The number of participants that has started the Combined Lifestyle Intervention (CLI) has more than doubled over the course of a single year. Nationwide, over 82,000 people have now started the CLI. According to RIVM’s annual report, most of the participants achieve a good outcome. For example, four out of five people lose body weight or keep their weight from going up. One-third even lose 5% (or more) of their body weight. Participants also rate their quality of life higher than before they participated. On average, this score went up from 58.9 to 66.6 points (on a scale from 0 to 100).

The CLI offers people guidance and advice on healthy nutrition, eating habits and exercise. CLI has been available since 2019 to help adults make lifestyle and behaviour changes. It is covered by basic health insurance, subject to certain conditions.

Differences between regions

While every municipality offers the CLI, RIVM has noticed significant differences between regions. In the Central Gelderland region, for example, there are over 200 CLI participants for every 10,000 residents with overweight or obesity. In the three regions with the most limited reach (Haaglanden, Amsterdam and the southern part of South Holland), on the other hand, CLI participants number fewer than 70 per 10,000 residents with overweight or obesity.

Greater weight loss results in better quality of life

At the end of the treatment phase, which lasts around nine months, participants can rate their quality of life. On average, they rate this 7.5 points higher (on a scale from 0 to 100). Among other things, this means people can move more comfortably and have an easier time performing daily activities, or they experience less pain. Participants who lost 5% of their body weight or more during the treatment phase even rated their quality of life 11.3 points higher than before they started the CLI. This group also met the goal from the new guidelines for overweight and obesity of losing 5% of their body weight or more after one year of treatment. People who had lost less weight were likewise more positive about their quality of life, rating this 5.7 points higher on average.

Starting year makes a difference

The latest CLI report also shows that participants who started later (in 2021 or 2022) lost more weight on average. Their waist circumference also decreased by a greater amount compared to people who started shortly after the CLI was introduced, i.e. in 2019 or 2020. This might be due to the experience gained with the CLI programmes. Similarly, coaches might have gained a better understanding of who would probably benefit from the CLI and who would probably not.

RIVM’s role

RIVM has been monitoring the development of the CLI for the Dutch Ministry of Health, Welfare and Sport since 2019. It publishes data on the CLI twice a year. These are based on claims data from care insurers and, since August 2021, from the CLI register. This register is continuously updated with data of participants.

Further research

RIVM will continue to monitor the CLI until 2026. For example, a next report in 2024 will look at the availability and reach of CLI programmes. In that report, RIVM will also take a first look at the effects on health at the end of the full two-year CLI programme. RIVM has so far only looked at the effects at the end of the treatment phase (maximum of one year). Furthermore, an in-depth study will be conducted in 2024 to examine dropout from the CLI.