The growth of pet obesity
Correction: The growth of pet obesity - November 23, 2019
Pet obesity is on the rise, bringing with it increased risks of ill health and poor quality of life for companion animals. The profession is, rightly, concerned. But is it clear on the complex, interconnected causes for this change and well equipped to confront them? Some argue a greater degree of understanding is required. Claire Read reports.
It's 15 years since Alexander German made cat and dog obesity a major focus of his clinical and research work. During that time, German – Royal Canin professor of small animal medicine at the University of Liverpool and Twitter's @TheFatVet – says the direction of travel has been patently clear.
We can make a big difference if we manage the problem right
'From my perspective, I see the problem getting worse rather than better. We can make a big difference if we manage the problem right, but sadly I see more failure than I see success; I see a lack of engagement, particularly within the veterinary profession, about what is to me the number one problem.'
Thoroughly quantifying the scale of that problem is a challenging task, with definitive data on the scale of obesity in pets hard to come by. That said, a 2010 paper by Courcier et al (JSAP, vol 51, pp 362–7) reviewing prevalence – the most recent on the subject – found 59 per cent of pet dogs in the UK were overweight or obese.
Furthermore, surveys of veterinary professionals have indicated a real issue. For the 2018 PDSA Animal Wellbeing Report, 50 per cent of vets surveyed predicted that pet obesity will have the biggest health and welfare implications in 10 years' time. Meanwhile, research by the BVA and the British Veterinary Nursing Association (BVNA) found vet professionals estimate that some 34 per cent of the cats they see in practice each week are overweight or obese.
In short, if you are seeing more and more overweight animals in your practice then you are far from alone.
Ask German just why so many animals are affected by a condition now formally classified as a disease by organisations including the British Small Animal Veterinary Association (BSAVA), and he immediately says the answer is a complex one. He suspects, however, that isn't the reaction of many of those in the profession when confronted with increasingly heavy animals in practice.
'The tendency is to see this as a simple lifestyle issue, which is just an imbalance of energy-in versus energy-out.' It is that, he fears, which leads to a failure to truly address the problem – and an overly simplistic conclusion that, when obesity occurs in a companion animal, it is simply the owners' fault.
'The trouble is if we start to think of it as a lifestyle issue, automatically you blame the owner – because if you say it's too much in and not enough activity, who's responsible for that?'
Richard Butterwick admits that, in searching for solutions to the pet obesity problem, members of the nutrition community have perhaps previously been guilty of simply focusing on that energy-in versus energy-out equation. Global nutrition adviser at Mars Petcare, he joined the company almost three decades ago charged with creating diets to ensure pets could lose weight in a healthy way. It's a mission which he says has been accomplished and yet the problem of obesity remains. For Butterwick, that's in part down to a failure to look at the problem in a more multifaceted way.
'As nutritionists, we've looked at this through a narrow nutrition window. So we've said: "OK, it's a problem with diets – let's design diets that effectively will be the silver bullet for pet obesity", and then we've been surprised in a way that we haven't found the answer to this,' argues Butterwick.
'We've looked at this through a very narrow lens, through our lens as nutritionists, as opposed to the much broader lens that we need because we know that there are psychological, behavioural and other factors that are really driving or contributing to why pets are consuming more energy than they need to.'
German says these 'other factors' likely include genetics. 'In the human field, they believe that about 70 per cent of your risk in [terms of] your body mass index is conveyed in your genes. We're only beginning to start looking at genetics, but we already have identified genes associated with appetite and weight gain in dogs. So the same is likely to be true [in animals].'
With all of that said, the fact remains that behavioural and environmental factors are at play. 'And of course there is the influence within that of, not necessarily the owner, but what I would call the family unit,' says German. 'Most people see their pets as another child.'
There can be a tendency for owners to treat pets in exactly the same way as they would a loved one
Understanding the causes
'The reason pets become overweight is because they consume more energy than they need, but that isn't just because of the foods they have available to them. The problem is much more complex and is connected to the environment and the relationship they have with the owner. You need to look at it in a much more holistic way.'
