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In the 1980s and 1990s, it became increasingly clear that changes in external nutrient loads alone could not entirely explain the severe eutrophication of surface waters in the Netherlands. Nowadays, ‘internal eutrophication’ has become a widely accepted term in Dutch water management practice to describe the eutrophication of an ecosystem without additional external input of nutrients (N, P, K). This review surveys the principal mechanisms involved in this process. It also discusses possible remedies to combat internal eutrophication.