managing obese pets

ManagingObese

Pets

Managing Obese Pets

Definition and incidence

Assessing body condition

Energy balance

Preventing obesity

Treating obesity and preventing recurrence

Definition and Incidence

Definition- Increase in body fat

→impairs health or function- > 20% above ideal body

weight

Definition and Incidence

Increasing incidence of obesity

Definition and incidence

- Estimated 25-40% pets are overweight or obese

- Owners and veterinarians tend to underestimate incidence of obesity

- Body condition scoring is useful tool for recognition of obesity

Incidence

Definition and incidence

Owner evaluation of pet weightUnder

2%Over 18%

Average 80%

Dog Cat

Under 4%

Over 19%

Average 77%

1992 AAHA Survey

Definition and incidence

- Associated with or exacerbates specific diseases

- May make pets less tolerant of metabolic stress

- Can complicate therapeutic and diagnostic procedures

Health risks of obesity

Health Benefits and Risks

Obesity issues

Metabolic Functional Disease risks

Hyperlipidemia Joint stress Dermatoses

Hyperinsulinemia Dyspnea Reproduction

Glucose intolerance Hypertension Immunocompromise

Diabetes mellitus Tumors

DOD/osteoarthritis

Assessing Body Condition

Diagnosis of obesity- Body weight- Compare to

weight at 1 year

- Body condition scoring

Assessing body condition

Body Condition Scoring A clinical assessment of body fat Accounts for animal’s frame size

independent of its weight Uses defined criteria to help make

the process more objective Recommend a 5-point system for

body condition scoring

DEXA

Assessing body condition

5-Point Body Condition Scoring System

1 – Very Thin

2 – Underweight

3 – Ideal

4 – Over weight

5 - Obese

Assessing body condition

3 – Ideal Ribs – Easily felt with

slight fat cover Bony prominences –

easily felt with slight fat cover

Side view – Abdominal tuck

Overhead view – Well-pronounced waist

Assessing body condition

4 – Overweight Ribs – Difficult to feel

under moderate fat cover

Abdominal fat pad – Moderate

Side view – No abdominal tuck

Overhead view – Back is slightly broadened at waist

Assessing body condition

5 – Obese Ribs – Difficult to feel

under thick fat cover Abdominal fat pad marked Side view – No waist; fat

hangs from abdomen Overhead view – Back is

markedly broadened Fat deposits – Limbs & face

Assessing body condition

BCS = 1

Assessing body condition

BCS=3

Assessing body condition

BCS = 5

BCS % Body Fat% Ideal Wt.

1 5 852 6-14 86-943 15-24 95-1064 25-34 107-1225 35-45+ 124-146+

Toll P, et al. SACN, 4th Ed, 2000

Assessment of body condition

ENERGY BALANCE

Caloric intakeActivity

Intake > Use = Weight GainUse > Intake = Weight Loss

Energy Balance

Internal– Genetics (breed)– Gender/neuter status– Age– Decreased metabolism– Exessive appetite

External– Food availability– Food palatability– Food composition (high

fat/calorie)– Owner’s behavior

RER TEF Environmen

t Activity Production

EnergyExpenditure

EnergyIntakeFactors

Energy Balance

Variation in Energy Requirement for Body Weight Maintenance of Dogs

Number of Dogs

% of average metabolizable energy intake per kg metabolic body weight

151413121110987654321

45 50 55 60 65 70 75 80 85 90 95 100 5 10 15 20 25 30 35 40 45 50

Preventing Obesity

Risk factors

– Owner– Patient– Food– Activities

DVM assessment

Preventing Obesity

Owner risk factors– Relationship to

food– Overweight– Age– Child substitute

Preventing Obesity

Patient risk factors– Life stage– Gender– Neutering– Breed

Preventing Obesity

Life stageObese puppies

and kittens

Obese adults

Percent Body Fat - Canine

Age: p = 0.0001Age2: p = 0.0001

55

1010

1515

2020

2525

00 11 2 3 4 5 6 7 8 9 10 11 12

Years of Age

%F

at%

Fat

Preventing obesity

Percent Body Fat - Feline

Age: p = 0.046Age2: p = 0.042

1010

2020

3030

4040

00 11 2 3 4 5 6 7 8 9 10 11 12

Years of Age

%F

at%

Fat

Preventing obesity

Preventing Obesity

Effects of Age on Obesity

1 - 4 5 - 7 8 - 11 > 1210

30

50

% ofDogsOverweig

ht

Age (years)

Source: Mason, Vet Rec 86:612 (1970)

Preventing Obesity

Effects of Age on Energy Req.

