Ernie Ward, DVM, CVFT
There’s a secret life of pets we don’t often talk about. The secret begins with the fact that over half the nation’s dogs and cats are now classified as overweight or diagnosed with obesity by their veterinary healthcare provider. Nearly 60% of cats and 54% of dogs equaling over 50 million cats and 42 million dogs are at risk for weight-related disorders (2015). In addition to confronting pet obesity and its associated maladies and complications, I’ve also been uncovering another secret of pet obesity: Inflammation. In fact, I’d go as far as to say inflammation is the new obesity and is the real secret we need to reveal to both pet parents and the public.
I’ve been studying and working on pet and human obesity for the past twenty years. During that time, I’ve witnessed the pet obesity discussion evolve from “fat is funny” to “fat is deadly” to “fat is boring.” People ignore warnings about pet obesity the same way they disregarded that smoking was deadly to humans for decades. Deep down most folks know obesity is dangerous; they just don’t think anything bad will happen to them or their pet. Psychologists call this phenomenon of believing you or your pet is at less risk for harm despite evidence to contrary “optimism bias.” It’s a necessary coping mechanism that allows us to get through our days without succumbing to a neurotic crisis. It also gets in the way of change. Maybe it’s time we change how we talk about pet obesity.
For over five years, I’ve begun altering the way I describe pet obesity to clients and veterinarians. Pet owners see a “big pet.” Most veterinarians see a “pet with obesity.” I see dysregulated chronic inflammation. Inflammation?
The real danger of obesity in pets and people isn’t the fat; it’s the inflammation the excess fat tissues cause. That's what I’ve been communicating the past few years: Reducing chronic inflammation associated with obesity should be our true medical objective.
I’ve been teaching pet owners and veterinary professionals for two decades, “Don’t chase a number on a scale; focus on improving quality of life and decreasing disease risk.” What this really means is to take measures to help reduce obesity-related inflammation. Fortunately, this is one area the media is helping.
The popular press has latched onto the idea that inflammation is bad. Rarely does a week pass without a story on “inflammation” making the news. This public awareness offers physicians and veterinarians an opportunity to pivot the conversation from “you or your cat have obesity” to “you or your cat is experiencing severe systemic inflammation caused by obesity.” That helps remove the stigma associated with “obesity” and allows us to focus on addressing the underlying medical problems and improve quality of life.
I’m so passionate about helping pets with obesity because I’ve witnessed the toll it takes on their quality of life. In my pet obesity book appropriately titled, “Chow Hounds,” I speculate that dogs with obesity must feel lousy most of the time. This is based on studies of humans suffering from obesity who confront chronic fatigue, malaise, decreased energy and vitality, and a laundry list of aches and pains. I can’t imagine pets with obesity feel any better. I think it’s time we clearly convey to pet owners how terrible obesity may make pets feel.
In addition to feeling less than optimal, pets with obesity are more likely to develop diabetes and insulin resistance. Hypertension and kidney disease are also common, especially in cats diagnosed with obesity. Managing these conditions in pets can be challenging, even for the most dedicated pet lover. Administering insulin injections and blood pressure medications requires patience, persistence, and lots of veterinary checkups. The great news is these diseases can often be prevented by proper nutrition, an active lifestyle, and maintaining a healthy weight.
Arthritis and joint problems are also common in pets enduring obesity. The hips, knees, shoulders, and elbows of dogs and cats are commonly affected. Dogs with obesity are much more likely to suffer severe arthritis pain and debilitation. Arthritic cats can cleverly hide their pain until the disease is advanced. Recent research has shown most cats with obesity have joint damage. Sadly, that’s not the worst consequence of obesity.
Cancer is now recognized as a result of obesity. While studies in dogs are cats are currently lacking, the physiological connection between laboratory animals, humans, pets, and cancer is clear. Human and animal doctors need to more openly discuss the emerging evidence that links many cancers and obesity with patients and clients. And that leads us to the biggest challenge of all in the fight against human and pet obesity.
I believe the biggest adversary in the war on pet obesity is silence. Many veterinarians complain they aren’t comfortable talking about a pet’s weight for fear of inadvertently offending the client. Physicians grumble that patients don’t change. I understand their concerns. I urge my veterinary colleagues to “forget fat; start talking about inflammation and disease.” I ask M.D.’s to persist. Overcoming obesity is not a simple task; it requires commitment, exploration, and adaptability. We must evolve until we find the perfect balance between science and language, promotion and procedures, and health and happiness. Because the challenges are substantial and the stakes extraordinary, human and veterinary medical forces must unite and share shields and swords to preserve the human and animal family.
It’s also time veterinarians reshape the pet obesity conversation. I’m calling on my profession and the human medical community to help me accomplish the following (click here for the 2018 Global Pet Obesity Initiative Statement):
1) Define pet obesity. Currently, veterinarians can’t define what “obesity” is in animals. This confuses and clouds the issue. We don’t have a consensus for the terms “overweight” and “obese.” I’m officially offering the independent organization the Association for Pet Obesity Prevention to help jumpstart the conversation. Now, I need your help, physicians, nurses, academicians, practitioners, and industry representatives.
2) Standardize Body Condition Scores (BCS). BCS is the pet world’s closest equivalent to Body Mass Index (BMI). There are at least three major dog and cat BCS scales used worldwide. I’ll be the first to agree that there are limitations to the BCS. The advantages are the BCS is simple to administer, works well in most situations, and is already widely accepted and used in clinical practice. Our profession needs to come together and settle on one scale and move forward. Now.
3) Define pet obesity as a disease. The American Medical Association (AMA) officially defined obesity as a human disease in 2013. I’d like to see the American Veterinary Medical Association (AVMA), World Small Animal Veterinary Association (WSAVA), and other global organizations follow (click here for 2019 update). I believe classifying pet obesity as a disease would ultimately encourage more veterinarians to talk about the condition and inspire our industry to innovate better solutions.
4) Define Prediabetes. For years, I struggled with the concept of “prediabetes” until I started evaluating studies on people diagnosed with prediabetes. Screening and discussions appear to raise awareness of diabetes and offers a potential early intervention point for clinicians. There’s growing evidence we may be able to apply the prediabetes strategy in veterinary medicine, especially in cats with obesity. There are useful veterinary biomarkers that could help general practitioners identify at-risk pets earlier.
5) Develop Better Technology. We need a technological solution to quickly and accurately assess body fat composition in dogs and cats. As I frequently tell industry colleagues, “Give veterinarians something to do, not something to sell.” We desperately need improved tools for tracking weight, BCS, and dimensions.
This is only a glimpse into the secret lives of pet and human obesity. Obesity is perhaps the most complex, challenging, and, ultimately, one of the most important medical conditions in both human and veterinary medicine. Obesity affects nearly everyone – human and animal – in some harmful manner, steals billions in medical bills, and robs quality of life and life expectancy for hundreds of millions. That’s why the battle to cure obesity is so important and why I’m committed to fighting it. Let’s combine veterinary and human medical efforts to benefit the people, children, and pets with obesity we love and cherish. Ultimately, the real secret I want to share is a healthier and happier future for all living things.
Dr. Ernie Ward - 2015