarded as systems, influence one
another within a whole. In nature, systems thinking examples include ecosystems in which various
elements such as air, water, movement, plants, and animals work together to survive or perish. In
organizations, systems consist of people, structures, and processes that work together to make an
organization "healthy" or "unhealthy".
Systems thinking has been defined as an approach to problem solving, by viewing "problems" as parts
of an overall system, rather than reacting to specific part, outcomes or events and potentially
contributing to further development of unintended consequences. Systems’ thinking is not one
thing but a set of habits or practices within a framework that is based on the belief that the component
parts of a system can best be understood in the context of relationships with each other and with
other systems, rather than in isolation. Systems’ thinking focuses on cyclical rather than linear
cause and effect.

Introduction
In systems science, it is argued that the only way to fully understand why a problem or element occurs
and persists is to understand the parts in relation to the whole. Standing in contrast to Descartes's
scientific reductionism and philosophical analysis, it proposes to view systems in a holistic manner.
Consistent with systems philosophy, systems thinking concerns an understanding of a system by

examining the linkages and interactions between the elements that compose the entirety of the
system.
Systems science thinking attempts to illustrate

how small catalytic events that are separated
by distance and time can be the cause of
significant changes in complex systems.
Acknowledging that an improvement in one
area of a system can adversely affect another
area of the system, it promotes organizational
communication at all levels in order to avoid
the silo effect. Systems thinking techniques
may be used to study any kind of system —
natural, scientific, engineered, human, or
conceptual.

Introduction
Systems Thinking
Introduction
Session 1-
Part 2

Introduction
Causal loop diagram
Example of positive reinforcing loop: Bank

balance and Earned interest A causal loop
diagram (CLD) is a causal diagram that aids in
visualizing how interrelated variables affect
one another. The diagram consists of a set of
nodes representing the variables connected
together. The relationships between these
variables, represented by arrows, can be
labeled as positive or negative.
Example of positive reinforcing loop:
The amount of the Bank Balance will affect the amount of the Earned Interest, as represented by the
top blue arrow, pointing from Bank Balance to Earned Interest.

Introduction
Since an increase in Bank balance results in an increase in Earned Interest, this link is positive, which is
denoted with a ""+"". The Earned interest gets added to the Bank balance, also a positive link,
represented by the bottom blue arrow. The causal effect between these nodes forms a positive
reinforcing loop, represented by the green arrow, which is denoted with an "R".
History
The use of nodes and arrows, to construct directed graph models of cause and effect, dates back to
the invention of path analysis by Sewall Wright in 1918, long before System Dynamics. Due to the
limitations of genetic data, however, these early causal graphs contained no loops — they were
directed acyclic graphs. The first formal use of Causal Loop Diagrams was explained by Dr. Dennis
Meadows at a conference for educators (Systems Thinking & Dynamic Modeling Conference for K-12
Education in New Hampshire sponsored by Creative Learning Exchange).
Meadows explained that when he and others were working on the World3 model (circa 1970–72),
they realized they would not be able to use the computer output to explain how the feedback loops
worked in their model when presenting their results to others. They decided to show feedback loops
(without the stocks, flows and every variable), using arrows connecting the names of major model
components in the feedback loops. This may have been the first formal use of Causal Loop Diagrams.
Positive and negative causal links
Positive causal link means that the two nodes change in the same direction, i.e. if the node in which
the link starts decreases, the other node also decreases. Similarly, if the node in which the link starts
increases, the other node increases.
Negative causal link means that the two nodes change in opposite directions, i.e. if the node in
which the link starts increases, then the other node decreases, and vice versa.
Example
Dynamic causal loop diagram: positive and negative links

Introduction
Reinforcing and balancing loops
To determine if a causal loop is reinforcing or balancing, one can start with an assumption, e.g. "Node
1 increases" and follow the loop around. The loop is reinforcing if, after going around the loop, one
ends up with the same result as the initial assumption and balancing if the result contradicts the initial
assumption.
Or to put it in other words: Reinforcing loops have an even number of negative links (zero also is
even, see example above) balancing loops have an uneven number of negative links.
Identifying reinforcing and balancing loops is an important step for identifying Reference Behavior
Patterns, i.e. possible dynamic behaviors of the system.
Reinforcing loops are associated with exponential increases/decreases. Balancing loops are associated
with reaching a plateau. If the system has delays, often denoted by drawing a short line across the
causal link, the system might fluctuate.
Example
Causal loop diagram of Adoption model, used to demonstrate systems dynamics

Introduction
Causal loop diagram of a model examining the growth or decline of a life insurance company
Positive feedback
Alarm or panic can spread by positive feedback

among a herd of animals to cause a stampede.
Positive feedback is a process in which the effects of a small disturbance on a system include an
increase in the magnitude of the perturbation. That is, A produces more of B which in turn produces
more of A. In contrast, a system in which the results of a change act to reduce or counteract it has
negative feedback.
Causal loop diagram that depicts the causes of a

stampede as a positive feedback loop.

Introduction
In sociology a network effect can quickly create
the positive feedback of a bank run. The above
photo is of the UK Northern Rock 2007 bank
run. See also viral video.
Mathematically, positive feedback is defined as a positive loop gain around a feedback loop. That is,
positive feedback is in phase with the input, in the sense that it adds to make the input larger. Positive
feedback tends to cause system instability. When the loop gain is positive and above 1, there will
typically be exponential growth, increasing oscillations or divergences from equilibrium. System
parameters will typically accelerate towards extreme values, which may damage or destroy the
system, or may end with the system latched into a new stable state. Positive feedback may be
controlled by signals in the system being filtered, damped, or limited, or it can be cancelled or reduced
by adding negative feedback.
Positive feedback is used in digital electronics to force voltages away from intermediate voltages into
'0' and '1' states. On the other hand, thermal runaway is a positive feedback that can destroy
semiconductor junctions. Positive feedback in chemical reactions can increase the rate of reactions,
and in some cases can lead to explosions. Positive feedback in mechanical design causes tipping- point,
or 'over-centre', mechanisms to snap into position, for example in switches and locking pliers. Out of
control, it can cause bridges to collapse. Positive feedback in economic systems can cause boom-then-
bust cycles. If a PA system's microphone picks up sounds from its own loudspeakers, and these sounds
are re-amplified enough, the effect of this feedback can be loud squealing or howling noises from the
loudspeakers.
In feedback loops a chain of cause and effect exists where a state variable of a system has a feedback
loop influencing its own rate of change. Such feedback can be direct, or can be via other state
variables.
Such systems can give rich qualitative behaviors, but whether the feedback is positive or negative in
sign is an extremely important influence on the results. In positive feedback, the derivative of the
variable is positively affected by the variables value, and the opposite is true in negative feedback.
A key feature of positive feedback is thus that small disturbances get bigger. When a change occurs
in a system, positive feedback causes further change, in the same direction.
Negative feedback
Negative feedback occurs when the result of a process influences the operation of the process itself
in such a way as to reduce changes. Negative feedback tends to make a system self-regulating; it can
produce stability and reduce the effect of fluctuations. Negative feedback loops where just the right
amount of correction is applied in the most timely manner can be very stable, accurate, and

Introduction
responsive. Negative feedback is widely used in mechanical and electronic engineering, but it also
occurs naturally within living organisms, and can be seen in many other fields from chemistry and
economics to social behavior and the climate.
Simple feedback model. The

feedback is negative if AB < 0
In some systems controlled by a negative feedback loop, the level of some measured parameter is
compared to a reference value, and any difference triggers an action that reduces the gap between
the two levels. Negative feedback as a control technique in electronic systems was first introduced by
Harold S. Black at Bell Telephone Laboratories in 1933.
Overview
In many physical and biological systems, qualitatively different influences can oppose each other. For
example, in biochemistry, one set of chemicals drives the system in a given direction, whereas another
set of chemicals drives it in an opposing direction. If one or both of these opposing influences are non-
linear, equilibrium point(s) result.
In biology, this process (generally biochemical) is often referred to as homeostasis; whereas in

mechanics, the more common term is equilibrium.
In engineering, mathematics and the physical and biological sciences, common terms for the points
around which the system gravitates include: attractors, stable states, eigenstates/eigenfunctions,
equilibrium points, and set points.
Negative refers to the sign of the multiplier in mathematical models for feedback. In delta notation,
−Δ output is added to or mixed into the input. In multivariate systems, vectors help to illustrate how
several influences can both partially complement and partially oppose each other.
In contrast, positive feedback is feedback in which

the system responds so as to increase the
magnitude of any particular perturbation,
resulting in amplification of the original signal
instead of stabilization. Any system where there is
positive feedback together with a gain greater
than one will result in a runaway situation. Both
positive and negative feedback require a feedback
loop to operate.
We are all part of the system!

Introduction
Systems Thinking
Introduction
Session 1-
Part 2

Introduction
Causal loop diagram
Example of positive reinforcing loop: Bank

balance and Earned interest A causal loop
diagram (CLD) is a causal diagram that aids in
visualizing how interrelated variables affect
one another. The diagram consists of a set of
nodes representing the variables connected
together. The relationships between these
variables, represented by arrows, can be
labeled as positive or negative.
Example of positive reinforcing loop:
The amount of the Bank Balance will affect the amount of the Earned Interest, as represented by the
top blue arrow, pointing from Bank Balance to Earned Interest.

Introduction
Since an increase in Bank balance results in an increase in Earned Interest, this link is positive, which is
denoted with a ""+"". The Earned interest gets added to the Bank balance, also a positive link,
represented by the bottom blue arrow. The causal effect between these nodes forms a positive
reinforcing loop, represented by the green arrow, which is denoted with an "R".
History
The use of nodes and arrows, to construct directed graph models of cause and effect, dates back to
the invention of path analysis by Sewall Wright in 1918, long before System Dynamics. Due to the
limitations of genetic data, however, these early causal graphs contained no loops — they were
directed acyclic graphs. The first formal use of Causal Loop Diagrams was explained by Dr. Dennis
Meadows at a conference for educators (Systems Thinking & Dynamic Modeling Conference for K-12
Education in New Hampshire sponsored by Creative Learning Exchange).
Meadows explained that when he and others were working on the World3 model (circa 1970–72),
they realized they would not be able to use the computer output to explain how the feedback loops
worked in their model when presenting their results to others. They decided to show feedback loops
(without the stocks, flows and every variable), using arrows connecting the names of major model
components in the feedback loops. This may have been the first formal use of Causal Loop Diagrams.
Positive and negative causal links
Positive causal link means that the two nodes change in the same direction, i.e. if the node in which
the link starts decreases, the other node also decreases. Similarly, if the node in which the link starts
increases, the other node increases.
Negative causal link means that the two nodes change in opposite directions, i.e. if the node in
which the link starts increases, then the other node decreases, and vice versa.
Example
Dynamic causal loop diagram: positive and negative links

Introduction
Reinforcing and balancing loops
To determine if a causal loop is reinforcing or balancing, one can start with an assumption, e.g. "Node
1 increases" and follow the loop around. The loop is reinforcing if, after going around the loop, one
ends up with the same result as the initial assumption and balancing if the result contradicts the initial
assumption.
Or to put it in other words: Reinforcing loops have an even number of negative links (zero also is
even, see example above) balancing loops have an uneven number of negative links.
Identifying reinforcing and balancing loops is an important step for identifying Reference Behavior
Patterns, i.e. possible dynamic behaviors of the system.
Reinforcing loops are associated with exponential increases/decreases. Balancing loops are associated
with reaching a plateau. If the system has delays, often denoted by drawing a short line across the
causal link, the system might fluctuate.
Example
Causal loop diagram of Adoption model, used to demonstrate systems dynamics

Introduction
Causal loop diagram of a model examining the growth or decline of a life insurance company
Positive feedback
Alarm or panic can spread by positive feedback

among a herd of animals to cause a stampede.
Positive feedback is a process in which the effects of a small disturbance on a system include an
increase in the magnitude of the perturbation. That is, A produces more of B which in turn produces
more of A. In contrast, a system in which the results of a change act to reduce or counteract it has
negative feedback.
Causal loop diagram that depicts the causes of a

stampede as a positive feedback loop.

Introduction
In sociology a network effect can quickly create
the positive feedback of a bank run. The above
photo is of the UK Northern Rock 2007 bank
run. See also viral video.
Mathematically, positive feedback is defined as a positive loop gain around a feedback loop. That is,
positive feedback is in phase with the input, in the sense that it adds to make the input larger. Positive
feedback tends to cause system instability. When the loop gain is positive and above 1, there will
typically be exponential growth, increasing oscillations or divergences from equilibrium. System
parameters will typically accelerate towards extreme values, which may damage or destroy the
system, or may end with the system latched into a new stable state. Positive feedback may be
controlled by signals in the system being filtered, damped, or limited, or it can be cancelled or reduced
by adding negative feedback.
Positive feedback is used in digital electronics to force voltages away from intermediate voltages into
'0' and '1' states. On the other hand, thermal runaway is a positive feedback that can destroy
semiconductor junctions. Positive feedback in chemical reactions can increase the rate of reactions,
and in some cases can lead to explosions. Positive feedback in mechanical design causes tipping- point,
or 'over-centre', mechanisms to snap into position, for example in switches and locking pliers. Out of
control, it can cause bridges to collapse. Positive feedback in economic systems can cause boom-then-
bust cycles. If a PA system's microphone picks up sounds from its own loudspeakers, and these sounds
are re-amplified enough, the effect of this feedback can be loud squealing or howling noises from the
loudspeakers.
In feedback loops a chain of cause and effect exists where a state variable of a system has a feedback
loop influencing its own rate of change. Such feedback can be direct, or can be via other state
variables.
Such systems can give rich qualitative behaviors, but whether the feedback is positive or negative in
sign is an extremely important influence on the results. In positive feedback, the derivative of the
variable is positively affected by the variables value, and the opposite is true in negative feedback.
A key feature of positive feedback is thus that small disturbances get bigger. When a change occurs
in a system, positive feedback causes further change, in the same direction.
Negative feedback
Negative feedback occurs when the result of a process influences the operation of the process itself
in such a way as to reduce changes. Negative feedback tends to make a system self-regulating; it can
produce stability and reduce the effect of fluctuations. Negative feedback loops where just the right
amount of correction is applied in the most timely manner can be very stable, accurate, and

Introduction
responsive. Negative feedback is widely used in mechanical and electronic engineering, but it also
occurs naturally within living organisms, and can be seen in many other fields from chemistry and
economics to social behavior and the climate.
Simple feedback model. The

feedback is negative if AB < 0
In some systems controlled by a negative feedback loop, the level of some measured parameter is
compared to a reference value, and any difference triggers an action that reduces the gap between
the two levels. Negative feedback as a control technique in electronic systems was first introduced by
Harold S. Black at Bell Telephone Laboratories in 1933.
Overview
In many physical and biological systems, qualitatively different influences can oppose each other. For
example, in biochemistry, one set of chemicals drives the system in a given direction, whereas another
set of chemicals drives it in an opposing direction. If one or both of these opposing influences are non-
linear, equilibrium point(s) result.
In biology, this process (generally biochemical) is often referred to as homeostasis; whereas in

mechanics, the more common term is equilibrium.
In engineering, mathematics and the physical and biological sciences, common terms for the points
around which the system gravitates include: attractors, stable states, eigenstates/eigenfunctions,
equilibrium points, and set points.
Negative refers to the sign of the multiplier in mathematical models for feedback. In delta notation,
−Δ output is added to or mixed into the input. In multivariate systems, vectors help to illustrate how
several influences can both partially complement and partially oppose each other.
In contrast, positive feedback is feedback in which

the system responds so as to increase the
magnitude of any particular perturbation,
resulting in amplification of the original signal
instead of stabilization. Any system where there is
positive feedback together with a gain greater
than one will result in a runaway situation. Both
positive and negative feedback require a feedback
loop to operate.
We are all part of the system!

