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Prevention of Obesity

Prevention of overweight and obesity aid the patient’s overall quality of life and may contribute to a lengthened life span.19,21,32–34 It is easier to prevent weight gain than it is to treat obesity, adding to the advantages of prevention.35,36 Obesity discussions can be challenging, as there may be a perception that recommendations are a judgment of the owner’s ability to properly care for their pet or a judgment of the owner’s own body composition. It is best to enter these conversations with compassion and sensitivity, while also remaining a steadfast advocate for the pet’s wellbeing (see section on Communicating with Clients).

Obesity comorbidities include osteoarthritis and endocrine diseases (e.g., hypothyroidism, diabetes mellitus, hyperadrenocorticism).37–40 In some cases (e.g., feline diabetes mellitus), preventing obesity may help reduce the risk of developing the comorbidity, whereas in others (e.g., hypothyroidism), the underlying condition will continue to predispose to obesity development unless adequately managed.


Table 6

Obesity Risk Factors
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Excess calorie consumption

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Human factors >

Causes

Management

Overfeeding primary diets

  • Lack of pet owners’ awareness of
    • Calorie density of food
    • Pet’s caloric needs
    • How to feed pet (ad libitum vs meal feeding)
  • Calculate MER using ideal weight
    • Compare with current intake
  • Weigh food using a gram scale to improve precision and accuracy vs measuring cups72,74,77
  • Caution when following commercial product feeding recommendation labels
    • May overestimate energy requirements, causing overfeeding
  • Use kibble as treats • Switch to diet with reduced energy density
  • Use short handouts for feeding recommendations to help inform all members of the household

Eating the other pets’ food

  • If one pet eats faster than the other or can “bully” the other pet, one pet is eating the calories of two
  • Feed pets separately
  • Use automated feeders or feeders that identify pets via collar tag or microchip
    • Ensure they provide a measured amount
  • Use food-dispensing and/or foraging toys to control intake and provide enrichment and activity

Too many treats (>10% of diet)

  • Dilute the nutrition of the primary food
  • Use multiple terms to capture all items being fed (e.g., treats, snacks, desserts, toppers, table foods, food scraps, human food, meal leftovers, foods for medication administration)
    • Use communication strategies to elicit a more complete response
  • Supplements (e.g., fish oil, chewable tablets, soft chews) also contain calories
  • Keep total treat intake ≤10% of daily caloric intake
    • Avoids disrupting nutrient balance of primary diet
  • Use kibble as treats by separating out a portion of the daily primary diet quantity
  • Measure treats into a daily treat jar
  • Mix high- and low-calorie treat items for training
  • Educate owners that carrots, green beans, and other human foods have calories, too
  • Consider unintentional sources (e.g., waiting by a child’s highchair, licking dinner dishes, food dropped during human food preparation process)

Animal factors >

Causes

Management

Spay/neuter changes in metabolism

  • Energy requirements decrease and feeding amounts change34–36
  • Because surgery usually occurs at a young age, it is challenging to feed to support sufficient growth while avoiding excess
  • Frequent BCS monitoring
  • Consult growth charts79
    • Not available for cats or giant-breed dogs
  • If predicting ≥70 lb as adult, use diet formulated for large-breed growth
  • Keep large-breed puppies at ideal BCS to reduce risk of orthopedic disease15,80
  • Switch to adult formulation when pet achieves ≥80% skeletal maturity
    • May stay on “all life stages” diets
    • Switching too early may affect nutrients necessary to support development
  • Consider “birthday visit” to evaluate pet when transitioning between growth and maintenance life stages

Decreased energy expenditure

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Human factors >

Causes

Management

Overestimate pet’s activity level

  • Owners believe their pets are more active than they actually are30
  • Insufficient exercise leads to unintentional weight gain32
  • Ask about specific types of activity and amount to get full picture
  • Educate owners that exercise plays a minimal role in weight loss compared with diet
  • Up to 30–60 min walking/trotting 3×/wk can result in muscle and adipose tissue changes, suggesting improved glucose metabolism81
  • Increasing exercise may
    • Increase energy expenditure82
    • Maintain lean body mass75
    • Strengthen human-animal bond83
  • Fitness trackers may motivate owners to exercise their dogs31
  • Consider feather toys, laser pointers, cat trees, exercise wheels for cats

Animal factors >

Causes

Management

Age-related issues

  • Obesity prevalence increases through middle age46,47
  • Energy requirements may decrease with age, but this is not consistent
    • Influenced by breed and respective life expectancy52
  • Lean body mass decreases with age in dogs
  • Fat, protein, and energy digestibility decreases with age in cats
    • Cats will compensate by increasing total caloric intake56
  • Always assess BCS and MCS
    • Adjust feeding plan as needed as soon as changes occur
  • Encourage routine exercise and activity
  • Remember that cats may actually need an increased calorie intake later in life

Genetic predisposition

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Genetics >

Causes

Management

  • Certain breeds (e.g., Labrador retrievers, beagles, Norwegian forest cats, Persians) are predisposed37–46
  • Inform owners of breeds with known predisposition, even if currently ideal BCS
  • Consider breed-specific diets for likely controlled energy density with at-risk breeds

In order to successfully prevent obesity, an approach including risk factor assessment and mitigation is recommended. Obesity risk factors stem from both human-related and animal-related roots (Table 6). A main human factor is the ability to overfeed the primary diet, and owners find it difficult to make subsequent adjustments. Animals may also overeat if they have access to another pet’s food bowl. Compare reported intake against calculated requirements based on ideal BW and make downward recommendations accordingly. Reassess and adjust recommendations as needed at each subsequent visit.

Owners also have the ability to overfeed food items that are not the primary diet and overestimate their pet’s activity level.41 Advise owners to maintain all additional item intake to ≤10% total daily caloric intake to avoid disrupting nutrient balance of the primary diet. To increase exercise in cats, consider the use of feather toys, cat trees, exercise wheels, or similar devices. Fitness trackers may increase owner motivation to increase their dog’s physical activity.42

Animal factors must also be considered to effectively prevent obesity (Table 6). Energy requirements are reduced after spaying or neutering, necessitating intake reduction.43–45 Certain breeds (e.g., Labrador retrievers, beagles, Norwegian forest cats, Persians) are predisposed to weight gain and the owner should be educated regarding obesity risk, even if their pet currently has an ideal BCS.46,47

Increase in BW through middle age contributes to the prevalence of obesity.46–48 Energy requirements are thought to decrease through middle age in the dog, which contributes to this weight gain,49,50 although results are not consistent.51 Metabolic rates in the dog can also be influenced by breed and their respective life expectancy. 52 During senior and geriatric life stages, loss of lean body mass and overall weight loss can occur.53 In cats, fat, protein, and energy digestibility can decrease with advanced aging.54,55 Energy intake can be higher for senior cats to compensate for this decrease in digestibility.56 An important aspect of obesity prevention and maintenance of ideal BCS and MCS is incorporating the entire practice team in client education. Appropriate training is essential to ensure that the team speaks with a common voice (see section on Leveraging the Value of Proper Nutrition in Your Practice).

These guidelines are supported by generous educational grants from Hill’s Pet Nutrition, Inc., Purina® Pro Plan® Veterinary Diets, and Royal Canin®.

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