Several holistic urban concepts point to the importance of taking an integrated resources approach in the city. The reason for this is obvious: resource flows are highly interconnected. Think for instance of the high water, energy, and land input for most of our food production, or the vast energy input in water desalination processes. In addition, taking a single-resource approach to cities, mostly done for energy, often leads to negative feedbacks on other resource flows. Carbon-neutral cities do not usually account for higher material in- and output for insulation, efficient appliances, or renewable energy systems, and most often do not even account for the embodied energy of these extra material flows. If, on top of that, carbon offsetting is allowed, one should definitely question if the claimed carbon neutrality weighs against all the externalities of realizing this claim. Therefore, on a conceptual basis, an integrated approach towards resources makes a lot of sense. It is, however, in the translation from theory to practice that such concepts often get stuck. One of the obvious obstacles with respect to hindering progress in implementation is the difficulty to realize cooperation between institutions, experts, and bureaucrats that are neatly organized in a sectorial way, the famous silo effect. Other challenges that are often mentioned are short-termism, lack of mandate and financing of local governments and corruption (WFC 2014). While these are well-known obstacles, I will discuss some often missed elements that are crucial for a successful implementation of holistic urban concepts aiming at sustainable cities and regions. These elements are: transformative change, transdisciplinarity, performance measurability, and demand-side change.