The main challenges today are complex systems problems, with equally complex solutions; there are problems that have the potential to affect all individuals at different levels, affecting health, the sustainability of health services, and potentially the long-term economic prosperity of the country. The evidence shows that unless people themselves are engaged, releasing their potential for action, supporting a cultural shift towards a health promoting society, it is unlikely that the necessary sustainable impact on obesity, diabetes and other chronic diseases will be achieved. By reflecting on experience in England, this article will provide an insight into the potential for change that can be generated by rebalancing the relationship between the state, the individual and civil society.