According to the latest Pet Obesity Prevalence Survey from the Association for Pet Obesity Prevention (APOP), 59 percent of evaluated dogs in the United States were classified as being overweight or obese in 2022.¹

Excess body weight puts dogs at an increased risk of developing secondary health concerns, such as musculoskeletal disorders, metabolic and endocrine disorders, cardiorespiratory dysfunction, and urinary tract disease.²

How can veterinary professionals help clients understand the real risks of excess weight, both in terms of pet health and quality of life? Further, how can we help clients turn that understanding into action to improve the health and well-being of their pets? There are data and facts that support the weight management advice veterinarians and staff members provide.

Study #1: Feeding less means a healthier life

A 14-year study showed feeding dogs to an ideal body condition throughout their lives can significantly extend their healthy years.³

The study had 48 eight-week-old Labrador retrievers paired within their litters according to gender and body weight, and randomly assigned to either a control or restricted-fed group. All dogs received the same 100 percent nutritionally complete and balanced diet; only the amount differed (25 percent less for the restricted-fed group). In the study’s key findings, restricted-fed dogs:

• Extended healthy years by a median of 1.8 years³
• Experienced a delayed need for long-term treatment of osteoarthritis (OA), which was treated at an average of three years later³
• Experienced a delayed need to treat chronic conditions, which required treatment at an average of 2.1 years later³

One of the most striking takeaways was the dogs did not have to be obese to suffer significant effects on their quality of life. Using a 9-point scale, the mean body condition score (BCS) during the period from 6 to 12 years of age was 6.7 for dogs in the control-fed group, and 4.6 for dogs in the lean-fed group.³ Most veterinarians routinely see dogs with a 6 to 7 BCS and know these dogs are overweight, not obese. However, this study showed that just being overweight proved to be a negative factor for the study dogs.

Body condition score refers to the evaluation of body fat in pets, with lean or ideal falling at approximately 20 percent body fat in the dog.

Study #2: Breed matters

One study published in 2019 examined the effects of an overweight versus ideal body condition in 50,787 middle-aged neutered client-owned dogs (12 different breeds).⁴ For all breeds, instantaneous risk of death for dogs with an overweight body condition was greater than for dogs in ideal body condition throughout the age range studied.⁴

In all breeds, median life span was shorter in overweight compared with ideal-weight dogs, with the difference being greatest in Yorkshire terriers (overweight: 13.7 years; ideal: 16.2 years) and least in German shepherds (overweight: 12.1 years; ideal: 12.5 years).⁴

Study #3: Weight reduction eases lameness

In addition to reducing median lifespan, excess weight can significantly reduce a dog’s quality of life. In terms of OA, for example, a reduction in body weight of just 6.10 percent in obese dogs caused a significant decrease in lameness.⁵

So, while the evidence is clear consequences of canine obesity can be severe—and the rewards of even modest weight loss significant—it has proven difficult for veterinary professionals to move the obesity needle. Some factors, such as breed/genetic disposition for weight gain, are difficult to control. However, there are aspects veterinarians and veterinary teams can influence, including: how they communicate with clients who have overweight or obese dogs, and the weight management diets they recommend. Each can factor prominently into whether healthy weight loss is achieved.

Quality of client interaction sets the tone

What is said, how it is said, and how words and body language are perceived by clients are important to consider when discussing weight management. As a critical first step, weight loss success hinges on performing an effective nutritional assessment for each patient to determine animal-, diet-, environment- and human-related factors present. These include:

• Animal factors. Overall health and activity level of the individual pet
• Dietary factors. What the pet eats, including supplements, medications, and treats
• Environmental factors. Who/how many people feed the pet and how often, as well as accessibility of food
• Human factors. What the client thinks about their pet’s diet, and if they believe changing diet and treats would affect relationships between the pet and family members

Proceeding to client conversations about weight management may not always be easy and simple. However, this can be more effective and fluid for both veterinary professionals and clients by applying these tips:

