When Systems Resist Change: Lessons for Food System Transformation

“Healthcare systems and hospitals are usually inert to most forces that try to get them to change,” observed a former UK government civil servant in a recent study I co-authored examining climate and health policy. “They are built to be incredibly stable and resilient systems, and do a very, very good job of resisting the will of a CEO, a CFO, a health minister, a patient, anything.” This observation could just as easily describe our food systems.

The study—based on interviews with 42 experts across government, healthcare, academia, and civil society—shows how large institutions resist transformation even when the need for change is clear and urgent. Resource constraints, siloed decision-making, and institutional inertia repeatedly block progress to integrating climate and health policies. These same barriers arise consistently in efforts to transform our food systems, suggesting more profound systemic challenges that cut across policy domains.

This is hardly surprising. Climate change, public health, and agri-food systems are fundamentally interconnected. Poor diets drive climate change and ill health. Climate change threatens food security and human health. And our food choices impact our wellbeing and planetary health. But these connections aren’t just about overlapping behaviours and impacts; they also reflect deeper structural similarities. Just as healthcare systems resist change, so too can food systems, suggesting parallels in how both might adapt—or fail to—when transformative policies are needed. Understanding how these systems resist change—and learning from efforts to overcome that resistance—could enable transformation within and between these interconnected systems.

The Stability Paradox

There is a paradox inherent in large institutions and complex systems: their stability, which may have been by design or simply grew over time, becomes a source of vulnerability. That very stability can manifest as resistance to change, making it more difficult to implement new policies and practices.

An institution’s core mission can be its own barrier to change

Resistance to change can take on a distinct character for different institutions. In the study on integrating climate and health policy, we found that this resistance isn’t just about active opposition—it manifests in how organizations define their core mission and defend their established ways of working.

“If you go to what used to be BEIS [the Department for Business, Energy & Industrial Strategy], they will talk about business, and they don’t give a monkey’s about climate change or health,” observed one policy advisor. “If you go to the Department of Health, they’ll talk about that climate change might be bad for health, but they’ve got COVID recovery, and cancer, and four-hour waits … And if you go to anyone else in Treasury, they don’t care about any of the above, they just want things to carry on as it is.”

We see this same mission-driven resistance in our food systems. Different government departments approach food through narrow lenses defined by their core responsibilities—agriculture, health, business, or fiscal policy. As one analysis found, responsibility for food policy in England alone is spread across at least 16 different departments and agencies, each defending a part of the system rather than enabling joined-up change, with their individual missions becoming barriers to transformative, system-wide solutions.

Inertia also creates resistance to systemic change

This departmental myopia is particularly problematic for interconnected challenges like climate change, health and food security. But the problem is greater than simple tunnel vision. Trying to change anything in large organizations like government departments—or on an even bigger scale, the NHS—becomes, as one former government minister put it, “a monumental task in itself which most people just don’t try”. The very structures designed to ensure stability become barriers to necessary transformation.

The same patterns emerge in our food systems. Agricultural subsidies designed to ensure a stable food supply often lock farmers into practices that are increasingly unsuited to a changing climate. Food procurement systems prioritizing reliability can prevent schools and hospitals from sourcing more sustainable, healthy ingredients. The mechanisms intended to provide stability are now increasing our vulnerability.?

Stability should not be confused for resilience

But there’s a crucial distinction to be made between stability and genuine resilience. Stability enables a return to equilibrium after a disturbance; what was before can be reestablished following an event or significant change. A truly resilient system, however, can adapt and evolve to changing conditions over time—particularly important when confronting interconnected challenges like climate change, health and food security. The NHS is a telling example: while its size and institutional structures provide stability in delivering healthcare, these same features make it harder to reduce its significant carbon footprint or tackle the growing burden of diet-related disease. The cost of this rigidity is mounting. More than 2.8 million people are currently out of work with long-term illness, most with conditions caused or exacerbated by poor nutrition.

This tension between stability and resilience is equally evident in our food systems. Our reliance on “just in time” supermarket supply chains illustrates the paradox perfectly. While these streamlined systems create stability through efficiency and predictable food availability in normal times, they leave us vulnerable to disruption—as we saw during COVID-19 when shelves emptied rapidly. Breaking this cycle requires systems that maintain essential stability while building genuine resilience through greater adaptability, like maintaining more diverse supply networks and local food infrastructure.

The Evidence Paradox

Our study identified another paradox in the quest for system change: The more complex and multifaceted the challenge, the more rigorous the evidence requirements are to justify change. Yet conventional evidence standards are increasingly ill-suited to evaluating such system-wide changes, and may even make it harder to change in the needed ways.

Inappropriate methods and unequal standards

“[M]ost of the interventions that we’re talking about … involve transformational or system level change”, explained one experienced public health professional. “So evaluating them in the way and providing the evidence that an economist would require is really an unreasonable ask.” Quantitative cost-benefit analyses, and randomized controlled trials tend to be privileged in healthcare and many other decision-making contexts. But such methods may be inappropriate for understanding complex, system-wide challenges.

