The Lighter Side of Obesity, Part 2
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The Lighter Side of Obesity, Part 2:
Putting It All Together - Strategies for
Quick and Easy Proactive Nutrition
Conversations

Deborah Linder, DVM, MS, DACVIM (Nutrition)
Board Certified Veterinary Nutritionist®
Shrewsbury, Mass.

A TWO-PART SERIES ON MAKING PROACTIVE NUTRITION CONVERSATIONS QUICK AND EASY (& MAYBE EVEN FUN)

One size doesn't fit all

Because some pets seem to ‘eat to live,’ while others seem more like they ‘live to eat,’ proactive nutrition is often not a one-size-fits-all approach. A full nutritional assessment, as described in the American Animal Hospital Association 2021 Guidelines,1 can help identify and prioritize obesity risk factors and highlight opportunities for change, which may differ for each pet and family. More in-depth than a ‘diet history,’ this full nutritional assessment not only evaluates the diet (or diet-specific factors), but also takes into account animal-specific and human-specific factors, including those that predispose pets to weight gain. While most animal-specific factors cannot be changed, such as breed, genetics, age and neuter status (after the procedure), they can highlight which pets may need closer monitoring and when intervention with proactive nutrition can be most useful to prevent obesity (e.g., at the time of spay and neuter).

Human-specific factors more often provide opportunities for change throughout a pet’s life and include feeding management, physical activity and, most importantly, the relationship between members of the family and the pet.

While this assessment may take more time initially, it allows more strategic and targeted conversations for tailored proactive nutrition that would most benefit the family and save time.

 

Start early

The initial puppy/kitten/adoption visit is an excellent opportunity to set families up for success with their new addition to the household. Most families still look to veterinarians for dietary recommendations, with 97% of owners in one study reporting they felt veterinarians should have a role in weight management for their cats.2 When discussed at this first visit, having targeted information on heathy feeding behaviors and ensuring a balanced diet could provide opportunities to reduce or mitigate obesity risk factors before they even occur and without even needing to mention obesity.

Example: When asked about ad lib feeding due to one family’s changing work schedule, I was worried that ad lib feeding would be an obesity risk factor since many pets cannot self-regulate their calorie intake to maintain an ideal body condition.1 I instead recommended timed auto feeders that could provide measured meals at regular intervals. The family noted it was much easier on them and helped them not worry about coordinating which family member fed the dog when!

 

Make it part of the routine workflow

Including nutrition recommendations as part of a clinic’s routine or standard operating procedures can be an opportunity to include proactive nutrition while minimizing time and effort from veterinarians and staff. For example, the time of spay/neuter is a known obesity risk factor, where calorie needs may decrease by up 30%!3,4 This information can be included in templates for surgery discharge instructions given to families or put on checklists for staff to discuss when pets are picked up from surgery to ensure families are made aware of this information. These recommendations should also include whether it is safe for that pet to have their current amount of food reduced or whether a dietary change is needed to avoid nutrient deficiency with recommended foods and amounts appropriate for that pet (see other articles here for more information).

Example: Consider a clinic-wide protocol that all pets have a recommended first birthday visit to discuss transition to a diet that meets AAFCO adult maintenance requirements if the pet has reached full skeletal maturity, and to confirm if the dietary recommendations made at the time of the spay/neuter procedure are still meeting the pet’s needs.

 

Don’t recreate the wheel!

There are many excellent resources, handouts, guidelines and tools developed by various groups of experts to help make proactive nutrition easier and less time-consuming. Especially for conversations that can be challenging, controversial or may be in areas outside of a particular expertise, providing reliable and trusted sources of nutrition information can allow nutrition to be a part of the conversation even for staff members who aren’t as comfortable or experienced in discussing nutrition.   

Example 1: A family is confused by the many brands of pet foods available and wants to know how to tell if a food is high quality, but a staff member seeing the pet isn’t sure how best to guide them. One method is to normalize the concern by letting them know that many families have that same confusion, and that the clinic recommends using the World Small Animal Veterinary Association (WSAVA) Nutrition Toolkit (available online here), which is a helpful set of guidelines developed by a group of experts to help guide families when evaluating pet foods.

