[Intensive lifestyle interventions: are they effective against obesity?]

The intensive lifestyle intervention (ILI) has recently become part of the reimbursed care in the Netherlands. What is the value of the ILI in the treatment of obesity and diabetes? Large clinical randomized studies on the effect of ILI showed a weight loss of more than 5% in selected patients, which could be partly sustained for several years. The ILI reduced risk factors without improving cardiovascular morbidity and mortality. The expensive clinical ILI had to be translated into an accessible and affordable primary care version. With this translation the effectiveness of the ILI has disappeared. With the current ILI, the weight loss is less than 5% and the health advantages are limited. It is foreseeable that the dismal results of the ILI will not generate enthusiasm among potential participants. The impact of ILI on the obesity epidemic will be very limited. Prevention will provide the way to go.