Combined lifestyle interventions for children with overweight and obesity: Exploring multiple Dutch community-based initiatives

Unhealthy lifestyle behaviours play an important role in the development of overweight and obesity in children. Combined Lifestyle Interventions (CLIs) have been developed to address these behaviours. Within these interventions, multidisciplinary teams of professionals support children and their families in adopting and maintaining a healthier lifestyle. Although CLIs are increasingly being implemented in municipalities across the Netherlands, important knowledge gaps remain regarding their effects and implementation in real-world settings.

A better understanding of the characteristics, functioning, and implementation of CLIs may help to optimise their impact and, ultimately, contribute to preventing and reducing overweight and obesity in children. The overall aim of this dissertation was therefore to strengthen the evidence base on CLIs for children with overweight and obesity in the Netherlands, with a particular focus on understanding what is needed for these interventions to be effective and successfully implemented in everyday practice.

Specifically, this dissertation examined the effects of CLIs, potentially effective components of CLIs, parents’ perceptions of their child’s weight, the composition and collaboration of professional teams delivering CLIs, and barriers and facilitators experienced by professionals during the implementation of CLIs.

Overall, this dissertation shows that CLIs for children with overweight and obesity demonstrate promising effects in Dutch real-world practice, while also facing substantial implementation challenges. Implementation is complex and context-dependent and is influenced by intervention content, team composition, collaboration between professionals, coordination, and professional competencies. Strengthening the organisational embedding of CLIs within integrated care structures, together with coordinated monitoring and evaluation and sustained investment in professional expertise and capacity, is therefore essential to improve their sustainability and impact.

Together, these findings provide practical insights into how CLIs can be better organised, implemented, evaluated, and sustained in everyday practice, ultimately supporting better care and outcomes for children and their families.