Introduction
Systems Thinking
Natural Systems:
Global Warming
Session 2
Part 1
Exclusive property of IBPAP. This material or any portions thereof may not be copied, reproduced or
distributed in any manner and for any purpose without the prior written approval of IBPAP.
OVERVIEW
Global mean land-ocean temperature change from 1880–

2012, relative to the 1951–1980 mean. The black line is the
annual mean and the red line is the 5-year running mean. The
green bars show uncertainty estimates. Source: NASA GISS.
The map shows the 10-year average (2000–2009) global mean temperature anomaly relative to the
1951–1980 mean. The largest temperature increases are in the Arctic and the Antarctic Peninsula.
Source: NASA Earth Observatory.
Fossil fuel related CO2 emissions compared to five of the IPCC's

"SRES" emissions scenarios. The dips are related to global
recessions. Image source: Skeptical Science.
Global warming is the rise in the average temperature of Earth's atmosphere and oceans since the
late 19th century and its projected continuation. Since the early 20th century, Earth's mean surface
temperature has increased by about 0.8 C (1.4 F), with about two-thirds of the increase occurring
since 1980. Warming of the climate system is unequivocal, and scientists are more than 90% certain
that it is primarily caused by increasing concentrations of greenhouse gases produced by human

Natural Systems: Global Warming
activities such as the burning of fossil fuels and deforestation. These findings are recognized by the
national science academies of all major industrialized nations.
Climate model projections were summarized in the 2007 Fourth Assessment Report (AR4) by the
Intergovernmental Panel on Climate Change (IPCC). They indicated that during the 21st century the
global surface temperature is likely to rise a further 1.1 to 2.9 C (2 to 5.2 F) for their lowest emissions
scenario and 2.4 to 6.4 C (4.3 to 11.5 °F) for their highest. The ranges of these estimates arise from
the use of models with differing sensitivity to greenhouse gas concentrations.
Future warming and related changes will vary from region to region around the globe. The effects of
an increase in global temperature include a rise in sea levels and a change in the amount and pattern
of precipitation, as well a probable expansion of subtropical deserts. Warming is expected to be
strongest in the Arctic and would be associated with the continuing retreat of glaciers, permafrost
and sea ice. Other likely effects of the warming include a more frequent occurrence of extreme-
weather events including heat waves, droughts and heavy rainfall, ocean acidification and species
extinctions due to shifting temperature regimes. Effects significant to humans include the threat to
food security from decreasing crop yields and the loss of habitat from inundation.
Proposed policy responses to global warming include mitigation by emissions reduction, adaptation
to its effects, and possible future geoengineering. Most countries are parties to the United Nations
Framework Convention on Climate Change (UNFCCC), whose ultimate objective is to prevent
dangerous anthropogenic (i.e., human-induced) climate change. Parties to the UNFCCC have adopted
a range of policies designed to reduce greenhouse gas emissions and to assist in adaptation to global
warming. Parties to the UNFCCC have agreed that deep cuts in emissions are required, and that future
global warming should be limited to below 2.0 °C (3.6 °F) relative to the pre-industrial level. Reports
published in 2011 by the United Nations Environment Programme and the International Energy
Agency suggest that efforts as of the early 21st century to reduce emissions may be inadequate to
meet the UNFCCC's 2 °C target.
Observed temperature changes
The increase in ocean heat content is much larger than

any other store of energy in the Earth’s heat balance
over the two periods 1961 to 2003 and 1993 to 2003,
and accounts for more than 90% of the possible
increase in heat content of the Earth system during
these periods.

Two millennia of mean surface temperatures
according to different reconstructions from
climate proxies, each smoothed on a decadal
scale, with the instrumental temperature
record overlaid in black.
The Earth's average surface temperature rose

by 0.74±0.18 °C over the period 1906–2005.
The rate of warming over the last half of that
period was almost double that for the period
as a whole (0.13±0.03 °C per decade, versus
0.07±0.02 °C per decade). The urban heat
island effect is very small, estimated to
account for less than 0.002 °C of warming per
decade since 1900.
Temperatures in the lower troposphere have increased between 0.13 and 0.22 °C (0.22 and 0.4 °F)
per decade since 1979, according to satellite temperature measurements. Climate proxies show the
temperature to have been relatively stable over the one or two thousand years before 1850, with
regionally varying fluctuations such as the Medieval Warm Period and the Little Ice Age.
The warming that is evident in the instrumental temperature record is consistent with a wide range
of observations, as documented by many independent scientific groups. Examples include sea level
rise (water expands as it warms), widespread melting of snow and ice, increased heat content of the
oceans, increased humidity, and the earlier timing of spring events, e.g., the flowering of plants. The
probability that these changes could have occurred by chance is virtually zero.
Recent estimates by NASA's Goddard Institute for Space Studies (GISS) and the National Climatic Data
Center show that 2005 and 2010 tied for the planet's warmest year since reliable, widespread
instrumental measurements became available in the late 19th century, exceeding 1998 by a few
hundredths of a degree. Estimates by the Climatic Research Unit (CRU) show 2005 as the second
warmest year, behind 1998 with 2003 and 2010 tied for third warmest year, however, "the error
estimate for individual years ... is at least ten times larger than the differences between these three
years." The World Meteorological Organization (WMO) statement on the status of the global climate
in 2010 explains that, "The 2010 nominal value of +0.53 °C ranks just ahead of those of 2005 (+0.52
°C) and 1998 (+0.51 °C), although the differences between the three years are not statistically
significant..."
NOAA graph of Global Annual Temperature Anomalies

1950–2012, showing the El Niño-Southern Oscillation
Temperatures in 1998 were unusually warm because global
temperatures are affected by the El Niño-Southern
Oscillation (ENSO), and the strongest El Niño in the past
century occurred during that year. Global temperature is
subject to short-term fluctuations that overlay long term
trends and can temporarily mask them. The relative stability
in temperature from 2002 to 2009 is consistent with such
an episode. 2010 was also an El Niño year. On
the low swing of the oscillation, 2011 as an La Niña year was cooler but it was still the 11th warmest
year since records began in 1880. Of the 13 warmest years since 1880, 11 were the years from 2001
to 2011. Over the more recent record, 2011 was the warmest La Niña year in the period from 1950 to
2011, and was close to 1997 which was not at the lowest point of the cycle.
Temperature changes vary over the globe. Since 1979, land temperatures have increased about twice
as fast as ocean temperatures (0.25 °C per decade against 0.13 °C per decade). Ocean temperatures
increase more slowly than land temperatures because of the larger effective heat capacity of the
oceans and because the ocean loses more heat by evaporation. The northern hemisphere warms
faster than the southern hemisphere because it has more land and because it has extensive areas of
seasonal snow and sea-ice cover subject to ice-albedo feedback. Although more greenhouse gases are
emitted in the Northern than Southern Hemisphere this does not contribute to the difference in
warming because the major greenhouse gases persist long enough to mix between hemispheres.
The thermal inertia of the oceans and slow responses of other indirect effects mean that climate can
take centuries or longer to adjust to changes in forcing. Climate commitment studies indicate that
even if greenhouse gases were stabilized at 2000 levels, a further warming of about 0.5 °C (0.9 °F)
would still occur.

Systems Thinking
Natural Systems:
Global Warming
Session 2
Part 1
OVERVIEW
Global mean land-ocean temperature change from 1880–

2012, relative to the 1951–1980 mean. The black line is the
annual mean and the red line is the 5-year running mean. The
green bars show uncertainty estimates. Source: NASA GISS.
The map shows the 10-year average (2000–2009) global mean temperature anomaly relative to the
1951–1980 mean. The largest temperature increases are in the Arctic and the Antarctic Peninsula.
Source: NASA Earth Observatory.
Fossil fuel related CO2 emissions compared to five of the IPCC's

"SRES" emissions scenarios. The dips are related to global
recessions. Image source: Skeptical Science.
Global warming is the rise in the average temperature of Earth's atmosphere and oceans since the
late 19th century and its projected continuation. Since the early 20th century, Earth's mean surface
temperature has increased by about 0.8 C (1.4 F), with about two-thirds of the increase occurring
since 1980. Warming of the climate system is unequivocal, and scientists are more than 90% certain
that it is primarily caused by increasing concentrations of greenhouse gases produced by human

activities such as the burning of fossil fuels and deforestation. These findings are recognized by the
national science academies of all major industrialized nations.
Climate model projections were summarized in the 2007 Fourth Assessment Report (AR4) by the
Intergovernmental Panel on Climate Change (IPCC). They indicated that during the 21st century the
global surface temperature is likely to rise a further 1.1 to 2.9 C (2 to 5.2 F) for their lowest emissions
scenario and 2.4 to 6.4 C (4.3 to 11.5 °F) for their highest. The ranges of these estimates arise from
the use of models with differing sensitivity to greenhouse gas concentrations.
Future warming and related changes will vary from region to region around the globe. The effects of
an increase in global temperature include a rise in sea levels and a change in the amount and pattern
of precipitation, as well a probable expansion of subtropical deserts. Warming is expected to be
strongest in the Arctic and would be associated with the continuing retreat of glaciers, permafrost
and sea ice. Other likely effects of the warming include a more frequent occurrence of extreme-
weather events including heat waves, droughts and heavy rainfall, ocean acidification and species
extinctions due to shifting temperature regimes. Effects significant to humans include the threat to
food security from decreasing crop yields and the loss of habitat from inundation.
Proposed policy responses to global warming include mitigation by emissions reduction, adaptation
to its effects, and possible future geoengineering. Most countries are parties to the United Nations
Framework Convention on Climate Change (UNFCCC), whose ultimate objective is to prevent
dangerous anthropogenic (i.e., human-induced) climate change. Parties to the UNFCCC have adopted
a range of policies designed to reduce greenhouse gas emissions and to assist in adaptation to global
warming. Parties to the UNFCCC have agreed that deep cuts in emissions are required, and that future
global warming should be limited to below 2.0 °C (3.6 °F) relative to the pre-industrial level. Reports
published in 2011 by the United Nations Environment Programme and the International Energy
Agency suggest that efforts as of the early 21st century to reduce emissions may be inadequate to
meet the UNFCCC's 2 °C target.
Observed temperature changes
The increase in ocean heat content is much larger than

any other store of energy in the Earth’s heat balance
over the two periods 1961 to 2003 and 1993 to 2003,
and accounts for more than 90% of the possible
increase in heat content of the Earth system during
these periods.

Two millennia of mean surface temperatures
according to different reconstructions from
climate proxies, each smoothed on a decadal
scale, with the instrumental temperature
record overlaid in black.
The Earth's average surface temperature rose

by 0.74±0.18 °C over the period 1906–2005.
The rate of warming over the last half of that
period was almost double that for the period
as a whole (0.13±0.03 °C per decade, versus
0.07±0.02 °C per decade). The urban heat
island effect is very small, estimated to
account for less than 0.002 °C of warming per
decade since 1900.
Temperatures in the lower troposphere have increased between 0.13 and 0.22 °C (0.22 and 0.4 °F)
per decade since 1979, according to satellite temperature measurements. Climate proxies show the
temperature to have been relatively stable over the one or two thousand years before 1850, with
regionally varying fluctuations such as the Medieval Warm Period and the Little Ice Age.
The warming that is evident in the instrumental temperature record is consistent with a wide range
of observations, as documented by many independent scientific groups. Examples include sea level
rise (water expands as it warms), widespread melting of snow and ice, increased heat content of the
oceans, increased humidity, and the earlier timing of spring events, e.g., the flowering of plants. The
probability that these changes could have occurred by chance is virtually zero.
Recent estimates by NASA's Goddard Institute for Space Studies (GISS) and the National Climatic Data
Center show that 2005 and 2010 tied for the planet's warmest year since reliable, widespread
instrumental measurements became available in the late 19th century, exceeding 1998 by a few
hundredths of a degree. Estimates by the Climatic Research Unit (CRU) show 2005 as the second
warmest year, behind 1998 with 2003 and 2010 tied for third warmest year, however, "the error
estimate for individual years ... is at least ten times larger than the differences between these three
years." The World Meteorological Organization (WMO) statement on the status of the global climate
in 2010 explains that, "The 2010 nominal value of +0.53 °C ranks just ahead of those of 2005 (+0.52
°C) and 1998 (+0.51 °C), although the differences between the three years are not statistically
significant..."
NOAA graph of Global Annual Temperature Anomalies

1950–2012, showing the El Niño-Southern Oscillation
Temperatures in 1998 were unusually warm because global
temperatures are affected by the El Niño-Southern
Oscillation (ENSO), and the strongest El Niño in the past
century occurred during that year. Global temperature is
subject to short-term fluctuations that overlay long term
trends and can temporarily mask them. The relative stability
in temperature from 2002 to 2009 is consistent with such
an episode. 2010 was also an El Niño year. On
the low swing of the oscillation, 2011 as an La Niña year was cooler but it was still the 11th warmest
year since records began in 1880. Of the 13 warmest years since 1880, 11 were the years from 2001
to 2011. Over the more recent record, 2011 was the warmest La Niña year in the period from 1950 to
2011, and was close to 1997 which was not at the lowest point of the cycle.
Temperature changes vary over the globe. Since 1979, land temperatures have increased about twice
as fast as ocean temperatures (0.25 °C per decade against 0.13 °C per decade). Ocean temperatures
increase more slowly than land temperatures because of the larger effective heat capacity of the
oceans and because the ocean loses more heat by evaporation. The northern hemisphere warms
faster than the southern hemisphere because it has more land and because it has extensive areas of
seasonal snow and sea-ice cover subject to ice-albedo feedback. Although more greenhouse gases are
emitted in the Northern than Southern Hemisphere this does not contribute to the difference in
warming because the major greenhouse gases persist long enough to mix between hemispheres.
The thermal inertia of the oceans and slow responses of other indirect effects mean that climate can
take centuries or longer to adjust to changes in forcing. Climate commitment studies indicate that
even if greenhouse gases were stabilized at 2000 levels, a further warming of about 0.5 °C (0.9 °F)
would still occur.