Example 2: A veterinary technician is frustrated because the last three families in a row couldn’t remember which food they were feeding or didn’t have the name of the treats, which led to the staff spending extra time trying to look up products online and confirm with the families. As part of a full nutritional assessment, consider sending out a diet history form that can be emailed ahead of time and filled out at home or online to save time in visits.

 

Empower families with the tools to be proactive

Providing the right tools and knowledge can empower families to mitigate risk factors for obesity and proactively engage in their pet’s health and well-being. This is much easier to accomplish and bring up in conversation when done with prevention in mind, and can focus on wellness and encouraging healthy behaviors that their pet enjoys.

Example: A family is considering moving from a house to a smaller apartment and mentions during a visit that they worry their cat may not get as much exercise if they move. Letting the family know about resources like the Indoor Pet Initiative (available online here) can give them many strategies and options to consider when looking at various apartments so they can create or modify an environment that provides the right mental and physical enrichment for an indoor pet.

 

Embrace the emotion (and let it help you)!

While I have heard frustrations from colleagues that the human-animal bond can be an obesity risk factor for pets when it leads to a ‘food is love’ mentality, I also see the love families have for their pets as a great potential untapped resource in keeping pets healthy. When conversations shift to quality of life instead of obesity, this opens the door for creativity, engagement and opportunity to discuss what pets may need or want to be happy. One strategy is to ask families to brainstorm all the activities their pet currently enjoys or might enjoy but hasn’t experienced yet. This can be helpful to refocus the conversation and the family’s love and energy into positive and healthy behaviors that allow them to enjoy time with their pet without predisposing their pet to obesity. This method could be useful if there is a possibility that a family might be misinterpreting begging for attention as begging for food out of hunger or deficiency.

Example: A dog owner was worried that his dog was constantly hungry because she would come up to him and bark while he was working remotely all day unless he gave her a treat each time. Once I had calculated the amount of food and assured him that her calorie and nutrient needs were being met, I asked about what activities his dog enjoyed most. He noted that aside from treats, she had a great prey drive and loved chasing after things, so we brainstormed about him throwing the treat for her to chase. Much to his surprise, she was much more engaged in the chase and brought the treat back for him to throw again instead of eating it, which made for a fun new favorite activity for both of them!

 

Remembering what’s important

Conversations about nutrition, and especially obesity, have the potential to be challenging, emotional and time-consuming for both families and veterinary healthcare teams. Being strategic about when and how conversations occur, utilizing resources and being as proactive as possible can help support easier and efficient nutrition communication. Troubleshooting nutrition conversations often lies in understanding the relationship that families have with their pets and making recommendations that will enhance and support that relationship in healthy ways.5 In over a decade of working with families on nutrition and especially obesity, my most effective strategy has been communicating that our shared goal is an excellent quality of life for their pet. This allows for the veterinary healthcare team and the family to work together to prevent obesity and to keep pets happy and healthy throughout their lives.

References
  1. 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(4):153-178. doi:10.5326/JAAHA-MS-7232.
  2. Hanford R, Linder DE. Impact of obesity on quality of life and owner’s perception of weight loss programs in cats. Vet Sci. 2021;8(2):32. doi:10.3390/vetsci8020032.
  3. Kanchuk ML, Backus RC, Calvert CC, Morris JG, Rogers, QR. Neutering induces changes in food intake, body weight, plasma insulin and leptin concentrations in normal and lipoprotein lipase-deficient male cats. J Nutr. 2002;132(6 Suppl 2):1730S-1732S. doi:10.1093/jn/132.6.1730S.
  4. Jeusette I, Detilleux J, Cuvelier C, Istasse L, Dies M. Ad libitum feeding following ovariectomy in female Beagle dogs: effect on maintenance energy requirement and on blood metabolites. J Anim Physiol Anim Nutr (Berl). 2004;88(3-4):117-121. doi:10.1111/j.1439-0396.2003.00467.x.
  5. Linder D, Mueller M. Pet obesity management: beyond nutrition. Vet Clin North Am Small Anim Pract. 2014;44(4):789-806, vii. doi:10.1016/j.cvsm.2014.03.004.