Multilevel interventions are inspired by socio-ecological models, and seek to create change on various levels--for example by increasing the health literacy of individuals as well as modifying the social norms within a community. Despite becoming a buzzword in public health, actual multilevel interventions remain scarce. In this commentary, we explore the operational and empirical barriers to designing and implementing multilevel interventions, and argue that the current theoretical framework based on the socio-ecological model is insufficient to guide those seeking to design multilevel interventions. We consider two theories, namely, the complementarity principle theory and the risk compensation theory--to address the gap between theory and translation into practice.