Systems Thinking
Natural Systems:
Global Warming
Session 2-
Part 2
Exclusive property of IBPAP. This material or any portions thereof may not be copied, reproduced or distributed in any manner and
for any purpose without the prior written approval of IBPAP.

Initial causes of temperature changes (external forcing)
Greenhouse effect schematic showing energy flows

between space, the atmosphere, and earth's surface. Energy
exchanges are expressed in watts per square meter (W/m2).
This graph, known as the Keeling Curve, shows the

increase of atmospheric carbon dioxide (CO2)
concentrations from 1958–2008. Monthly CO2
measurements display seasonal oscillations in an
upward trend; each year's maximum occurs during
the Northern Hemisphere's late spring, and
declines during its growing season as plants
remove some atmospheric CO2.

The climate system can respond to changes in external forcings. External forcings can "push" the
climate in the direction of warming or cooling. Examples of external forcings include changes in
atmospheric composition (e.g., increased concentrations of greenhouse gases), solar luminosity,
volcanic eruptions, and variations in Earth's orbit around the Sun. Orbital cycles vary slowly over tens
of thousands of years and at present are in an overall cooling trend which would be expected to lead
towards an ice age, but the 20th century instrumental temperature record shows a sudden rise in
global temperatures.
Greenhouse gases
The greenhouse effect is the process by which absorption and emission of infrared radiation by gases
in the atmosphere warm a planet's lower atmosphere and surface. It was proposed by Joseph Fourier
in 1824 and was first investigated quantitatively by Svante Arrhenius in 1896.[
Annual world greenhouse gas emissions, in

2005, by sector.
Bubble diagram showing the share of

global cumulative energy-related
carbon dioxide emissions for major
emitters between 1890-2007.
Naturally occurring amounts of
greenhouse gases have a mean
warming effect of about 33 °C (59 °F).
The major greenhouse gases are water
vapor, which causes about 36–70% of
the greenhouse effect; carbon dioxide
(CO2), which causes 9–26%; methane
(CH4), which causes 4–9%; and ozone
(O3), which causes 3–7%. Clouds also
affect the radiation balance through
cloud forcings similar to greenhouse
gases.
Human activity since the Industrial Revolution has increased the amount of greenhouse gases in the
atmosphere, leading to increased radiative forcing from CO2, methane, tropospheric ozone, CFCs and
nitrous oxide. The concentrations of CO2 and methane have increased by 36% and 148% respectively
since 1750. These levels are much higher than at any time during the last 800,000 years, the period
for which reliable data has been extracted from ice cores. Less direct geological evidence indicates
that CO2 values higher than this were last seen about 20 million years ago. Fossil fuel burning has
produced about three-quarters of the increase in CO2 from human activity over the past 20 years. The
rest of this increase is caused mostly by changes in land-use, particularly deforestation.
Over the last three decades of the 20th century, gross domestic product per capita and population
growth were the main drivers of increases in greenhouse gas emissions. CO2 emissions are continuing
to rise due to the burning of fossil fuels and land-use change. Emissions can be

attributed to different regions, e.g., see the figure opposite. Attribution of emissions due to land-use
change is a controversial issue.
Emissions scenarios, estimates of changes in future emission levels of greenhouse gases, have been
projected that depend upon uncertain economic, sociological, technological, and natural
developments. In most scenarios, emissions continue to rise over the century, while in a few,
emissions are reduced. Fossil fuel reserves are abundant, and will not limit carbon emissions in the
21st century. Emission scenarios, combined with modeling of the carbon cycle, have been used to
produce estimates of how atmospheric concentrations of greenhouse gases might change in the
future.
Using the six IPCC SRES "marker" scenarios, models suggest that by the year 2100, the atmospheric
concentration of CO2 could range between 541 and 970 ppm. This is an increase of 90–250% above
the concentration in the year 1750.
The popular media and the public often confuse global warming with ozone depletion, i.e., the
destruction of stratospheric ozone by chlorofluorocarbons. Although there are a few areas of linkage,
the relationship between the two is not strong. Reduced stratospheric ozone has had a slight cooling
influence on surface temperatures, while increased tropospheric ozone has had a somewhat larger
warming effect.

Systems Thinking
Natural Systems:
Global Warming
Session 2-
Part 2
Exclusive property of IBPAP. This material or any portions thereof may not be copied, reproduced or distributed in any manner and
for any purpose without the prior written approval of IBPAP.

Initial causes of temperature changes (external forcing)
Greenhouse effect schematic showing energy flows

between space, the atmosphere, and earth's surface. Energy
exchanges are expressed in watts per square meter (W/m2).
This graph, known as the Keeling Curve, shows the

increase of atmospheric carbon dioxide (CO2)
concentrations from 1958–2008. Monthly CO2
measurements display seasonal oscillations in an
upward trend; each year's maximum occurs during
the Northern Hemisphere's late spring, and
declines during its growing season as plants
remove some atmospheric CO2.

The climate system can respond to changes in external forcings. External forcings can "push" the
climate in the direction of warming or cooling. Examples of external forcings include changes in
atmospheric composition (e.g., increased concentrations of greenhouse gases), solar luminosity,
volcanic eruptions, and variations in Earth's orbit around the Sun. Orbital cycles vary slowly over tens
of thousands of years and at present are in an overall cooling trend which would be expected to lead
towards an ice age, but the 20th century instrumental temperature record shows a sudden rise in
global temperatures.
Greenhouse gases
The greenhouse effect is the process by which absorption and emission of infrared radiation by gases
in the atmosphere warm a planet's lower atmosphere and surface. It was proposed by Joseph Fourier
in 1824 and was first investigated quantitatively by Svante Arrhenius in 1896.[
Annual world greenhouse gas emissions, in

2005, by sector.
Bubble diagram showing the share of

global cumulative energy-related
carbon dioxide emissions for major
emitters between 1890-2007.
Naturally occurring amounts of
greenhouse gases have a mean
warming effect of about 33 °C (59 °F).
The major greenhouse gases are water
vapor, which causes about 36–70% of
the greenhouse effect; carbon dioxide
(CO2), which causes 9–26%; methane
(CH4), which causes 4–9%; and ozone
(O3), which causes 3–7%. Clouds also
affect the radiation balance through
cloud forcings similar to greenhouse
gases.
Human activity since the Industrial Revolution has increased the amount of greenhouse gases in the
atmosphere, leading to increased radiative forcing from CO2, methane, tropospheric ozone, CFCs and
nitrous oxide. The concentrations of CO2 and methane have increased by 36% and 148% respectively
since 1750. These levels are much higher than at any time during the last 800,000 years, the period
for which reliable data has been extracted from ice cores. Less direct geological evidence indicates
that CO2 values higher than this were last seen about 20 million years ago. Fossil fuel burning has
produced about three-quarters of the increase in CO2 from human activity over the past 20 years. The
rest of this increase is caused mostly by changes in land-use, particularly deforestation.
Over the last three decades of the 20th century, gross domestic product per capita and population
growth were the main drivers of increases in greenhouse gas emissions. CO2 emissions are continuing
to rise due to the burning of fossil fuels and land-use change. Emissions can be

attributed to different regions, e.g., see the figure opposite. Attribution of emissions due to land-use
change is a controversial issue.
Emissions scenarios, estimates of changes in future emission levels of greenhouse gases, have been
projected that depend upon uncertain economic, sociological, technological, and natural
developments. In most scenarios, emissions continue to rise over the century, while in a few,
emissions are reduced. Fossil fuel reserves are abundant, and will not limit carbon emissions in the
21st century. Emission scenarios, combined with modeling of the carbon cycle, have been used to
produce estimates of how atmospheric concentrations of greenhouse gases might change in the
future.
Using the six IPCC SRES "marker" scenarios, models suggest that by the year 2100, the atmospheric
concentration of CO2 could range between 541 and 970 ppm. This is an increase of 90–250% above
the concentration in the year 1750.
The popular media and the public often confuse global warming with ozone depletion, i.e., the
destruction of stratospheric ozone by chlorofluorocarbons. Although there are a few areas of linkage,
the relationship between the two is not strong. Reduced stratospheric ozone has had a slight cooling
influence on surface temperatures, while increased tropospheric ozone has had a somewhat larger
warming effect.

Systems Thinking
Health Systems:
Obesity Epidemic
Session 3-
Part 1
OVERVIEW
Silhouettes and waist circumferences representing

normal, overweight, and obese
Obesity is a medical condition in which excess body fat has accumulated to the extent that it may have
an adverse effect on health, leading to reduced life expectancy and/or increased health problems.
People are considered obese when their body mass index (BMI), a measurement obtained by dividing
a person's weight in kilograms by the square of the person's height in meters, exceeds 30 kg/m2.
Obesity increases the likelihood of various diseases, particularly heart disease, type 2 diabetes,
obstructive sleep apnea, certain types of cancer, and osteoarthritis. Obesity is most commonly caused
by a combination of excessive food energy intake, lack of physical activity, and genetic susceptibility,
although a few cases are caused primarily by genes, endocrine disorders, medications or psychiatric
illness. Evidence to support the view that some obese people eat little yet gain weight due to a slow
metabolism is limited; on average obese people have a greater energy expenditure than their thin
counterparts due to the energy required to maintain an increased body mass.
Dieting and physical exercise are the mainstays of treatment for obesity. Diet quality can be improved
by reducing the consumption of energy-dense foods such as those high in fat and sugars, and by
increasing the intake of dietary fiber. Anti-obesity drugs may be taken to reduce appetite or inhibit
fat absorption together with a suitable diet. If diet, exercise and medication are not effective, a gastric
balloon may assist with weight loss, or surgery may be performed to reduce stomach volume and/or
bowel length, leading to earlier satiation and reduced ability to absorb nutrients from food.

Health Systems: Obesity Epidemic
Obesity is a leading preventable cause of death worldwide, with increasing prevalence in adults and
children, and authorities view it as one of the most serious public health problems of the 21st century.
Obesity is stigmatized in much of the modern world (particularly in the Western world), though it was
widely perceived as a symbol of wealth and fertility at other times in history, and still is in some parts
of the world.
Classification
an adverse effect on health. It is defined by body mass index (BMI) and further evaluated in terms of
fat distribution via the waist–hip ratio and total cardiovascular risk factors. BMI is closely related to
both percentage body fat and total body fat.
A "super obese" male with a BMI of 47 kg/m2: weight 146 kg

(322 lb), height 177 cm (5 ft 10 in)
In children, a healthy weight varies with age and sex. Obesity in children and adolescents is defined
not as an absolute number but in relation to a historical normal group, such that obesity is a BMI
greater than the 95th percentile. The reference data on which these percentiles were based date from
1963 to 1994, and thus have not been affected by the recent increases in weight.
BMI is defined as the subject's weight divided by the square of their height and is calculated as
follows.
where m and h are the subject's weight in kilograms and height in meters respectively
BMI is usually expressed in kilograms per square meter. To convert from pounds per square inch
multiply by 703 (kg/m2)/(lb/sq in)
BMI Classification
< 18.5 underweight
18.5–24.9 normal weight
The most commonly used definitions, established by
25.0–29.9 overweight the World Health Organization (WHO) in 1997 and
30.0–34.9 class I obesity published in 2000, provide the values listed in the
table.
35.0–39.9 class II obesity
≥ 40.0 class III obesity

Some modifications to the WHO definitions have been made by particular bodies. The surgical
literature breaks down "class III" obesity into further categories whose exact values are still disputed.
• Any BMI ≥ 35 or 40 is severe obesity
• A BMI of ≥ 35 or 40–44.9 or 49.9 is morbid obesity
• A BMI of ≥ 45 or 50 is super obesity
As Asian populations develop negative health consequences at a lower BMI than Caucasians, some
nations have redefined obesity; the Japanese have defined obesity as any BMI greater than 25 while
China uses a BMI of greater than 28.
Effects on health
Excessive body weight is associated with various diseases, particularly cardiovascular diseases,
diabetes mellitus type 2, obstructive sleep apnea, certain types of cancer, osteoarthritis and asthma.
As a result, obesity has been found to reduce life expectancy.
Mortality
Relative risk of death over 10 years for White men (left) and women (right) who have
never smoked in the United States by BMI.
Obesity is one of the leading preventable causes of death worldwide.
Large-scale American and European studies have found that mortality risk is lowest at a BMI of 20–
25 kg/m2 in non-smokers and at 24–27 kg/m2 in current smokers, with risk increasing along with
changes in either direction. A BMI above 32 kg/m2 has been associated with a doubled mortality rate
among women over a 16-year period. In the United States obesity is estimated to cause 111,909 to
365,000 deaths per year, while 1 million (7.7%) of deaths in Europe are attributed to excess weight.
On average, obesity reduces life expectancy by six to seven years, a BMI of 30– 35 kg/m2reduces
life expectancy by two to four years, while severe obesity (BMI > 40 kg/m 2) reduces life expectancy
by ten years.
Morbidity
Obesity increases the risk of many physical and mental conditions. These comorbidities are most
commonly shown in metabolic syndrome, a combination of medical disorders which includes:
diabetes mellitus type 2, high blood pressure, high blood cholesterol, and high triglyceride levels.