1. Ask permission to discuss weight management. This shows the client respect and is a good way to assess their willingness to change their pet’s diet. For example, “Alex, I’d like to talk with you about Cooper’s diet and body weight—would you be open to that?” If Alex says no, that can be written in the patient record and the veterinarian or staff member can move on. However, clients are usually receptive to at least broaching the topic.
2. Pose open-ended questions. These types of questions are geared to generate information-rich responses regarding a dog’s eating habits. For example, rather than asking Alex, “What diet are you feeding?” ask, “Can you tell me what Cooper eats throughout the day?”
3. Keep within the context of patient health. In a study involving 84 dog owners and 36 cat owners, statements based on pet health were the most effective for owners to consider changing their pet’s diet.⁶ In a weight management scenario, the health benefits that could be derived from getting the pet slimmer should be emphasized.
4. Recognize and manage biases and perceptions. Obesity is a multifactorial disease that involves both owner- and pet-related elements. Weight bias—a negative attitude or stereotype aimed at an individual because of their weight—is gaining increasing attention in human medicine. Weight bias is the tendency to focus on willpower and personal responsibility over environmental and biological factors as reasons for an individual being overweight or obese.⁷ It can even cause compromised patient care in human settings.⁸

In veterinary medicine, the area of weight bias is just beginning to be explored. One recent study found veterinarians and veterinary students may also exhibit weight bias. These groups reported negative feelings, such as blame and frustration, toward dogs with obesity and their owners, versus lean dogs and their owners. They were also pessimistic about weight management compliance by owners of dogs with obesity.⁹ As a profession, we have a long way to go in dealing with this issue.

Nutrition that facilitates weight management

In addition to empathetic client communication, recommending an appropriate therapeutic weight management diet is critical. These diets are formulated to achieve calorie reduction without restricting nutrients. Some of the critical nutritional modifications include:

• High nutrient-to-calorie ratio. Weight loss requires creating a calorie deficit, but this should not be done at the expense of creating a nutrient deficit. Therapeutic weight management diets are formulated to accomplish this, while over-the-counter weight management diets are not necessarily formulated to effectively restrict calories without also restricting nutrients.
• High protein levels. While all essential nutrients are important, protein is especially important because it helps maintain lean body mass. The majority of an animal’s metabolic energy requirements come from lean body mass and the goal is to minimize the loss of lean body mass as the pet loses body fat.
• Satiety. It is important for an animal on a weight management program to feel full and satisfied—otherwise, they might exhibit begging behaviors that prompt clients to provide added food and treats. Nutrients that can promote satiety include protein and fiber.
• Anti-inflammatory properties. Omega-3 fatty acids help manage inflammation and reduce the clinical signs associated with OA, which is often a weight-related condition.

Communication, nutrition key to improved canine health

Integrating effective client communication and nutritional management to facilitate canine weight loss requires the commitment and engagement of the entire veterinary team. The 2021 American Animal Hospital Association (AAHA) Weight Management Guidelines for Dogs and Cats¹⁰ provide a deep dive into a variety of topics from effective client communication strategies to creating nutritional recommendations. These can be paired with the 2014 AAHA Weight Management Guidelines,¹¹ which offer tools for the management of weight loss and long-term maintenance of healthy weight for both dogs and cats.