This methodological mismatch has real consequences for policy and spending decisions. Those trying to transform food systems, improve public health, or tackle climate change face demands for increasingly robust evidence. Yet the bar for evidence “is not equal across different topic areas,” as one policy advisor noted. “[The] bar for investing in public health, the evidence bar is higher than for the NHS. Politicians … every year will throw 10, 15, 20 billion pounds extra into the NHS. The idea they would do that on climate change is fanciful, isn’t it? We spend a lot on the NHS but in terms of its contribution to health outcomes the evidence is not great … the bar for evidence is clearly not equal.”

The evidence trap: Distracted into inaction

But there’s a deeper dynamic at play. Our research suggests that evidence requirements themselves can become a form of institutional resistance. Complex systems often set impossibly high evidence bars for change while requiring minimal justification for maintaining the status quo.

Since the early 1990s, the UK has published 14 different obesity strategies containing almost 700 individual policy proposals. But we already have evidence of what works: for example, the Soft Drinks Industry Levy has halved children’s sugar consumption from soft drinks, while Transport for London’s ban on junk food advertising has been linked to nearly 95,000 fewer cases of obesity. Yet in three decades, the proportion of adults living with obesity has doubled. The system’s resistance to change persists even when solutions are well-documented.

“We don’t need any more research—it’s all there, just start putting it into place,” urged one former public health minister in Nourishing Britain. Our climate-health study participants expressed similar frustrations about the gap between evidence and action. “I’m focused only on action now,” declared one academic advisor. “We don’t need more evidence. Policymakers and people and companies aren’t going to change because of more evidence.” In so many cases, the barrier isn’t knowledge—it’s the will to overcome systemic inertia, or simple resistance to change.

Rethinking what counts as “good” evidence?

Two complementary approaches appear particularly promising: gathering evidence from multiple real-world settings, and employing adaptive pathways that acknowledge and accommodate uncertainty.

Regarding the first, a 2025 study examining policy implementation found that the scale at which ideas have been tested—rather than the type of evidence used—better predicts policy success. Policies based on evidence from multiple real-world settings succeeded nearly 80% of the time, while those based on theoretical arguments alone succeeded only 38% of the time. This insight challenges conventional evidence hierarchies that privilege particular methodologies, suggesting that many types of evidence can be valuable if tested at a sufficient scale. It also reinforces what many of our study participants argued: that demanding specific types of evidence for complex system changes may be counterproductive. What matters more is understanding how ideas work across different contexts and settings.?

At the same time, our climate–health policy research highlighted another valuable approach: the adaptive pathways model. This framework, often used in fields like climate adaptation, involves mapping out multiple “pathways” for policy or program decisions, each linked to different future conditions or emerging evidence. By setting clear triggers to switch or refine pathways if certain thresholds (like temperature rises or cost changes) are met, practitioners can adapt their approach in real time, rather than waiting for definitive proof before acting. This makes uncertainty a feature of the policy process, not a barrier to it, and allows evidence-gathering to continue throughout implementation. “The adaptive pathways model is probably the best one to go with,” noted one public health expert, “because it’s very explicit about where the uncertainty sits and allows you to plug in the evidence you have … while being explicit about where the uncertainty is.”

These complementary approaches offer different ways to navigate evidence challenges in policy making. Where sufficient real-world testing exists, focusing on scale of implementation rather than a fixed idea about approach or methodological rigor can help justify action. Where uncertainty remains high but action is urgent—as with many climate and food system challenges—adaptive pathways allow for learning while doing. As one local government official explained: “We can set you in a direction that is not wrong to adapt for, but we cannot tell you exactly where you are going to flood or what days are going to be 45 degrees plus, but we know they are coming.”

Similarly with food systems: the precise circumstances of coming challenges are unpredictable, but we know enough about future threats to act now. This means taking steps today to ensure resilient supply chains and sustainable production methods, rather than waiting for the perfect set of knowledge.

Overcoming Resistance

Institutional stability and certain evidence requirements for change are normally considered assets, but these can become a liability when systems transformation is required. The urgency of climate change, coupled with mounting health and food security challenges, makes it clear we can no longer afford to let institutional inertia or overly rigid evidence requirements block the necessary transformation of our food systems.

But rather than trying to completely overhaul resistant systems, we need to work within them—building flexibility instead of just stability, and focusing on real-world testing rather than methodological perfection. The barriers to transforming our food, health and climate systems are not primarily technical or financial—they are institutional and political. Understanding how these barriers operate is the first step to overcoming them, but identifying solutions is just as important. Multiple-setting evidence challenges rigid hierarchies of “proof”, while adaptive pathways offer a built-in process for learning and evolving.

Together, these approaches break through both the inertia that keeps systems stuck and the excessive evidence demands that can stall innovation. By acknowledging the complexities of real-world contexts and building flexibility into policy, we can deliver the transformative change now that our food and health systems urgently require.

I write about the future of food and the connections between our food systems, the environment and public health. Sign up for my newsletter.

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