Complications are either directly caused by obesity or indirectly related through mechanisms sharing
a common cause such as a poor diet or a sedentary lifestyle. The strength of the link between obesity
and specific conditions varies. One of the strongest is the link with type 2 diabetes. Excess body fat
underlies 64% of cases of diabetes in men and 77% of cases in women.
Health consequences fall into two broad categories: those attributable to the effects of increased fat
mass (such as osteoarthritis, obstructive sleep apnea, social stigmatization) and those due to the
increased number of fat cells (diabetes, cancer, cardiovascular disease, non-alcoholic fatty liver
disease). Increases in body fat alter the body's response to insulin, potentially leading to insulin
resistance. Increased fat also creates a proinflammatory state, and a prothrombotic state.
Survival paradox
Although the negative health consequences of obesity in the general population are well supported
by the available evidence, health outcomes in certain subgroups seem to be improved at an increased
BMI, a phenomenon known as the obesity survival paradox. The paradox was first described in 1999
in overweight and obese people undergoing hemodialysis, and has subsequently been found in those
with heart failure and peripheral artery disease (PAD).
In people with heart failure, those with a BMI between 30.0 and 34.9 had lower mortality than those
with a normal weight. This has been attributed to the fact that people often lose weight as they
become progressively more ill. Similar findings have been made in other types of heart disease. People
with class I obesity and heart disease do not have greater rates of further heart problems than people
of normal weight who also have heart disease. In people with greater degrees of obesity, however,
the risk of further cardiovascular events is increased. Even after cardiac bypass surgery, no increase
in mortality is seen in the overweight and obese. One study found that the improved survival could
be explained by the more aggressive treatment obese people receive after a cardiac event. Another
found that if one takes into account chronic obstructive pulmonary disease (COPD) in those with PAD,
the benefit of obesity no longer exists.
Causes
At an individual level, a combination of excessive food energy intake and a lack of physical activity is
thought to explain most cases of obesity. A limited number of cases are due primarily to genetics,
medical reasons, or psychiatric illness. In contrast, increasing rates of obesity at a societal level are
felt to be due to an easily accessible and palatable diet, increased reliance on cars, and mechanized
manufacturing.
A 2006 review identified ten other possible contributors to the recent increase of obesity: (1)
insufficient sleep, (2) endocrine disruptors (environmental pollutants that interfere with lipid
metabolism), (3) decreased variability in ambient temperature, (4) decreased rates of smoking,
because smoking suppresses appetite, (5) increased use of medications that can cause weight gain
(e.g., atypical antipsychotics), (6) proportional increases in ethnic and age groups that tend to be
heavier, (7) pregnancy at a later age (which may cause susceptibility to obesity in children),
(8)epigenetic risk factors passed on generationally, (9) natural selection for higher BMI, and (10)
assortative mating leading to increased concentration of obesity risk factors (this would increase the
number of obese people by increasing population variance in weight). While there is substantial
evidence supporting the influence of these mechanisms on the increased prevalence of obesity, the
evidence is still inconclusive, and the authors state that these are probably less influential than the
ones discussed in the previous paragraph.
Diet
Map of dietary energy availability per person per day in 1961 (left) and
2001–2003 (right) in kcal/person/day.
no data 2600–2800
<1600 2800–3000
1600–1800 3000–3200
1800–2000 3200–3400
2000–2200 3400–3600
2200–2400 >3600
2400–2600
Average per capita energy

consumption of the world from 1961
to 2002
The per capita dietary energy

supply varies markedly between
different regions and countries. It
has also changed significantly over
time. From the early 1970s to the
late 1990s the average calories
available per person per day (the
amount of food bought) increased
in all parts of the world except Eastern Europe. The United States had the highest availability with
3,654 calories per person in 1996. This increased further in 2003 to 3,754. During the late 1990s
Europeans had 3,394 calories per person, in the developing areas of Asia there were 2,648 calories
per person, and in sub-Saharan Africa people had 2,176 calories per person. Total calorie consumption
has been found to be related to obesity
The widespread availability of nutritional guidelines has done little to address the problems of
overeating and poor dietary choice. From 1971 to 2000, obesity rates in the United States increased
from 14.5% to 30.9%. During the same period, an increase occurred in the average amount of food
energy consumed. For women, the average increase was 335 calories per day (1,542 calories in 1971
and 1,877 calories in 2004), while for men the average increase was 168 calories per day (2,450
calories in 1971 and 2,618 calories in 2004). Most of this extra food energy came from an increase in
carbohydrate consumption rather than fat consumption. The primary sources of these extra
carbohydrates are sweetened beverages, which now account for almost 25 percent of daily food
energy in young adults in America, and potato chips. Consumption of sweetened drinks is believed to
be contributing to the rising rates of obesity.
Systems Thinking
Health Systems:
Obesity Epidemic
Session 3-
Part 1
OVERVIEW
Silhouettes and waist circumferences representing

normal, overweight, and obese
an adverse effect on health, leading to reduced life expectancy and/or increased health problems.
People are considered obese when their body mass index (BMI), a measurement obtained by dividing
a person's weight in kilograms by the square of the person's height in meters, exceeds 30 kg/m2.
Obesity increases the likelihood of various diseases, particularly heart disease, type 2 diabetes,
obstructive sleep apnea, certain types of cancer, and osteoarthritis. Obesity is most commonly caused
by a combination of excessive food energy intake, lack of physical activity, and genetic susceptibility,
although a few cases are caused primarily by genes, endocrine disorders, medications or psychiatric
illness. Evidence to support the view that some obese people eat little yet gain weight due to a slow
metabolism is limited; on average obese people have a greater energy expenditure than their thin
counterparts due to the energy required to maintain an increased body mass.
Dieting and physical exercise are the mainstays of treatment for obesity. Diet quality can be improved
by reducing the consumption of energy-dense foods such as those high in fat and sugars, and by
increasing the intake of dietary fiber. Anti-obesity drugs may be taken to reduce appetite or inhibit
fat absorption together with a suitable diet. If diet, exercise and medication are not effective, a gastric
balloon may assist with weight loss, or surgery may be performed to reduce stomach volume and/or
bowel length, leading to earlier satiation and reduced ability to absorb nutrients from food.

Obesity is a leading preventable cause of death worldwide, with increasing prevalence in adults and
children, and authorities view it as one of the most serious public health problems of the 21st century.
Obesity is stigmatized in much of the modern world (particularly in the Western world), though it was
widely perceived as a symbol of wealth and fertility at other times in history, and still is in some parts
of the world.
Classification
an adverse effect on health. It is defined by body mass index (BMI) and further evaluated in terms of
fat distribution via the waist–hip ratio and total cardiovascular risk factors. BMI is closely related to
both percentage body fat and total body fat.
A "super obese" male with a BMI of 47 kg/m2: weight 146 kg

(322 lb), height 177 cm (5 ft 10 in)
In children, a healthy weight varies with age and sex. Obesity in children and adolescents is defined
not as an absolute number but in relation to a historical normal group, such that obesity is a BMI
greater than the 95th percentile. The reference data on which these percentiles were based date from
1963 to 1994, and thus have not been affected by the recent increases in weight.
BMI is defined as the subject's weight divided by the square of their height and is calculated as
follows.
where m and h are the subject's weight in kilograms and height in meters respectively
BMI is usually expressed in kilograms per square meter. To convert from pounds per square inch
multiply by 703 (kg/m2)/(lb/sq in)
BMI Classification
< 18.5 underweight
18.5–24.9 normal weight
The most commonly used definitions, established by
25.0–29.9 overweight the World Health Organization (WHO) in 1997 and
30.0–34.9 class I obesity published in 2000, provide the values listed in the
table.
35.0–39.9 class II obesity
≥ 40.0 class III obesity

Some modifications to the WHO definitions have been made by particular bodies. The surgical
literature breaks down "class III" obesity into further categories whose exact values are still disputed.
• Any BMI ≥ 35 or 40 is severe obesity
• A BMI of ≥ 35 or 40–44.9 or 49.9 is morbid obesity
• A BMI of ≥ 45 or 50 is super obesity
As Asian populations develop negative health consequences at a lower BMI than Caucasians, some
nations have redefined obesity; the Japanese have defined obesity as any BMI greater than 25 while
China uses a BMI of greater than 28.
Effects on health
Excessive body weight is associated with various diseases, particularly cardiovascular diseases,
diabetes mellitus type 2, obstructive sleep apnea, certain types of cancer, osteoarthritis and asthma.
As a result, obesity has been found to reduce life expectancy.
Mortality
Relative risk of death over 10 years for White men (left) and women (right) who have
never smoked in the United States by BMI.
Obesity is one of the leading preventable causes of death worldwide.
Large-scale American and European studies have found that mortality risk is lowest at a BMI of 20–
25 kg/m2 in non-smokers and at 24–27 kg/m2 in current smokers, with risk increasing along with
changes in either direction. A BMI above 32 kg/m2 has been associated with a doubled mortality rate
among women over a 16-year period. In the United States obesity is estimated to cause 111,909 to
365,000 deaths per year, while 1 million (7.7%) of deaths in Europe are attributed to excess weight.
On average, obesity reduces life expectancy by six to seven years, a BMI of 30– 35 kg/m2reduces
life expectancy by two to four years, while severe obesity (BMI > 40 kg/m 2) reduces life expectancy
by ten years.
Morbidity
Obesity increases the risk of many physical and mental conditions. These comorbidities are most
commonly shown in metabolic syndrome, a combination of medical disorders which includes:
diabetes mellitus type 2, high blood pressure, high blood cholesterol, and high triglyceride levels.

Complications are either directly caused by obesity or indirectly related through mechanisms sharing
a common cause such as a poor diet or a sedentary lifestyle. The strength of the link between obesity
and specific conditions varies. One of the strongest is the link with type 2 diabetes. Excess body fat
underlies 64% of cases of diabetes in men and 77% of cases in women.
Health consequences fall into two broad categories: those attributable to the effects of increased fat
mass (such as osteoarthritis, obstructive sleep apnea, social stigmatization) and those due to the
increased number of fat cells (diabetes, cancer, cardiovascular disease, non-alcoholic fatty liver
disease). Increases in body fat alter the body's response to insulin, potentially leading to insulin
resistance. Increased fat also creates a proinflammatory state, and a prothrombotic state.
Survival paradox
Although the negative health consequences of obesity in the general population are well supported
by the available evidence, health outcomes in certain subgroups seem to be improved at an increased
BMI, a phenomenon known as the obesity survival paradox. The paradox was first described in 1999
in overweight and obese people undergoing hemodialysis, and has subsequently been found in those
with heart failure and peripheral artery disease (PAD).
In people with heart failure, those with a BMI between 30.0 and 34.9 had lower mortality than those
with a normal weight. This has been attributed to the fact that people often lose weight as they
become progressively more ill. Similar findings have been made in other types of heart disease. People
with class I obesity and heart disease do not have greater rates of further heart problems than people
of normal weight who also have heart disease. In people with greater degrees of obesity, however,
the risk of further cardiovascular events is increased. Even after cardiac bypass surgery, no increase
in mortality is seen in the overweight and obese. One study found that the improved survival could
be explained by the more aggressive treatment obese people receive after a cardiac event. Another
found that if one takes into account chronic obstructive pulmonary disease (COPD) in those with PAD,
the benefit of obesity no longer exists.
Causes
At an individual level, a combination of excessive food energy intake and a lack of physical activity is
thought to explain most cases of obesity. A limited number of cases are due primarily to genetics,
medical reasons, or psychiatric illness. In contrast, increasing rates of obesity at a societal level are
felt to be due to an easily accessible and palatable diet, increased reliance on cars, and mechanized
manufacturing.
A 2006 review identified ten other possible contributors to the recent increase of obesity: (1)
insufficient sleep, (2) endocrine disruptors (environmental pollutants that interfere with lipid
metabolism), (3) decreased variability in ambient temperature, (4) decreased rates of smoking,
because smoking suppresses appetite, (5) increased use of medications that can cause weight gain
(e.g., atypical antipsychotics), (6) proportional increases in ethnic and age groups that tend to be
heavier, (7) pregnancy at a later age (which may cause susceptibility to obesity in children),
(8)epigenetic risk factors passed on generationally, (9) natural selection for higher BMI, and (10)
assortative mating leading to increased concentration of obesity risk factors (this would increase the
number of obese people by increasing population variance in weight). While there is substantial
evidence supporting the influence of these mechanisms on the increased prevalence of obesity, the
evidence is still inconclusive, and the authors state that these are probably less influential than the
ones discussed in the previous paragraph.
Diet
Map of dietary energy availability per person per day in 1961 (left) and
2001–2003 (right) in kcal/person/day.
no data 2600–2800
<1600 2800–3000
1600–1800 3000–3200
1800–2000 3200–3400
2000–2200 3400–3600
2200–2400 >3600
2400–2600
Average per capita energy

consumption of the world from 1961
to 2002
The per capita dietary energy

supply varies markedly between
different regions and countries. It
has also changed significantly over
time. From the early 1970s to the
late 1990s the average calories
available per person per day (the
amount of food bought) increased
in all parts of the world except Eastern Europe. The United States had the highest availability with
3,654 calories per person in 1996. This increased further in 2003 to 3,754. During the late 1990s
Europeans had 3,394 calories per person, in the developing areas of Asia there were 2,648 calories
per person, and in sub-Saharan Africa people had 2,176 calories per person. Total calorie consumption
has been found to be related to obesity
The widespread availability of nutritional guidelines has done little to address the problems of
overeating and poor dietary choice. From 1971 to 2000, obesity rates in the United States increased
from 14.5% to 30.9%. During the same period, an increase occurred in the average amount of food
energy consumed. For women, the average increase was 335 calories per day (1,542 calories in 1971
and 1,877 calories in 2004), while for men the average increase was 168 calories per day (2,450
calories in 1971 and 2,618 calories in 2004). Most of this extra food energy came from an increase in
carbohydrate consumption rather than fat consumption. The primary sources of these extra
carbohydrates are sweetened beverages, which now account for almost 25 percent of daily food
energy in young adults in America, and potato chips. Consumption of sweetened drinks is believed to
be contributing to the rising rates of obesity.
Systems Thinking
Health Systems:
Obesity Epidemic
Session 3-
Part 2

As societies become increasingly reliant on energy-dense, big-portions, and fast-food meals, the
association between fast-food consumption and obesity becomes more concerning. In the United
States consumption of fast-food meals tripled and food energy intake from these meals quadrupled
between 1977 and 1995.
Agricultural policy and techniques in the United States and Europe have led to lower food prices. In
the United States, subsidization of corn, soy, wheat, and rice through the U.S. farm bill has made the
main sources of processed food cheap compared to fruits and vegetables.
Obese people consistently under-report their food consumption as compared to people of normal
weight. This is supported both by tests of people carried out in a calorimeter room and by direct
observation.
Sedentary lifestyle
A sedentary lifestyle plays a significant role in obesity. Worldwide there has been a large shift towards
less physically demanding work, and currently at least 30% of the world's population gets insufficient
exercise. This is primarily due to increasing use of mechanized transportation and a greater prevalence
of labor-saving technology in the home. In children, there appear to be declines in levels of physical
activity due to less walking and physical education. World trends in active leisure time physical activity
are less clear. The World Health Organization indicates people worldwide are taking up less active
recreational pursuits, while a study from Finland found an increase and a study from the United States
found leisure-time physical activity has not changed significantly.
In both children and adults, there is an association between television viewing time and the risk of
obesity. A review found 63 of 73 studies (86%) showed an increased rate of childhood obesity with
increased media exposure, with rates increasing proportionally to time spent watching television.
Genetics
Like many other medical conditions, obesity is the result of an interplay

between genetic and environmental factors. Polymorphisms in various
genes controlling appetite and metabolism predispose to obesity when
sufficient food energy present. As of 2006, more than 41 of these sites on
the human genome have been linked to the development of obesity when
a favorable environment is present. People with two copies of the FTO gene
(fat mass and obesity associated gene) have been found on average to
weigh 3–4 kg more and have a 1.67-fold greater risk of obesity compared
with those without the risk allele. The percentage of obesity that can be
attributed to genetics varies, depending on the population examined, from
6% to 85%.
A 1680 painting by Juan Carreno de Miranda of a girl presumed to have Prader–