STEPS TO SUCCESSFUL WEIGHT MANAGEMENT

Perform a complete nutritional assessment The individual pet, their diet, the environment in which they live, and human-related factors, such as giving treats and excess feeding, all impact the ability of that pet to lose weight. Begin with open-ended questions to draw out more detail from the client. Secure client buy-in Ask permission to talk about a pet’s weight. If the client says yes, emphasize the health benefits of weight loss and the health concerns associated with obesity. Express empathy, not judgment. Provide a tailored recommendation Consider the client’s lifestyle, goals, expectations, and the human-animal bond. Involve the client in decision-making by exploring nutrition options together. Make a clear nutritional management recommendation, then elicit client feedback and modify recommendation as necessary. Follow up and monitor Schedule regular weigh-ins, initially one to two weeks later. Focus on achieving a body condition score (BCS) goal and rate of weight loss (from one to two percent per week) rather than a final weight. Celebrate success! Encourage clinic staff to applaud both pet and client as the pet sheds pounds and eventually reaches ideal weight. This could entail a social media post, a success board in the lobby, or a printed certificate of achievement. The veterinary staff can get creative to determine what works best for the individual clinic. Source: AAHA Nutrition and Weight Management Guidelines for Dogs and Cats (2021)

Martha Cline, DVM, DACVIM (Nutrition), is a veterinary communications manager at Nestle Purina PetCare, and sees patients on a part-time basis at Red Bank Veterinary Hospitals (Tinton Falls, New Jersey). Dr. Cline is a Board-Certified Veterinary Nutritionist® and served as chair of the 2021 American Animal Hospital Association (AAHA) Nutrition and Weight Management Guidelines Task Force.

References

1. Association for Pet Obesity Prevention, 2022 State of U.S. Pet Obesity Report. https://www.petobesityprevention.org/2022
2. German AJ, Ryan VH, German AC, et al. Obesity, its associated disorders and the role of inflammatory adipokines in companion animals. Vet. J, 2010;185(1):4–9. https://pubmed.ncbi.nlm.nih.gov/20472476/
3. Kealy RD, Lawler DF, Ballam JM, et al. Effects of diet restriction on life span and age-related changes in dogs. J Am Vet Med Assoc, 2002;220(9): 1315–1320. https://pubmed.ncbi.nlm.nih.gov/11991408/
4. Salt C, Morris PJ, Wilson D, et al. Association between life span and body condition in neutered client-owned dogs. J Vet Intern Med. 2019;33:89–99. https://pubmed.ncbi.nlm.nih.gov/30548336/
5. Marshall WG, Hazewinkel HAW, Mullen D, et al. The effect of weight loss on lameness in obese dogs with osteoarthritis. Vet Res Commun,2010;34:241–253. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2855019/
6. Alvarez EE, Schultz KK. Effect of personal, food manufacturer, and pet health statements made by a veterinarian during a pet wellness appointment on a dog or cat owner’s decision to consider changing their pet’s diet. J Am Vet Med Assoc,2021;259:644–650. https://pubmed.ncbi.nlm.nih.gov/34448614/
7. Alberga AS, Pickering BJ, Hayden KA, et al. Weight bias reduction in health professionals: A systematic review. Clin Obes,2016;6:175–188. https://pubmed.ncbi.nlm.nih.gov/27166133/
8. Phelan SM, Burgess DJ, Yeazel, MW, et al. Impact of weight bias and stigma on quality of care and outcomes for patients with obesity. Obes Rev,2015;16;319–326. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4381543/
9. Pearl RL, Wadden TA, Bach C, et al. Who’s a good boy? Effects of dog and owner body weight on veterinarian perceptions and treatment recommendations. Int J Obes (Lond),2020;44(12):2455–2464. https://pubmed.ncbi.nlm.nih.gov/32523035
10. Cline MG, Burns KM, Coe JB, et al. 2021 AAHA Nutrition and Weight Management Guidelines for Dogs and Cats. J Am Anim Hosp Assoc,2021;57:153–174. https://www.aaha.org/aaha-guidelines/2021-aaha-nutrition-and-weight-management-guidelines/home/
11. Brooks D, Churchill J, Fein K, et al. 2014 AAHA Weight Management Guidelines for Dogs and Cats. J Am Anim Hosp Assoc,2014;50:1–11. https://www.aaha.org/globalassets/02-guidelines/weight-management/2014-AAHA-Weight-Management-Guidelines-for-Dogs-and-Cats