Water resources management has traditionally been done in a sectorial manner and with this fragmented approach it has not been possible to address fully the supply and demand problems for various water uses nor the cumulative effects of different land use activities on water quality. To stem the deterioration of water resources, the “Integrated Water Resources Management (IWRM)” approach has been promoted over the past 30 years as a better and more effective alternative to the traditional sectoral and top-down approach. After thousands of publications on the topic of IWRM, evidence of successful IWRM approaches are still being questioned. Why do we have so many difficulties in finding an integrated management approach that can deal with water in a holistic and coordinated manner? This working paper argues that it is essential that we simplify the IWRM process by not trying to address all the water problems and interconnections at the same time but by prioritizing the issues. Focusing on key interactions between water, energy and food security is of key importance because global changes such as urbanization, demographic and climate change are likely to intensify the demand for food and energy production, which require the most amount of water and have the greatest environmental impact. It is also important to point out in this context that adapting to the effects of global changes are more likely to be successful when attention is paid to environmental sustainability and its impacts on poverty. Attention to issues of environmental sustainability and poverty reduction are likely to be aided by a nexus approach that focuses on management of environmental resources such as water, soil and waste that lie at the heart of discussions on water, food and energy in the context of global changes currently underway.