Important dietary and lifestyle factors in obese and sick patients
DVM: What role does proper nutrition play in weight loss for animals?
For each animal, I start by determining its daily food intake, how active it is and its level of stress, as well as the extent to which the patient's problem of obesity is influenced by each of these factors. I try to identify which factor is the most important in each particular case and begin there. Sometimes the animal is eating too much. You don't want to cut an animal's intake overnight, however. If you don't believe me, try telling someone to cut his or her access to food by 25 percent or 50 percent and notice what happens.In the practice I work in, my perception is that animals are eating satisfactory diets. If they are quite overweight and upon interviewing the clients I learn that the animals are not eating very much, then sometimes we will change the diet to something higher in protein and lower in fat to try to change the balance of nutrients. There is some (not strong) evidence that the increase in protein and decrease in fat intake might alter metabolism in a helpful way. But to date, it has not been well-studied in naturally occurring obesity in dogs or cats.
DVM: How do you determine whether an animal is losing weight in a healthy manner?
Buffington: I like to see animals lose about 1 percent of body weight per week on average. Some weeks they may not lose any weight. Some weeks they may lose more. We shoot for 1 percent loss of current weight per week as a goal.
DVM: How important is a strict diet for a pet in terms of weight loss?
Buffington: This depends on how big a role diet is playing. In fact, the focus should be on "obesity therapy" rather than strictly on "weight loss." This is because we need to be more concerned with maintenance of the lost weight than with the weight loss.
I think an important goal is to find ways for clients to express love for their pets other than with food. If an animal's life is chaotic, we will explore finding routines that create a sense of control for the animal, as well as enrich the environment in which it lives.
DVM: Does the new diet need to be continued for the lifetime of the animal?
Buffington: No. One of the reasons we don't do a great job of treating obesity is that we only look at diet. A better question would be, "Does obesity therapy need to be continued for the lifetime of the animal?" The answer to this question is yes. Obesity is a chronic, recurring, relapsing medical condition that requires lifetime therapy.
DVM: What are some misconceptions surrounding weight loss and obesity therapy in pets?
Buffington: A common misconception is that to treat obesity, all you have to do is cut food intake — it's easy. If it were that easy, we wouldn't have a problem.
And one of the biggest myths regarding obesity therapy is that you can calculate the number of calories an animal needs. The only way to know appropriate calories for an individual patient is to use body condition score.