Transitioning away from single nutrient interventions and implementing ‘food as medicine’ for obesity-related chronic conditions is complex. It requires multipronged interactions across individuals, teams and entire health systems in order to provide the capability and workforce capacity to deliver interventions with a focus on diet quality and whole dietary patterns that are appropriate for diverse patient groups. Incorporating the voices of consumers in co-design and evaluation of diet quality interventions adds considerable value and needs to be formally embedded into the scientific process. Utilising technologies to better deliver dietary services within a tertiary hospital setting is critical to innovating the resource intensive approach to lifestyle interventions in high paced, complex clinical environments. Generating high quality evidence for the benefit of dietary management of complex chronic conditions is important and implementing the translation of this evidence equitably across the health system will be key to achieving health impacts.