Willi syndrome (right)

Obesity is a major feature in several syndromes, such as Prader-Willi syndrome, Bardet-Biedl
syndrome, Cohen syndrome, and MOMO syndrome. (The term "non-syndromic obesity" is sometimes
used to exclude these conditions.) In people with early-onset severe obesity (defined by an onset
before 10 years of age and body mass index over three standard deviations above normal), 7% harbor
a single point DNA mutation.
Studies that have focused on inheritance patterns rather than on specific genes have found that 80%
of the offspring of two obese parents were also obese, in contrast to less than 10% of the offspring of
two parents who were of normal weight
The thrifty gene hypothesis postulates that, due to dietary scarcity during human evolution, people
are prone to obesity. Their ability to take advantage of rare periods of abundance by storing energy
as fat would be advantageous during times of varying food availability, and individuals with greater
adipose reserves would be more likely to survive famine. This tendency to store fat, however, would
be maladaptive in societies with stable food supplies. This theory has received various criticisms, and
other evolutionarily-based theories such as the drifty gene hypothesis and the thrifty phenotype
hypothesis have also been proposed.
Other illnesses
Certain physical and mental illnesses and the pharmaceutical substances used to treat them can
increase risk of obesity. Medical illnesses that increase obesity risk include several rare genetic
syndromes (listed above) as well as some congenital or acquired conditions: hypothyroidism,
Cushing's syndrome, growth hormone deficiency, and the eating disorders: binge eating disorder and
night eating syndrome. However, obesity is not regarded as a psychiatric disorder, and therefore is
not listed in the DSM-IVR as a psychiatric illness. The risk of overweight and obesity is higher in
patients with psychiatric disorders than in persons without psychiatric disorders.
Certain medications may cause weight gain or changes in body composition; these include insulin,
sulfonylureas, thiazolidinediones, atypical antipsychotics, antidepressants, steroids, certain
anticonvulsants (phenytoin and valproate) , pizotifen, and some forms of hormonal contraception.
Social determinants
The disease scroll (Yamai no soshi, late 12th century) depicts a
woman moneylender with obesity, considered a disease of the rich.
While genetic influences are important to understanding

obesity, they cannot explain the current dramatic increase
seen within specific countries or globally.
Though it is accepted that energy consumption in excess of

energy expenditure leads to obesity on an individual basis, the
cause of the shifts in these two factors on the societal scale is
much debated. There are a number of theories as to the cause
but most believe it is a combination of various factors.

The correlation between social class and BMI varies globally. A review in 1989 found that in developed
countries women of a high social class were less likely to be obese. No significant differences were
seen among men of different social classes. In the developing world, women, men, and children from
high social classes had greater rates of obesity. An update of this review carried out in 2007 found the
same relationships, but they were weaker. The decrease in strength of correlation was felt to be due
to the effects of globalization. Among developed countries, levels of adult obesity, and percentage of
teenage children who are overweight, are correlated with income inequality. A similar relationship is
seen among US states: more adults, even in higher social classes, are obese in more unequal states.
Many explanations have been put forth for associations between BMI and social class. It is thought
that in developed countries, the wealthy are able to afford more nutritious food, they are under
greater social pressure to remain slim, and have more opportunities along with greater expectations
for physical fitness. In undeveloped countries the ability to afford food, high energy expenditure with
physical labor, and cultural values favoring a larger body size are believed to contribute to the
observed patterns. Attitudes toward body mass held by people in one's life may also play a role in
obesity. A correlation in BMI changes over time has been found among friends, siblings, and spouses.
Stress and perceived low social status, appear to increase risk of obesity.
Smoking has a significant effect on an individual's weight. Those who quit smoking gain an average of
4.4 kilograms (9.7 lb) for men and 5.0 kilograms (11.0 lb) for women over ten years. However,
changing rates of smoking have had little effect on the overall rates of obesity.
In the United States the number of children a person has is related to their risk of obesity. A woman's
risk increases by 7% per child, while a man's risk increases by 4% per child. This could be partly
explained by the fact that having dependent children decreases physical activity in Western parents.
In the developing world urbanization is playing a role in increasing rate of obesity. In China overall
rates of obesity are below 5%; however, in some cities rates of obesity are greater than 20%.
Malnutrition in early life is believed to play a role in the rising rates of obesity in the developing world.
Endocrine changes that occur during periods of malnutrition may promote the storage of fat once
more food energy becomes available.
Consistent with cognitive epidemiological data, numerous studies confirm that obesity is associated
with cognitive deficits. Whether obesity causes cognitive deficits, or vice versa is unclear at present.
Infectious agents
The study of the effect of infectious agents on metabolism is still in its early stages. Gut flora has been
shown to differ between lean and obese humans. There is an indication that gut flora in obese and
lean individuals can affect the metabolic potential. This apparent alteration of the metabolic potential
is believed to confer a greater capacity to harvest energy contributing to obesity. Whether these
differences are the direct cause or the result of obesity has yet to be determined unequivocally.

An association between viruses and obesity has been found in humans and several different animal
species. The amount that these associations may have contributed to the rising rate of obesity is yet
to be determined.
Pathophysiology
A comparison of a mouse unable to produce leptin thus resulting in
obesity (left) and a normal mouse (right)
Flier summarizes the many possible pathophysiological

mechanisms involved in the development and maintenance of
obesity. This field of research had been almost unapproached until
leptin was discovered in 1994. Since this discovery, many other
hormonal mechanisms have been elucidated that participate in
the regulation of appetite and food intake, storage
patterns of adipose tissue, and development of insulin resistance. Since leptin's discovery, ghrelin,
insulin, orexin, PYY 3-36, cholecystokinin, adiponectin, as well as many other mediators have been
studied. The adipokines are mediators produced by adipose tissue; their action is thought to modify
many obesity-related diseases.
Leptin and ghrelin are considered to be complementary in their influence on appetite, with ghrelin
produced by the stomach modulating short-term appetitive control (i.e. to eat when the stomach is
empty and to stop when the stomach is stretched). Leptin is produced by adipose tissue to signal fat
storage reserves in the body, and mediates long-term appetitive controls (i.e. to eat more when fat
storages are low and less when fat storages are high). Although administration of leptin may be
effective in a small subset of obese individuals who are leptin deficient, most obese individuals are
thought to be leptin resistant and have been found to have high levels of leptin. This resistance is
thought to explain in part why administration of leptin has not been shown to be effective in
suppressing appetite in most obese people.
On the left is a graphic depiction of a leptin molecule
While leptin and ghrelin are produced peripherally, they

control appetite through their actions on the central nervous
system. In particular, they and other appetite-related
hormones act on the hypothalamus, a region of the brain
central to the regulation of food intake and energy
expenditure. There are several circuits within the
hypothalamus that contribute to its role in integrating
appetite, the melanocortin pathway being the most well
understood. The circuit begins with an area of the hypothalamus, the arcuate nucleus, that has
outputs to the lateral hypothalamus (LH) and ventromedial hypothalamus (VMH), the brain's feeding
and satiety centers, respectively.
The arcuate nucleus contains two distinct groups of neurons. The first group coexpresses
neuropeptide Y (NPY) and agouti-related peptide (AgRP) and has stimulatory inputs to the LH and
inhibitory inputs to the VMH. The second group coexpresses pro-opiomelanocortin (POMC) and
cocaine- and amphetamine-regulated transcript (CART) and has stimulatory inputs to the VMH and
inhibitory inputs to the LH. Consequently, NPY/AgRP neurons stimulate feeding and inhibit satiety,
while POMC/CART neurons stimulate satiety and inhibit feeding. Both groups of arcuate nucleus
neurons are regulated in part by leptin. Leptin inhibits the NPY/AgRP group while stimulating the
POMC/CART group. Thus a deficiency in leptin signaling, both via leptin deficiency or leptin resistance,
leads to over feeding and may account for some genetic and acquired forms of obesity.
Public health
The World Health Organization (WHO) predicts that overweight and obesity may soon replace more
traditional public health concerns such as under nutrition and infectious diseases as the most
significant cause of poor health. Obesity is a public health and policy problem because of its
prevalence, costs, and health effects. The United States Preventive Services Task Force recommends
screening for all adults followed by behavioral interventions in those who are obese. Public health
efforts seek to understand and correct the environmental factors responsible for the increasing
prevalence of obesity in the population.
Solutions look at changing the factors that cause excess food energy consumption and inhibit physical
activity. Efforts include federally reimbursed meal programs in schools, limiting direct junk food
marketing to children, and decreasing access to sugar-sweetened beverages in schools. When
constructing urban environments, efforts have been made to increase access to parks and to develop
pedestrian routes.
Many countries and groups have published reports pertaining to obesity. In 1998 the first US Federal
guidelines were published, titled "Clinical Guidelines on the Identification, Evaluation, and Treatment
of Overweight and Obesity in Adults: The Evidence Report". In 2006 the Canadian Obesity Network
published the "Canadian Clinical Practice Guidelines (CPG) on the Management and Prevention of
Obesity in Adults and Children". This is a comprehensive evidence-based guideline to address the
management and prevention of overweight and obesity in adults and children.
In 2004, the United Kingdom Royal College of Physicians, the Faculty of Public Health and the Royal
College of Pediatrics and Child Health released the report "Storing up Problems", which highlighted
the growing problem of obesity in the UK. The same year, the House of Commons Health Select
Committee published its "most comprehensive inquiry [...] ever undertaken" into the impact of
obesity on health and society in the UK and possible approaches to the problem.
In 2006, the National Institute for Health and Clinical Excellence (NICE) issued a guideline on the
diagnosis and management of obesity, as well as policy implications for non-healthcare organizations
such as local councils. A 2007 report produced by Sir Derek Wanless for the King's Fund warned that
unless further action was taken, obesity had the capacity to cripple the National Health Service
financially.
Comprehensive approaches are being looked at to address the rising rates of obesity. The Obesity
Policy Action (OPA) framework divides measure into 'upstream' policies, 'midstream' policies,
'downstream' policies. 'Upstream' policies look at changing society, 'midstream' policies try to alter
individuals' behavior to prevent obesity, and 'downstream' policies try to treat currently afflicted
people.

Management
Orlistat (Xenical), the most commonly used medication to treat obesity,

andsibutramine (Meridia), a recently withdrawn medication due to
cardiovascular side effects
The main treatment for obesity consists of dieting and physical exercise. Diet programs may produce
weight loss over the short term, but maintaining this weight loss is frequently difficult and often
requires making exercise and a lower food energy diet a permanent part of a person's lifestyle. Success
rates of long-term weight loss maintenance with lifestyle changes are low, ranging from 2– 20%.
Dietary and lifestyle changes are effective in limiting excessive weight gain in pregnancy and improve
outcomes for both the mother and the child.
One medication, orlistat (Xenical), is current widely available and approved for long term use. Weight
loss however is modest with an average of 2.9 kg (6.4 lb) at 1 to 4 years and there is little information
on how these drugs affect longer-term complications of obesity. Its use is associated with high rates
of gastrointestinal side effects and concerns have been raised about negative effects on the kidneys.
Two other medications are also available. Lorcaserin (Belviq) results in an average
3.1 kg weight loss (3% of body mass) greater than placebo over a year. A combination of phentermine
and topiramate (Qsymia) is also somewhat effective.
The most effective treatment for obesity is bariatric surgery. Surgery for severe obesity is associated
with long-term weight loss and decreased overall mortality. One study found a weight loss of between
14% and 25% (depending on the type of procedure performed) at 10 years, and a 29% reduction in all
cause mortality when compared to standard weight loss measures. However, due to its cost and the
risk of complications, researchers are searching for other effective yet less invasive treatments

Systems Thinking
Health Systems:
Obesity Epidemic
Session 3-
Part 2

As societies become increasingly reliant on energy-dense, big-portions, and fast-food meals, the
association between fast-food consumption and obesity becomes more concerning. In the United
States consumption of fast-food meals tripled and food energy intake from these meals quadrupled
between 1977 and 1995.
Agricultural policy and techniques in the United States and Europe have led to lower food prices. In
the United States, subsidization of corn, soy, wheat, and rice through the U.S. farm bill has made the
main sources of processed food cheap compared to fruits and vegetables.
Obese people consistently under-report their food consumption as compared to people of normal
weight. This is supported both by tests of people carried out in a calorimeter room and by direct
observation.
Sedentary lifestyle
A sedentary lifestyle plays a significant role in obesity. Worldwide there has been a large shift towards
less physically demanding work, and currently at least 30% of the world's population gets insufficient
exercise. This is primarily due to increasing use of mechanized transportation and a greater prevalence
of labor-saving technology in the home. In children, there appear to be declines in levels of physical
activity due to less walking and physical education. World trends in active leisure time physical activity
are less clear. The World Health Organization indicates people worldwide are taking up less active
recreational pursuits, while a study from Finland found an increase and a study from the United States
found leisure-time physical activity has not changed significantly.
In both children and adults, there is an association between television viewing time and the risk of
obesity. A review found 63 of 73 studies (86%) showed an increased rate of childhood obesity with
increased media exposure, with rates increasing proportionally to time spent watching television.
Genetics
Like many other medical conditions, obesity is the result of an interplay

between genetic and environmental factors. Polymorphisms in various
genes controlling appetite and metabolism predispose to obesity when
sufficient food energy present. As of 2006, more than 41 of these sites on
the human genome have been linked to the development of obesity when
a favorable environment is present. People with two copies of the FTO gene
(fat mass and obesity associated gene) have been found on average to
weigh 3–4 kg more and have a 1.67-fold greater risk of obesity compared
with those without the risk allele. The percentage of obesity that can be
attributed to genetics varies, depending on the population examined, from
6% to 85%.
A 1680 painting by Juan Carreno de Miranda of a girl presumed to have Prader–

