Certain aspects of pet weight loss programmes are inherently alike, and the veterinary care provider should be comfortable with the fundamental routine elements. These include:
- Performing a nutritional assessment
- Estimating ideal body weight
- Determining energy allocation to achieve caloric restriction
- Recommending a suitable diet to effectively and safely facilitate weight loss
- Advising on appropriate physical activity
- Setting the appropriate follow-up plan
- Reassessing patient progress
- Troubleshooting challenges
- Adjusting the plan as needed to meet goals over time
However, beyond the basic mechanics of the weight loss programme, integrating the following tips into the care approach can help the veterinary team to more effectively manage the complexities of pet obesity cases and improve patient results.
Communicate with compassion and care
The classification of obesity as a disease, its association with comorbidities and its impact on both the quality and, potentially, the quantity of life makes it clear that veterinarians have a responsibility to advocate for their patients and address cases of obesity – a process which can only begin (and then, succeed) with effective communication (Day, 2017; Kipperman and German, 2018).
Veterinarians have a responsibility to advocate for their patients and address cases of obesity – a process which can only begin (and then, succeed) with effective communication
Client communication surrounding pet obesity can be sensitive, and there are a myriad of reasons why a veterinarian may avoid raising the topic of a patient’s obesity during a consultation: time constraints, the anticipation of poor compliance, worry about causing offence and the potential discomfort experienced by a veterinarian or pet owner who themselves has obesity, to name just a few (Cairns-Haylor and Fordyce, 2017). Despite these complexities, effective veterinarian–client communication generally enables better overall medical care, client satisfaction and compliance with treatment plans, and this unquestionably applies to outcomes of obesity care as well (Pun, 2020). Furthermore, recent client communication-focused research suggests pet owners have not only the desire to discuss their pet’s weight with their veterinarian but the expectation of this too (Sutherland et al., 2022).
Developing and honing the tools that enable the veterinary team to confidently and skillfully navigate these discussions and tailor the communication approach to the individual client requires resource investment in training and establishing clinic protocols, but the value is clear.
A relationship-centred approach built on a foundation of established trust and empathetic, compassionate communication applies well to pet obesity care
Paired with effective communication skills, employing a relationship-centred approach to veterinary care can empower the pet owner to take an active role in decision making for their pet and may improve overall adherence to therapy (Küper and Merle, 2019). A relationship-centred approach built on a foundation of established trust and empathetic, compassionate communication applies well to pet obesity care. Herein, the partnership between the pet owner and veterinary team is essential.
The power of words
Words hold power, and the language we use to communicate truly matters. The entire veterinary team should be aligned on the importance of using thoughtful and judgement-free language when it comes to all client communications surrounding patient body weight and obesity. Recognising that pet obesity is a medical condition, the team should consistently use appropriate and direct terminology (ie “overweight”, “obesity” and referring to body condition score) rather than colloquialisms or minimising language (eg “a little chubby”) that might downplay the significance of the pet’s condition or be interpreted offensively (Churchill and Ward, 2016).
Adopting [people-first language] for veterinary patients is an easy-to-implement shift – one that will not be felt directly by our patients but may be meaningful for the people who care for them
In the context of human obesity care and communication, it is encouraged to adopt the use of people-first language (eg referring to a “person with obesity” rather than applying the label of “obese person”) to help reduce weight-related stigma (The Obesity Society, 2022). Adopting similar language for veterinary patients (eg “cat or dog with obesity” rather than “obese cat or dog”) is an easy-to-implement shift – one that will not be felt directly by our patients but may be meaningful for the people who care for them.
Change cannot be forced: meet the pet owner where they are
The pet owner’s engagement with a weight loss programme is critical given the long-term commitment required and the fact that success requires the owner’s willingness to truly change their behaviour and habits and sustain these changes, often indefinitely. The idea of assessing a person’s readiness to implement behavioural change has recently been described in the context of pet obesity care and communication (Churchill and Ward, 2016).