Richard Butterwick, global nutrition adviser, Mars Petcare
That means there can be a tendency for owners to treat pets in exactly the same way as they would a loved one. It is here, suggests Jon Bowen – who leads the veterinary behaviour service at the University of London's Royal Veterinary College – that things can start going wrong.
'If you came around to my house and, after 20 or 30 minutes, you said to me: "Would you mind if we had a cup of tea?" then I'd feel terrible. Because that would mean I hadn't identified you had an unspoken need, and the way we show care for another is to ask ourselves what we think a person needs in that moment. If I meet that need, that shows care.
'Well, obviously, owners are the same with their animals. So we're likely to be dragged into inappropriate feeding regimes.'
Bowen says a lot of the cats he sees with problems such as feline idiopathic cystitis – which often leads to urination and spray marking in the home, as well as irritability – are obese. But he suggests vets need to understand the psychology of overfeeding an animal if they are to appropriately address this issue, understanding that it can often simply be a sign of misplaced love.
'The majority of people who come to us as clients love their animals, and sometimes that love goes a little bit wrong because they don't really understand the animal's biology,' he contends. 'That's not because they're obsessive; it's just what happens when you have two species that don't quite understand each other. So we've got to be very careful not to demonise people.'
Instead Bowen works with clients to help them better understand the behaviour of their cats, and better ways in which to demonstrate love. He believes these are lessons which could just as easily be passed on in general practice.
German agrees there is a desperate need for veterinary professionals to change the way in which they view the condition of obesity. 'We need to see it as a disease, not just a failing on the part of the owner, not just a lifestyle problem. We need to change how we address it, particularly how we support pet owners with what is a complicated problem. We mustn't stigmatise them, we've got to support them, we've got to change how we communicate about this condition.
'If you come in with a prejudice that it's the fault of the owner then you're going to start in the wrong place.'
Instead, a really concrete place to start when confronting the challenge of obesity, he suggests, is by recording body condition and body weight.
'We did a study about 10 years ago where we looked at about 2000 consultation records, the written records from veterinary practices. We found one recorded body condition score in those 2000. We've done a similar thing where we've looked at 15,000 records for just body weight, and only 1 per cent of records had a body weight on there.'
Long-term monitoring is vital – so it's weigh, weigh, weigh again, keep weighing
Recognising the problem earlier would, he says, make an enormous difference to overall prevalence. 'The long-term monitoring I think is vital – so it's weigh, weigh, weigh again, keep weighing. And I think that's one thing vet practices could try to do better if owners would be willing to. Coming in regularly just for weight checks, which are recorded in the notes, would be a start.'
Owner misperceptions of healthy weight
'If I release a picture on social media and say: "This is a healthy weight", a lot of people will say "that dog's underweight, it's too thin, what's wrong with it?" I think one of the challenges will be re-educating society as to what is normal.'
Alexander German, Royal Canin professor of small animal medicine at the University of Liverpool
This, coupled with evidence-based body condition scores, may also help address misperceptions among owners about what constitutes a healthy weight in cats and dogs. 'We see more and more pets that are overweight or have obesity, and we see those pictures and things in the media, and so we recalibrate what we see as normal,' suggests German.
'That's the same as has happened sadly in the human field as well. So I think that's where getting back to things like body condition scoring as an objective means to try to emphasise what is normal is a good start. I think one of the challenges will be re-educating society as to what is normal.'
But, in concluding his thoughts on the obesity epidemic, German again emphasises the need for re-education of veterinary professionals on the causes of – and responsibility for – overweight animals.
'Nobody chooses a life of obesity, and I don't think a pet owner would choose to make their dog or cat overweight. It's far, far more complex.
'One of the things I think we have to recognise is that we're facing a major challenge and there are no simple solutions. But there is enthusiasm for people to come together to try to make a difference. For me, that – above all else – is a start. I think we have a lot of the tools and a lot of the stakeholders to begin to change the rates of prevalence increase that we're seeing.'
Correction: The growth of pet obesity
BMJ Publishing Group Limited
Veterinary Record 2019; 185 616-616 Published Online First: 22 Nov 2019. doi: 10.1136/vr.l6498corr1