Willi syndrome (right)

Obesity is a major feature in several syndromes, such as Prader-Willi syndrome, Bardet-Biedl
syndrome, Cohen syndrome, and MOMO syndrome. (The term "non-syndromic obesity" is sometimes
used to exclude these conditions.) In people with early-onset severe obesity (defined by an onset
before 10 years of age and body mass index over three standard deviations above normal), 7% harbor
a single point DNA mutation.
Studies that have focused on inheritance patterns rather than on specific genes have found that 80%
of the offspring of two obese parents were also obese, in contrast to less than 10% of the offspring of
two parents who were of normal weight
The thrifty gene hypothesis postulates that, due to dietary scarcity during human evolution, people
are prone to obesity. Their ability to take advantage of rare periods of abundance by storing energy
as fat would be advantageous during times of varying food availability, and individuals with greater
adipose reserves would be more likely to survive famine. This tendency to store fat, however, would
be maladaptive in societies with stable food supplies. This theory has received various criticisms, and
other evolutionarily-based theories such as the drifty gene hypothesis and the thrifty phenotype
hypothesis have also been proposed.
Other illnesses
Certain physical and mental illnesses and the pharmaceutical substances used to treat them can
increase risk of obesity. Medical illnesses that increase obesity risk include several rare genetic
syndromes (listed above) as well as some congenital or acquired conditions: hypothyroidism,
Cushing's syndrome, growth hormone deficiency, and the eating disorders: binge eating disorder and
night eating syndrome. However, obesity is not regarded as a psychiatric disorder, and therefore is
not listed in the DSM-IVR as a psychiatric illness. The risk of overweight and obesity is higher in
patients with psychiatric disorders than in persons without psychiatric disorders.
Certain medications may cause weight gain or changes in body composition; these include insulin,
sulfonylureas, thiazolidinediones, atypical antipsychotics, antidepressants, steroids, certain
anticonvulsants (phenytoin and valproate) , pizotifen, and some forms of hormonal contraception.
Social determinants
The disease scroll (Yamai no soshi, late 12th century) depicts a
woman moneylender with obesity, considered a disease of the rich.
While genetic influences are important to understanding

obesity, they cannot explain the current dramatic increase
seen within specific countries or globally.
Though it is accepted that energy consumption in excess of

energy expenditure leads to obesity on an individual basis, the
cause of the shifts in these two factors on the societal scale is
much debated. There are a number of theories as to the cause
but most believe it is a combination of various factors.

The correlation between social class and BMI varies globally. A review in 1989 found that in developed
countries women of a high social class were less likely to be obese. No significant differences were
seen among men of different social classes. In the developing world, women, men, and children from
high social classes had greater rates of obesity. An update of this review carried out in 2007 found the
same relationships, but they were weaker. The decrease in strength of correlation was felt to be due
to the effects of globalization. Among developed countries, levels of adult obesity, and percentage of
teenage children who are overweight, are correlated with income inequality. A similar relationship is
seen among US states: more adults, even in higher social classes, are obese in more unequal states.
Many explanations have been put forth for associations between BMI and social class. It is thought
that in developed countries, the wealthy are able to afford more nutritious food, they are under
greater social pressure to remain slim, and have more opportunities along with greater expectations
for physical fitness. In undeveloped countries the ability to afford food, high energy expenditure with
physical labor, and cultural values favoring a larger body size are believed to contribute to the
observed patterns. Attitudes toward body mass held by people in one's life may also play a role in
obesity. A correlation in BMI changes over time has been found among friends, siblings, and spouses.
Stress and perceived low social status, appear to increase risk of obesity.
Smoking has a significant effect on an individual's weight. Those who quit smoking gain an average of
4.4 kilograms (9.7 lb) for men and 5.0 kilograms (11.0 lb) for women over ten years. However,
changing rates of smoking have had little effect on the overall rates of obesity.
In the United States the number of children a person has is related to their risk of obesity. A woman's
risk increases by 7% per child, while a man's risk increases by 4% per child. This could be partly
explained by the fact that having dependent children decreases physical activity in Western parents.
In the developing world urbanization is playing a role in increasing rate of obesity. In China overall
rates of obesity are below 5%; however, in some cities rates of obesity are greater than 20%.
Malnutrition in early life is believed to play a role in the rising rates of obesity in the developing world.
Endocrine changes that occur during periods of malnutrition may promote the storage of fat once
more food energy becomes available.
Consistent with cognitive epidemiological data, numerous studies confirm that obesity is associated
with cognitive deficits. Whether obesity causes cognitive deficits, or vice versa is unclear at present.
Infectious agents
The study of the effect of infectious agents on metabolism is still in its early stages. Gut flora has been
shown to differ between lean and obese humans. There is an indication that gut flora in obese and
lean individuals can affect the metabolic potential. This apparent alteration of the metabolic potential
is believed to confer a greater capacity to harvest energy contributing to obesity. Whether these
differences are the direct cause or the result of obesity has yet to be determined unequivocally.

An association between viruses and obesity has been found in humans and several different animal
species. The amount that these associations may have contributed to the rising rate of obesity is yet
to be determined.
Pathophysiology
A comparison of a mouse unable to produce leptin thus resulting in
obesity (left) and a normal mouse (right)
Flier summarizes the many possible pathophysiological

mechanisms involved in the development and maintenance of
obesity. This field of research had been almost unapproached until
leptin was discovered in 1994. Since this discovery, many other
hormonal mechanisms have been elucidated that participate in
the regulation of appetite and food intake, storage
patterns of adipose tissue, and development of insulin resistance. Since leptin's discovery, ghrelin,
insulin, orexin, PYY 3-36, cholecystokinin, adiponectin, as well as many other mediators have been
studied. The adipokines are mediators produced by adipose tissue; their action is thought to modify
many obesity-related diseases.
Leptin and ghrelin are considered to be complementary in their influence on appetite, with ghrelin
produced by the stomach modulating short-term appetitive control (i.e. to eat when the stomach is
empty and to stop when the stomach is stretched). Leptin is produced by adipose tissue to signal fat
storage reserves in the body, and mediates long-term appetitive controls (i.e. to eat more when fat
storages are low and less when fat storages are high). Although administration of leptin may be
effective in a small subset of obese individuals who are leptin deficient, most obese individuals are
thought to be leptin resistant and have been found to have high levels of leptin. This resistance is
thought to explain in part why administration of leptin has not been shown to be effective in
suppressing appetite in most obese people.
On the left is a graphic depiction of a leptin molecule
While leptin and ghrelin are produced peripherally, they

control appetite through their actions on the central nervous
system. In particular, they and other appetite-related
hormones act on the hypothalamus, a region of the brain
central to the regulation of food intake and energy
expenditure. There are several circuits within the
hypothalamus that contribute to its role in integrating
appetite, the melanocortin pathway being the most well
understood. The circuit begins with an area of the hypothalamus, the arcuate nucleus, that has
outputs to the lateral hypothalamus (LH) and ventromedial hypothalamus (VMH), the brain's feeding
and satiety centers, respectively.
The arcuate nucleus contains two distinct groups of neurons. The first group coexpresses
neuropeptide Y (NPY) and agouti-related peptide (AgRP) and has stimulatory inputs to the LH and
inhibitory inputs to the VMH. The second group coexpresses pro-opiomelanocortin (POMC) and
cocaine- and amphetamine-regulated transcript (CART) and has stimulatory inputs to the VMH and
inhibitory inputs to the LH. Consequently, NPY/AgRP neurons stimulate feeding and inhibit satiety,
while POMC/CART neurons stimulate satiety and inhibit feeding. Both groups of arcuate nucleus
neurons are regulated in part by leptin. Leptin inhibits the NPY/AgRP group while stimulating the
POMC/CART group. Thus a deficiency in leptin signaling, both via leptin deficiency or leptin resistance,
leads to over feeding and may account for some genetic and acquired forms of obesity.
Public health
The World Health Organization (WHO) predicts that overweight and obesity may soon replace more
traditional public health concerns such as under nutrition and infectious diseases as the most
significant cause of poor health. Obesity is a public health and policy problem because of its
prevalence, costs, and health effects. The United States Preventive Services Task Force recommends
screening for all adults followed by behavioral interventions in those who are obese. Public health
efforts seek to understand and correct the environmental factors responsible for the increasing
prevalence of obesity in the population.
Solutions look at changing the factors that cause excess food energy consumption and inhibit physical
activity. Efforts include federally reimbursed meal programs in schools, limiting direct junk food
marketing to children, and decreasing access to sugar-sweetened beverages in schools. When
constructing urban environments, efforts have been made to increase access to parks and to develop
pedestrian routes.
Many countries and groups have published reports pertaining to obesity. In 1998 the first US Federal
guidelines were published, titled "Clinical Guidelines on the Identification, Evaluation, and Treatment
of Overweight and Obesity in Adults: The Evidence Report". In 2006 the Canadian Obesity Network
published the "Canadian Clinical Practice Guidelines (CPG) on the Management and Prevention of
Obesity in Adults and Children". This is a comprehensive evidence-based guideline to address the
management and prevention of overweight and obesity in adults and children.
In 2004, the United Kingdom Royal College of Physicians, the Faculty of Public Health and the Royal
College of Pediatrics and Child Health released the report "Storing up Problems", which highlighted
the growing problem of obesity in the UK. The same year, the House of Commons Health Select
Committee published its "most comprehensive inquiry [...] ever undertaken" into the impact of
obesity on health and society in the UK and possible approaches to the problem.
In 2006, the National Institute for Health and Clinical Excellence (NICE) issued a guideline on the
diagnosis and management of obesity, as well as policy implications for non-healthcare organizations
such as local councils. A 2007 report produced by Sir Derek Wanless for the King's Fund warned that
unless further action was taken, obesity had the capacity to cripple the National Health Service
financially.
Comprehensive approaches are being looked at to address the rising rates of obesity. The Obesity
Policy Action (OPA) framework divides measure into 'upstream' policies, 'midstream' policies,
'downstream' policies. 'Upstream' policies look at changing society, 'midstream' policies try to alter
individuals' behavior to prevent obesity, and 'downstream' policies try to treat currently afflicted
people.

Management
Orlistat (Xenical), the most commonly used medication to treat obesity,

andsibutramine (Meridia), a recently withdrawn medication due to
cardiovascular side effects
The main treatment for obesity consists of dieting and physical exercise. Diet programs may produce
weight loss over the short term, but maintaining this weight loss is frequently difficult and often
requires making exercise and a lower food energy diet a permanent part of a person's lifestyle. Success
rates of long-term weight loss maintenance with lifestyle changes are low, ranging from 2– 20%.
Dietary and lifestyle changes are effective in limiting excessive weight gain in pregnancy and improve
outcomes for both the mother and the child.
One medication, orlistat (Xenical), is current widely available and approved for long term use. Weight
loss however is modest with an average of 2.9 kg (6.4 lb) at 1 to 4 years and there is little information
on how these drugs affect longer-term complications of obesity. Its use is associated with high rates
of gastrointestinal side effects and concerns have been raised about negative effects on the kidneys.
Two other medications are also available. Lorcaserin (Belviq) results in an average
3.1 kg weight loss (3% of body mass) greater than placebo over a year. A combination of phentermine
and topiramate (Qsymia) is also somewhat effective.
The most effective treatment for obesity is bariatric surgery. Surgery for severe obesity is associated
with long-term weight loss and decreased overall mortality. One study found a weight loss of between
14% and 25% (depending on the type of procedure performed) at 10 years, and a 29% reduction in all
cause mortality when compared to standard weight loss measures. However, due to its cost and the
risk of complications, researchers are searching for other effective yet less invasive treatments

Systems Thinking
Economic Systems:
Great Depression
Session 4-
Part 1
Dorothea Lange's Migrant Mother depicts destitute pea

pickers in California, centering on Florence Owens
Thompson, age 32, a mother of seven children, in Nipomo,
California, March 1936.
OVERVIEW
The Great Depression was a severe worldwide
economic depression in the decade preceding World
War II. The timing of the Great Depression varied across
nations, but in most countries it started in 1930 and
lasted until the late 1930s or middle 1940s. It was the
longest, most widespread, and deepest depression of
the 20th century.
USA annual real GDP from 1910–60, with the years The unemployment rate in the US 1910–1960, with
of the Great Depression (1929–1939) highlighted. the years of the Great Depression (1929– 1939)
highlighted.
In the 21st century, the Great Depression is commonly used as an example of how far the world's
economy can decline. The depression originated in the U.S., after the fall in stock prices that began
around September 4, 1929, and became worldwide news with the stock market crash of October 29,
1929 (known as Black Tuesday).

Economic Systems: Great Depression
The Great Depression had devastating effects in countries rich and poor. Personal income, tax
revenue, profits and prices dropped, while international trade plunged by more than 50%.
Unemployment in the U.S. rose to 25% and in some countries rose as high as 33%.
Cities all around the world were hit hard, especially those dependent on heavy industry. Construction
was virtually halted in many countries. Farming and rural areas suffered as crop prices fell by
approximately 60%. Facing plummeting demand with few alternate sources of jobs, areas dependent
on primary sector industries such as cash cropping, mining and logging suffered the most.
Some economies started to recover by the mid-1930s. In many countries, the negative effects of the
Great Depression lasted until the end of World War II.
Start of the Great Depression
The Dow Jones Industrial, 1928–1930.
Economic historians usually attribute the start of the Great Depression to the sudden devastating
collapse of US stock market prices on October 29, 1929, known as Black Tuesday; some dispute this
conclusion, and see the stock crash as a symptom, rather than a cause, of the Great Depression.
Even after the Wall Street Crash of 1929, optimism persisted for some time; John D. Rockefeller said
that "These are days when many are discouraged. In the 93 years of my life, depressions have come
and gone. Prosperity has always returned and will again." The stock market turned upward in early
1930, returning to early 1929 levels by April. This was still almost 30% below the peak of September
1929.
Together, government and business spent more in the first half of 1930 than in the corresponding
period of the previous year. On the other hand, consumers, many of whom had suffered severe losses
in the stock market the previous year, cut back their expenditures by ten percent. Likewise, beginning
in mid-1930, a severe drought ravaged the agricultural heartland of the US.

