Obesity in horses is an escalating problem, especially in leisure and show horses. In view of the clear association with laminitis, the management of obesity is now a high priority in equine practice and veterinary surgeons can play a pivotal role in tackling the complex issues surrounding obesity and the factors that contribute to it. However, the causes and solutions to the obesity problem are complicated.
Obesity is the excess accumulation of body fat; it develops because of abnormal biological regulation of energy balance, and can have multiple complications. As a result, some human medics, as well as some vets, believe that obesity should be considered to be a disease.
The Oxford Dictionary defines disease as “a disorder of structure or function… especially one that produces specific symptoms… and is not simply a direct result of physical injury”.
Human obesity, in which excess body fat has accumulated to such an extent that health may be adversely affected, meets that definition, and the World Health Organization has considered it a disease since 1936. However, this conclusion is controversial. The American Medical Association also classifies obesity in people as a disease, but the NHS does not.
Likewise, in the veterinary world, there are differences of opinion regarding the classification of obesity as a disease. The BSAVA considers obesity to be a disease, stating that “in companion animals, obesity has a significant adverse effect on health and welfare including associations with various additional and often concurrent conditions or diseases, reduced life expectancy, functional impairment and poor quality of life”. On the other hand, the BVA has decided that obesity is not a disease, stating that “while obesity can result from disease and often causes secondary disease processes, formally classifying it as a disease could have unintended negative consequences”.
Regardless of whether obesity itself is a disease or not, it is clear that obesity in horses can be associated with potentially devastating consequences, such as laminitis. As a result, the veterinary profession, including both vets and vet nurses, needs to educate and provide guidance to horse owners about the importance of achieving and maintaining an appropriate body weight in their animals, and how to feed and manage them accordingly.
However, this is easier said than done. Educational programmes are limited in their effectiveness; awareness of an issue is not enough to change people’s behaviour. Campaigns that rely on raising awareness alone often fail to achieve significant change, and this has been observed in the past with both human and veterinary promotions aimed at educating people about obesity.
Behaviour change science is a discipline focused on understanding what makes people tick, using this to develop interventions that change people’s habits, attitudes and behaviours towards a desired goal. In public health, behaviour-based tools have been effectively used to prevent disease and improve people’s health.
BEVA has recently launched a pilot project that takes a behaviour change science approach, based on advice from the Behaviour Insights Team. The objective is to motivate horse owners to look at their own horse’s body condition, and where appropriate to provide advice about what they can do to address any obesity problem. The scheme uses a traffic light colour system of vaccination reminder stickers that vets can place on the front of passports at the time of vaccination. The stickers are designed not only to remind owners as to when the next vaccination is due, but also to inform them about the horse’s body condition. A green sticker indicates a healthy body condition, whereas amber indicates moderate obesity requiring changes to the diet, exercise, management and rugging or clipping. A red sticker indicates that the horse is seriously obese which requires immediate action to reduce the risk of life-threatening complications.
The main objective of these stickers is to initiate a conversation with owners about their horse’s weight/body condition. The stickers have colour-specific QR codes that owners can use to find additional information and advice via their smartphone. Nine equine veterinary practices are currently trialling the scheme, which will run for six months. After this time the success of the scheme will be assessed in terms of what proportion of owners used the QR codes to visit the advice pages, and how effective the vets involved believe that the scheme has been in addressing the problem. If it proves to be a valuable tool in the battle against equine obesity, then it can be rolled out across the country.