While the veterinarian has a responsibility to address weight problems in their patients, this can only be realised in active partnership with the pet owner. As such, understanding the pet owner’s readiness to implement the types of changes required by a weight loss programme and using this information to tailor the approach may help to optimise successful patient outcomes and use of the veterinarian’s time.
When a weight problem has been identified on physical examination, a practical way to employ this tactic early on is to begin by asking the pet owner’s permission and gauging their openness to discuss the topic of their pet’s weight (Churchill and Ward, 2016). This question simply yet impactfully demonstrates that you respect the pet owner’s interests and time while simultaneously guiding the veterinarian’s next moves. The owner’s response provides the headway needed for the veterinarian to explore the appropriateness of planning a weight intervention at that time or consider the discussion as an opportunity to introduce the topic, effectively setting the stage for future follow-up and action.
Focus on the patient’s health and quality of life
From the outset, weight discussions with the pet owner should be centred on the health implications of the patient’s condition and the expected health benefits of addressing the problem. Optimising the pet’s health and quality of life is likely to be a shared goal of the veterinarian and the client, and early identification of this common ground can help to set the stage for a collaborative, rather than adversarial, dynamic. Furthermore, framing weight concerns in the context of the current or potential adverse effects on health associated with obesity may help to engage and motivate the owner to take eventual action towards solving the problem (Cairns-Haylor and Fordyce, 2017).
In addition to assessing the clinicopathological evidence of any problems and clinical signs related to the patient’s weight condition, the veterinarian’s history-gathering may also glean relevant insights into the impact of obesity on the pet’s quality of life. Asking the pet owner if any changes in their pet’s mobility, activity levels or playfulness have been observed (offering relevant examples for the species) may help bring to light compromises in their pet’s quality of life that are directly linked with obesity but which may not be obvious. Examples of these behavioural changes for cats include a hesitation to jump to an elevated surface or reduced grooming ability causing changes in the haircoat; for dogs, being slower to rise from recumbency or climb stairs is symbolic.
Optimising the pet’s health and quality of life is likely to be a shared goal […], and early identification of this common ground can help to set the stage for a collaborative, rather than adversarial, dynamic
Tracking the evolution of these quality-of-life indicators over the course of a weight loss programme can be useful to highlight and celebrate the patient’s progress and success.
Tailor the plan to the patient and the person
Facing the reality that weight loss programmes are difficult to complete, with approximately half typically failing to return their pet to ideal weight, the concept of customising the programme to the individual patient – specifically with respect to the targeted body weight and degree of weight loss – has been proposed as a strategy to improve success. With this approach, the veterinarian focuses on the “big picture”, namely the goal to make sustainable changes that will improve the patient’s health and quality of life, rather than simply achieving the targeted weight loss rate or final ideal body weight.
Using a tailored approach, the veterinarian may recommend complete (ie attaining an ideal body weight) or partial weight loss, with the appreciation that the latter can still benefit a pet with obesity (German, 2016). To customise the plan, the veterinarian might consider relevant patient factors such as age, concurrent disease and clinical signs (including those which might necessitate a specific nutritional strategy contradictory to that traditionally used for weight loss or those that abate with some weight loss). They may also consider pet behaviours exacerbated by implementing marked calorie restrictions.
Importantly, and in the framework of relationship-centred care, the veterinarian should establish the owner’s goals for their pet and factor them into the plan. Adapting the programme to fit the pet owner’s needs and life circumstances should involve exploring the changes that the owner believes they can readily make in addition to the limitations or barriers they anticipate and helping to identify possible solutions in advance.
Conclusion
While pet obesity care presents a multitude of challenges and weight loss programmes are often unsuccessful, employing a relationship-centred care approach based on thoughtful, effective and compassionate client communication and customising the recommendations in consideration of both medical and pet-owner goals can help the veterinary team to improve outcomes of obesity care and, ultimately, the health and well-being of their patients.