By mid-1930, interest rates had dropped to low levels, but expected deflation and the continuing
reluctance of people to borrow meant that consumer spending and investment were depressed. By
May 1930, automobile sales had declined to below the levels of 1928. Prices in general began to
decline, although wages held steady in 1930; but then a deflationary spiral started in 1931. Conditions
were worse in farming areas, where commodity prices plunged, and in mining and logging areas,
where unemployment was high and there were few other jobs.
The decline in the US economy was the factor that pulled down most other countries at first, then
internal weaknesses or strengths in each country made conditions worse or better. Frantic attempts
to shore up the economies of individual nations through protectionist policies, such as the 1930 U.S.
Smoot–Hawley Tariff Act and retaliatory tariffs in other countries, exacerbated the collapse in global
trade. By late 1930, a steady decline in the world economy had set in, which did not reach bottom
until 1933.
Economic indicators
Change in economic indicators 1929–32

United States Great Britain France Germany
Industrial production –46% –23% –24% –41%
Wholesale prices –32% –33% –34% –29%
Foreign trade –70% –60% –54% –61%
Unemployment +607% +129% +214% +232%
Causes
There were multiple causes for the first downturn in 1929. These include the structural weaknesses
and specific events that turned it into a major depression and the manner in which the downturn
spread from country to country.
In relation to the 1929 downturn, historians emphasize structural factors like major bank failures and
the stock market crash. In contrast, monetarist economists (such as Barry Eichengreen, Milton
Friedman and Peter Temin) point to monetary factors such as actions by the US Federal Reserve that
contracted the money supply, as well as Britain's decision to return to the gold standard at pre– World
War I parities (US$4.86:£1).

Crowd gathering at the intersection of Wall Street
and Broad Street after the 1929 crash.
Recessions and business cycles are thought to be a normal part of living in a world of inexact balances
between supply and demand. What turns a normal recession or 'ordinary' business cycle into a
depression is a subject of much debate and concern. Scholars have not agreed on the exact causes
and their relative importance. The search for causes is closely connected to the issue of avoiding
future depressions.
Thus, the personal political and policy viewpoints of scholars greatly color their analysis of historic
events occurring eight decades ago. An even larger question is whether the Great Depression was
primarily a failure on the part of free markets or a failure of government efforts to regulate interest
rates, curtail widespread bank failures, and control the money supply. Those who believe in a larger
economic role for the state believe that it was primarily a failure of free markets, while those who
believe in a smaller role for the state believe that it was primarily a failure of government that
compounded the problem.
Current theories may be broadly classified into two main points of view and several heterodox points
of view. There are demand-driven theories, most importantly Keynesian economics, but also including
those who point to the breakdown of international trade, and Institutional economists who point to
under consumption and over-investment (causing an economic bubble), malfeasance by bankers and
industrialists, or incompetence by government officials. The consensus among demand-driven
theories is that a large-scale loss of confidence led to a sudden reduction in consumption and
investment spending.
Once panic and deflation set in, many people believed they could avoid further losses by keeping clear
of the markets. Holding money became profitable as prices dropped lower and a given amount of
money bought ever more goods, exacerbating the drop in demand.
There are the monetarists, who believe that the Great Depression started as an ordinary recession,
but that significant policy mistakes by monetary authorities (especially the Federal Reserve), caused
a shrinking of the money supply which greatly exacerbated the economic situation, causing a
recession to descend into the Great Depression. Related to this explanation are those who point to
debt deflation causing those who borrow to owe ever more in real terms.
There are also various heterodox theories that downplay or reject the explanations of the Keynesians
and monetarists. For example, some new classical macroeconomists have argued that various labor
market policies imposed at the start caused the length and severity of the Great Depression. The
Austrian school of economics focuses on the macroeconomic effects of money supply, and how
central banking decisions can lead to over-investment (economic bubble).
Demand-driven
Keynesian
British economist John Maynard Keynes argued in General Theory of Employment Interest and Money
that lower aggregate expenditures in the economy contributed to a massive decline in income and to
employment that was well below the average. In such a situation, the economy reached equilibrium
at low levels of economic activity and high unemployment.
Keynes' basic idea was simple: to keep people fully employed, governments have to run deficits when
the economy is slowing, as the private sector would not invest enough to keep production at the
normal level and bring the economy out of recession. Keynesian economists called on governments
during times of economic crisis to pick up the slack by increasing government spending and/or cutting
taxes.
US industrial production (1928–39) US Farm Prices, (1928–35)
As the Depression wore on, Franklin D. Roosevelt tried public works, farm subsidies, and other devices
to restart the US economy, but never completely gave up trying to balance the budget. According to
the Keynesians, this improved the economy, but Roosevelt never spent enough to bring the economy
out of recession until the start of World War II.[15]

Systems Thinking
Economic Systems:
Great Depression
Session 4-
Part 1
Exclusive property of IBPAP. This material or any portions thereof may not be copied, reproduced or distributed in any manner and for
any purpose without the prior written approval of IBPAP.

Breakdown of international trade
Many economists have argued that the sharp decline in international trade after 1930 helped to
worsen the depression, especially for countries significantly dependent on foreign trade. Most
historians and economists partly blame the American Smoot-Hawley Tariff Act (enacted June 17,
1930) for worsening the depression by seriously reducing international trade and causing retaliatory
tariffs in other countries. While foreign trade was a small part of overall economic activity in the U.S.
and was concentrated in a few businesses like farming, it was a much larger factor in many other
countries. The average ad valorem rate of duties on dutiable imports for 1921–1925 was 25.9% but
under the new tariff it jumped to 50% in 1931–1935.
In dollar terms, American exports declined from about $5.2 billion in 1929 to $1.7 billion in 1933; but
prices also fell, so the physical volume of exports only fell by half. Hardest hit were farm commodities
such as wheat, cotton, tobacco, and lumber. According to this theory, the collapse of farm exports
caused many American farmers to default on their loans, leading to the bank runs on small rural banks
that characterized the early years of the Great Depression.
Debt deflation Irving Fisher argued that the predominant factor leading to the Great Depression was
over-indebtedness and deflation. Fisher tied loose credit to over-indebtedness, which fueled
speculation and asset bubbles. He then outlined 9 factors interacting with one another under
conditions of debt and deflation to create the mechanics of boom to bust. The chain of events
proceeded as follows:
• Debt liquidation and distress selling
• Contraction of the money supply as bank loans are paid off
• A fall in the level of asset prices
• A still greater fall in the net worth’s of business, precipitating bankruptcies
• A fall in profits
• A reduction in output, in trade and in employment.
• Pessimism and loss of confidence
• Hoarding of money
• A fall in nominal interest rates and a rise in deflation adjusted interest rates.
Crowds outside the Bank of United States in New

York after its failure in 1931.
During the Crash of 1929 preceding the Great Depression, margin requirements were only 10%.[18]
Brokerage firms, in other words, would lend $9 for every $1 an investor had deposited. When the
market fell, brokers called in these loans, which could not be paid back.
Banks began to fail as debtors defaulted on debt and depositors attempted to withdraw their deposits
en masse, triggering multiple bank runs. Government guarantees and Federal Reserve

banking regulations to prevent such panics were ineffective or not used. Bank failures led to the loss
of billions of dollars in assets.
Outstanding debts became heavier, because prices and incomes fell by 20–50% but the debts
remained at the same dollar amount. After the panic of 1929, and during the first 10 months of 1930,
744 US banks failed. (In all, 9,000 banks failed during the 1930s). By April 1933, around $7 billion in
deposits had been frozen in failed banks or those left unlicensed after the March Bank Holiday.
Bank failures snowballed as desperate bankers called in loans which the borrowers did not have time
or money to repay. With future profits looking poor, capital investment and construction slowed or
completely ceased. In the face of bad loans and worsening future prospects, the surviving banks
became even more conservative in their lending. Banks built up their capital reserves and made fewer
loans, which intensified deflationary pressures. A vicious cycle developed and the downward spiral
accelerated.
The liquidation of debt could not keep up with the fall of prices which it caused. The mass effect of
the stampede to liquidate increased the value of each dollar owed, relative to the value of declining
asset holdings. The very effort of individuals to lessen their burden of debt effectively increased it.
Paradoxically, the more the debtors paid, the more they owed. This self-aggravating process turned a
1930 recession into a 1933 great depression.
Macroeconomists including Ben Bernanke, the current chairman of the U.S. Federal Reserve Bank,
have revived the debt-deflation view of the Great Depression originated by Fisher.
Monetarist
Crowd at New York's American Union Bank during

a bank run early in the Great Depression.
Monetarists, including Milton Friedman, argue that the Great Depression was mainly caused by
monetary contraction, the consequence of poor policy-making by the American Federal Reserve
System and continued crisis in the banking system. In this view, the Federal Reserve, by not acting,
allowed the money supply as measured by the M2 to shrink by one-third from 1929–1933, thereby
transforming a normal recession into the Great Depression. Friedman argued that the downward turn
in the economy, starting with the stock market crash, would have been just another recession.

The Federal Reserve allowed some large public bank failures – particularly that of the New York Bank
of the United States – which produced panic and widespread runs on local banks, and the Federal
Reserve sat idly by while banks collapsed. He claimed that, if the Fed had provided emergency lending
to these key banks, or simply bought government bonds on the open market to provide liquidity and
increase the quantity of money after the key banks fell, all the rest of the banks would not have fallen
after the large ones did, and the money supply would not have fallen as far and as fast as it did.
With significantly less money to go around, businessmen could not get new loans and could not even
get their old loans renewed, forcing many to stop investing. This interpretation blames the Federal
Reserve for inaction, especially the New York branch.
One reason why the Federal Reserve did not act to limit the decline of the money supply was
regulation. At that time, the amount of credit the Federal Reserve could issue was limited by the
Federal Reserve Act, which required 40% gold backing of Federal Reserve Notes issued. By the late
1920s, the Federal Reserve had almost hit the limit of allowable credit that could be backed by the
gold in its possession. This credit was in the form of Federal Reserve demand notes.
A "promise of gold" is not as good as "gold in the hand", particularly when they only had enough gold
to cover 40% of the Federal Reserve Notes outstanding. During the bank panics a portion of those
demand notes were redeemed for Federal Reserve gold. Since the Federal Reserve had hit its limit on
allowable credit, any reduction in gold in its vaults had to be accompanied by a greater reduction in
credit. On April 5, 1933, President Roosevelt signed Executive Order 6102 making the private
ownership of gold certificates, coins and bullion illegal, reducing the pressure on Federal Reserve gold.
New classical approach
Recent work from a neoclassical perspective focuses on the decline in productivity that caused the
initial decline in output and a prolonged recovery due to policies that affected the labor market. This
work, collected by Kehoe and Prescott, decomposes the economic decline into a decline in the labor
force, capital stock, and the productivity with which these inputs are used.
This study suggests that theories of the Great Depression have to explain an initial severe decline but
rapid recovery in productivity, relatively little change in the capital stock, and a prolonged depression
in the labor force. This analysis rejects theories that focus on the role of savings and posit a decline in
the capital stock.
Austrian School
Another explanation comes from the Austrian School of economics. Theorists of the "Austrian School"
who wrote about the Depression include Austrian economist Friedrich Hayek and American economist
Murray Rothbard, who wrote America's Great Depression (1963). In their view and like the
monetarists, the Federal Reserve, which was created in 1913, shoulders much of the blame; but in
opposition to the monetarists, they argue that the key cause of the Depression was the expansion of
the money supply in the 1920s that led to an unsustainable credit-driven boom.

In the Austrian view it was this inflation of the money supply that led to an unsustainable boom in
both asset prices (stocks and bonds) and capital goods. By the time the Fed belatedly tightened in
1928, it was far too late and, in the Austrian view, a significant economic contraction was inevitable.
According to the Austrians, the artificial interference in the economy was a disaster prior to the
Depression, and government efforts to prop up the economy after the crash of 1929 only made things
worse.
According to Rothbard, government intervention delayed the market's adjustment and made the road
to complete recovery more difficult. However, Hayek, unlike Rothbard, also believed, along with the
monetarists, that the Federal Reserve further contributed to the problems of the Depression by
permitting the money supply to shrink during the earliest years of the Depression.
Marxist
Karl Marx saw recession and depression as unavoidable under free-market capitalism as there are no
restrictions on accumulations of capital other than the market itself. In the Marxist view, capitalism
tends to create unbalanced accumulations of wealth, leading to over-accumulations of capital which
inevitably lead to a crisis. This especially sharp bust is a regular feature of the boom and bust pattern
of what Marxists term "chaotic" capitalist development. It is a tenet of many Marxist groupings that
such crises are inevitable and will be increasingly severe until the contradictions inherent in the
mismatch between the mode of production and the development of productive forces reach the final
point of failure. At which point the crisis period encourages intensified class conflict and forces societal
change.
Inequality
Power farming displaces tenants from the land in

the western dry cotton area. Childress County,
Texas, 1938.
Two economists of the 1920s, Waddill Catchings and William Trufant Foster, popularized a theory that
influenced many policy makers, including Herbert Hoover, Henry A. Wallace, Paul Douglas, and
Marriner Eccles. It held the economy produced more than it consumed, because the consumers did
not have enough income. Thus the unequal distribution of wealth throughout the 1920s caused the
Great Depression.
According to this view, the root cause of the Great Depression was a global over-investment in heavy
industry capacity compared to wages and earnings from independent businesses, such as farms. The
solution was the government must pump money into consumers' pockets. That is, it must

redistribute purchasing power, maintain the industrial base, but re-inflate prices and wages to force
as much of the inflationary increase in purchasing power into consumer spending. The economy was
overbuilt, and new factories were not needed. Foster and Catchings recommended federal and state
governments start large construction projects, a program followed by Hoover and Roosevelt.
Productivity shock
“It cannot be emphasized too strongly that the [productivity, output and employment] trends we
are describing are long-time trends and were thoroughly evident prior to 1929. These trends are in
nowise the result of the present depression, nor are they the result of the World War. On the contrary,
the present depression is a collapse resulting from these long-term trends.” -M. King Hubbert.
The first three decades of the 20th century saw economic output surge with electrification, mass
production and motorized farm machinery, and because of the rapid growth in productivity there was
a lot of excess production capacity and the work week was being reduced.
The dramatic rise in productivity of major industries in the U. S. and the effects of productivity on
output, wages and the work week are discussed by Spurgeon Bell in his book Productivity, Wages, and
National Income (1940).

Systems Thinking
Economic Systems:
Great Depression
Session 4-
Part 1
Dorothea Lange's Migrant Mother depicts destitute pea

pickers in California, centering on Florence Owens
Thompson, age 32, a mother of seven children, in Nipomo,
California, March 1936.
OVERVIEW
The Great Depression was a severe worldwide
economic depression in the decade preceding World
War II. The timing of the Great Depression varied across
nations, but in most countries it started in 1930 and
lasted until the late 1930s or middle 1940s. It was the
longest, most widespread, and deepest depression of
the 20th century.
USA annual real GDP from 1910–60, with the years The unemployment rate in the US 1910–1960, with
of the Great Depression (1929–1939) highlighted. the years of the Great Depression (1929– 1939)
highlighted.
In the 21st century, the Great Depression is commonly used as an example of how far the world's
economy can decline. The depression originated in the U.S., after the fall in stock prices that began
around September 4, 1929, and became worldwide news with the stock market crash of October 29,
1929 (known as Black Tuesday).

The Great Depression had devastating effects in countries rich and poor. Personal income, tax
revenue, profits and prices dropped, while international trade plunged by more than 50%.
Unemployment in the U.S. rose to 25% and in some countries rose as high as 33%.
Cities all around the world were hit hard, especially those dependent on heavy industry. Construction
was virtually halted in many countries. Farming and rural areas suffered as crop prices fell by
approximately 60%. Facing plummeting demand with few alternate sources of jobs, areas dependent
on primary sector industries such as cash cropping, mining and logging suffered the most.
Some economies started to recover by the mid-1930s. In many countries, the negative effects of the
Great Depression lasted until the end of World War II.
Start of the Great Depression
The Dow Jones Industrial, 1928–1930.
Economic historians usually attribute the start of the Great Depression to the sudden devastating
collapse of US stock market prices on October 29, 1929, known as Black Tuesday; some dispute this
conclusion, and see the stock crash as a symptom, rather than a cause, of the Great Depression.
Even after the Wall Street Crash of 1929, optimism persisted for some time; John D. Rockefeller said
that "These are days when many are discouraged. In the 93 years of my life, depressions have come
and gone. Prosperity has always returned and will again." The stock market turned upward in early
1930, returning to early 1929 levels by April. This was still almost 30% below the peak of September
1929.
Together, government and business spent more in the first half of 1930 than in the corresponding
period of the previous year. On the other hand, consumers, many of whom had suffered severe losses
in the stock market the previous year, cut back their expenditures by ten percent. Likewise, beginning
in mid-1930, a severe drought ravaged the agricultural heartland of the US.

By mid-1930, interest rates had dropped to low levels, but expected deflation and the continuing
reluctance of people to borrow meant that consumer spending and investment were depressed. By
May 1930, automobile sales had declined to below the levels of 1928. Prices in general began to
decline, although wages held steady in 1930; but then a deflationary spiral started in 1931. Conditions
were worse in farming areas, where commodity prices plunged, and in mining and logging areas,
where unemployment was high and there were few other jobs.
The decline in the US economy was the factor that pulled down most other countries at first, then
internal weaknesses or strengths in each country made conditions worse or better. Frantic attempts
to shore up the economies of individual nations through protectionist policies, such as the 1930 U.S.
Smoot–Hawley Tariff Act and retaliatory tariffs in other countries, exacerbated the collapse in global
trade. By late 1930, a steady decline in the world economy had set in, which did not reach bottom
until 1933.
Economic indicators
Change in economic indicators 1929–32

United States Great Britain France Germany
Industrial production –46% –23% –24% –41%
Wholesale prices –32% –33% –34% –29%
Foreign trade –70% –60% –54% –61%
Unemployment +607% +129% +214% +232%
Causes
There were multiple causes for the first downturn in 1929. These include the structural weaknesses
and specific events that turned it into a major depression and the manner in which the downturn
spread from country to country.
In relation to the 1929 downturn, historians emphasize structural factors like major bank failures and
the stock market crash. In contrast, monetarist economists (such as Barry Eichengreen, Milton
Friedman and Peter Temin) point to monetary factors such as actions by the US Federal Reserve that
contracted the money supply, as well as Britain's decision to return to the gold standard at pre– World
War I parities (US$4.86:£1).

Crowd gathering at the intersection of Wall Street
and Broad Street after the 1929 crash.
Recessions and business cycles are thought to be a normal part of living in a world of inexact balances
between supply and demand. What turns a normal recession or 'ordinary' business cycle into a
depression is a subject of much debate and concern. Scholars have not agreed on the exact causes
and their relative importance. The search for causes is closely connected to the issue of avoiding
future depressions.
Thus, the personal political and policy viewpoints of scholars greatly color their analysis of historic
events occurring eight decades ago. An even larger question is whether the Great Depression was
primarily a failure on the part of free markets or a failure of government efforts to regulate interest
rates, curtail widespread bank failures, and control the money supply. Those who believe in a larger
economic role for the state believe that it was primarily a failure of free markets, while those who
believe in a smaller role for the state believe that it was primarily a failure of government that
compounded the problem.
Current theories may be broadly classified into two main points of view and several heterodox points
of view. There are demand-driven theories, most importantly Keynesian economics, but also including
those who point to the breakdown of international trade, and Institutional economists who point to
under consumption and over-investment (causing an economic bubble), malfeasance by bankers and
industrialists, or incompetence by government officials. The consensus among demand-driven
theories is that a large-scale loss of confidence led to a sudden reduction in consumption and
investment spending.
Once panic and deflation set in, many people believed they could avoid further losses by keeping clear
of the markets. Holding money became profitable as prices dropped lower and a given amount of
money bought ever more goods, exacerbating the drop in demand.
There are the monetarists, who believe that the Great Depression started as an ordinary recession,
but that significant policy mistakes by monetary authorities (especially the Federal Reserve), caused
a shrinking of the money supply which greatly exacerbated the economic situation, causing a
recession to descend into the Great Depression. Related to this explanation are those who point to
debt deflation causing those who borrow to owe ever more in real terms.
There are also various heterodox theories that downplay or reject the explanations of the Keynesians
and monetarists. For example, some new classical macroeconomists have argued that various labor
market policies imposed at the start caused the length and severity of the Great Depression. The
Austrian school of economics focuses on the macroeconomic effects of money supply, and how
central banking decisions can lead to over-investment (economic bubble).
Demand-driven
Keynesian
British economist John Maynard Keynes argued in General Theory of Employment Interest and Money
that lower aggregate expenditures in the economy contributed to a massive decline in income and to
employment that was well below the average. In such a situation, the economy reached equilibrium
at low levels of economic activity and high unemployment.
Keynes' basic idea was simple: to keep people fully employed, governments have to run deficits when
the economy is slowing, as the private sector would not invest enough to keep production at the
normal level and bring the economy out of recession. Keynesian economists called on governments
during times of economic crisis to pick up the slack by increasing government spending and/or cutting
taxes.
US industrial production (1928–39) US Farm Prices, (1928–35)
As the Depression wore on, Franklin D. Roosevelt tried public works, farm subsidies, and other devices
to restart the US economy, but never completely gave up trying to balance the budget. According to
the Keynesians, this improved the economy, but Roosevelt never spent enough to bring the economy
out of recession until the start of World War II.[15]

Systems Thinking
Economic Systems:
Great Depression
Session 4-
Part 1



accelerated.
Monetarist


the capital stock.
Austrian School

worse.
Marxist
change.
Inequality

Texas, 1938.
Great Depression.

Productivity shock

Systems Thinking
Economic Systems:
Great Depression
Session 4-
Part 2



accelerated.
Monetarist


the capital stock.
Austrian School

worse.
Marxist
change.
Inequality

Texas, 1938.
Great Depression.

Productivity shock

Systems Thinking
Economic Systems:
Great Depression
Session 4-
Part 2



accelerated.
Monetarist


the capital stock.
Austrian School

worse.
Marxist
change.
Inequality

Texas, 1938.
Great Depression.

Productivity shock

Systems Thinking
Introduction
Session 1-
Part 1
VIDEO PRESENTATION
As a class, develop on the board or manila paper a causal loop diagram, a chain of cause-effect
circular events that influence global warming.
OVERVIEW
System
A schematic representation of a
closed system and its boundary
A system is a set of interacting or interdependent components forming an integrated whole or a set

of elements (often called 'components') and relationships which are different from relationships of
the set or its elements to other elements or sets.
Fields that study the general properties of systems include Systems science, systems theory,
cybernetics, dynamical systems, thermodynamics, and complex systems. They investigate the abstract
properties of systems' matter and organization, looking for concepts and principles that are
independent of domain, substance, type, or temporal scale. Some systems share common
characteristics, including:
A system has structure, it contains parts (or components) that are directly or indirectly related to each
other; A system has behavior, it contains processes that transform inputs into outputs (material,
energy or data).
A system has interconnectivity: the parts and processes are connected by structural and/or behavioral
relationships. A system's structure and behavior may be decomposed via subsystems and sub-
processes to elementary parts and process steps.
The term system may also refer to a set of rules that governs structure and/or behavior. Alternatively,
and usually in the context of complex social systems, the term institution is used to describe the set
of rules that govern structure and/or behavior.

Introduction
Etymology
The term is from the Latin word systēma, in turn from Greek σύστημα systēma, "whole
compounded of several parts or members, system", literary "composition", History
The word system in its meaning here, has a long history which can be traced back to Plato (Philebus),
Aristotle (Politics) and Euclid (Elements). It had meant "total", "crowd" or "union" in even more
ancient times, as it derives from the verb sunìstemi, uniting, putting together. "System" means
"something to look at". You must have a very high visual gradient to have systematization. In
philosophy, before Descartes, there was no "system". Plato had no "system". Aristotle had no
"system". (Marshall McLuhan in: McLuhan: Hot & Cool. Ed. by Gerald Emanuel Stearn. A Signet Book
published by The New American Library, New York, 1967, p. 288).
In the 19th century the first to develop the concept of a "system" in the natural sciences was the
French physicist Nicolas Léonard Sadi Carnot who studied thermodynamics. In 1824 he studied the
system which he called the working substance, i.e. typically a body of water vapor, in steam engines,
in regards to the system's ability to do work when heat is applied to it. The working substance could
be put in contact with either a boiler, a cold reservoir (a stream of cold water), or a piston (to which
the working body could do work by pushing on it). In 1850, the German physicist Rudolf Clausius
generalized this picture to include the concept of the surroundings and began to use the term
"working body" when referring to the system.
One of the pioneers of the general systems theory was the biologist Ludwig von Bertalanffy. In 1945
he introduced models, principles, and laws that apply to generalized systems or their subclasses,
irrespective of their particular kind, the nature of their component elements, and the relation or 'forces'
between them.
Significant development to the concept of a system was done by Norbert Wiener and Ross Ashby who
pioneered the use of mathematics to study systems.
In the 1980s the term complex adaptive system was coined at the interdisciplinary Santa Fe Institute
by John H. Holland, Murray Gell-Mann and others.
Systems thinking is the process of understanding how things, regarded as systems, influence one
another within a whole. In nature, systems thinking examples include ecosystems in which various
elements such as air, water, movement, plants, and animals work together to survive or perish. In
organizations, systems consist of people, structures, and processes that work together to make an
organization "healthy" or "unhealthy".
Systems thinking has been defined as an approach to problem solving, by viewing "problems" as parts
of an overall system, rather than reacting to specific part, outcomes or events and potentially
contributing to further development of unintended consequences. Systems’ thinking is not one
thing but a set of habits or practices within a framework that is based on the belief that the component
parts of a system can best be understood in the context of relationships with each other and with
other systems, rather than in isolation. Systems’ thinking focuses on cyclical rather than linear
cause and effect.

Introduction
In systems science, it is argued that the only way to fully understand why a problem or element occurs
and persists is to understand the parts in relation to the whole. Standing in contrast to Descartes's
scientific reductionism and philosophical analysis, it proposes to view systems in a holistic manner.
Consistent with systems philosophy, systems thinking concerns an understanding of a system by

examining the linkages and interactions between the elements that compose the entirety of the
system.
Systems science thinking attempts to illustrate

how small catalytic events that are separated
by distance and time can be the cause of
significant changes in complex systems.
Acknowledging that an improvement in one
area of a system can adversely affect another
area of the system, it promotes organizational
communication at all levels in order to avoid
the silo effect. Systems thinking techniques
may be used to study any kind of system —
natural, scientific, engineered, human, or
conceptual.

Introduction

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Systems Thinking

From Wikipedia, the free encyclopedia

A system is a set of interacting or interdependent components forming an integrated whole or a set

Systems Thinking Teacher’s Guide Session 1

Systems Thinking Teacher’s Guide Session 1

Consistent with systems philosophy, systems thinking concerns an understanding of a system by

Systems science thinking attempts to illustrate

Systems Thinking Teacher’s Guide Session 1

Systems Thinking Teacher’s Guide Session 1

Example of positive reinforcing loop: Bank

Example of positive reinforcing loop:

Systems Thinking Teacher’s Guide Session 1

Positive and negative causal links

Dynamic causal loop diagram: positive and negative links

Systems Thinking Teacher’s Guide Session 1

Causal loop diagram of Adoption model, used to demonstrate systems dynamics

Systems Thinking Teacher’s Guide Session 1

Alarm or panic can spread by positive feedback

Causal loop diagram that depicts the causes of a

Systems Thinking Teacher’s Guide Session 1

Systems Thinking Teacher’s Guide Session 1

Simple feedback model. The

In biology, this process (generally biochemical) is often referred to as homeostasis; whereas in

In contrast, positive feedback is feedback in which

We are all part of the system!

Systems Thinking Teacher’s Guide Session 1

Systems Thinking Teacher’s Guide Session 1

Example of positive reinforcing loop: Bank

Example of positive reinforcing loop:

Systems Thinking Teacher’s Guide Session 1

Positive and negative causal links

Dynamic causal loop diagram: positive and negative links

Systems Thinking Teacher’s Guide Session 1

Causal loop diagram of Adoption model, used to demonstrate systems dynamics

Systems Thinking Teacher’s Guide Session 1

Alarm or panic can spread by positive feedback

Causal loop diagram that depicts the causes of a

Systems Thinking Teacher’s Guide Session 1

Systems Thinking Teacher’s Guide Session 1

Simple feedback model. The

In biology, this process (generally biochemical) is often referred to as homeostasis; whereas in

In contrast, positive feedback is feedback in which

We are all part of the system!

Systems Thinking Teacher’s Guide Session 1

From Wikipedia, the free encyclopedia

Global mean land-ocean temperature change from 1880–

Fossil fuel related CO2 emissions compared to five of the IPCC's

Systems Thinking Teacher’s Guide Session 2

Observed temperature changes

The increase in ocean heat content is much larger than

Systems Thinking Teacher’s Guide Session 2

The Earth's average surface temperature rose

NOAA graph of Global Annual Temperature Anomalies

Systems Thinking Teacher’s Guide Session 2

From Wikipedia, the free encyclopedia

Global mean land-ocean temperature change from 1880–

Fossil fuel related CO2 emissions compared to five of the IPCC's