< 1 2 3-7 > 7

kcal DE/kg

Age (years)

Kleazle & Rainbird, Waltham Symp, 1990

Labrador Retrievers140

150

135

110

Preventing Obesity

Effects of Gender on K-9 Obesity

Intact Neutered Intact Neutered

10

30

50

% ofDogsOverweight

Male

Source: Edney & Smith, Vet Rec 118:391 (1986)

Female

Preventing Obesity

Feline Obesity Study

Preneuter Postneuter(3 mos.)

Preneuter Postneuter(3 mos.)

80

60

40

20

0

Food Intake (g/day)

Male Female

Preventing Obesity

Feline Obesity Study

Preneuter Postneuter(3 mos.)

Preneuter Postneuter(3 mos.)

40

30

20

10

0

%Weight Gain

Male Female

Preventing Obesity

Food risk factors– High palatability– Ad-lib intake– Competition– Treats– Table scraps– Hunting and

scavenging

Commercial Foods - Forms

Frequency of feeding

Dog dry Cat dryCat moist

Once daily 45% 22% 43%Twice daily 26% 19% 30%Bowl always full 26% 51%

3%< once daily 1% 2%

18%

Habits & Practices Study, Sept 2002

Preventing Obesity

Activity risk factor assessment– Lifestyle of owner and

pet– Concurrent diseases in

pet

Treating Obesity

Success in obesity treatment– Humans 0-5%

– Animals up to 50%

Treating Obesity

Successful treatment depends on:– Owner education– Owner motivation– Veterinary involvement– Provision of key nutritional

factors

Treating Obesity

Veterinary involvement– Estimate ideal weight– Select reducing food– Calculate food dose– Recommend exercise– Graph weight vs. time

Treating Obesity

Weight Loss Performance Chart

Weig

ht

321 4 75 9 1110 12 1413 1586

GOAL

Time (Weeks)

Treating Obesity – Energy Restriction

Determining energy req’t– Resting Energy Requirment

RER = 70BWkg0.75 or 30BWkg

+70– Daily Energy Requirement

Dog 1.6 X RERCat 1.2 x RER

Treating Obesity – Energy Restriction

Determining energy req’t

Use care in feline caloric restriction

Dogs: 1.0 RER(60% DER)

Cats: 0.8 x RER(70% DER)

@ estimatedideal weight

Treating Obesity

Food dose calculation– Example: 13.5 kg obese dog

10 kg ideal weight

– RER (kcal/day) = (30 Wtkg+70)[30 (10) + 70] = 370 kcal/day

Treating Obesity

Select a reducing diet:

260 kcal/can370 kcal 260 kcal/can =1.4 cans (vs. 0.75 can maintenance food)

200 kcal/cup370 kcal 200 kcal/cup =1.85 cups (vs. 1.25 cups maintenance food)

Treating obesity

Nutritional technology for weight loss:- Calorie Control – reduce caloric density- Intake Control

- Reduce internal drive to eat – satiety via fiber, water, AA’s

- Metabolic Control- Shift metabolism from storage to usage- Carnitine

Treatment Options

Reducing diet characteristics– Moderate kcal restriction

(20-50%)– Non-energy nutrients

balanced to dry matter intake

– Low fat– High fiber for satiety and

kcal– Protein and micronutrients – Profile suitable for dogs and

cats

Treating obesity

Key nutritional factors for weight loss (DMB):- Energy canine < 3.4 kcal ME/g- Energy feline < 3.6 kcal ME/g- Fat 5-12% for dogs, 7-14% cats- Fiber 12-30% crude fiber- Protein >25% for dogs, >35% for

cats

highhigh

highlowlow

lowlowFiber (energy dilution)

Energy Diet

Low

Fat

, Low

Fib

er

Inta

ke

Inta

ke

Low

Fat

, Low

Fib

er

Low

Fat

, Mod

erat

e F

iber

Low

Fat

, Hig

h F

iber

The Effect of Fiber on Energy and Total Diet Intake

Effect of a Dry Fiber-Enhanced, Low Calorie Food* for Weight Loss in DogsEffect of a Dry Fiber-Enhanced, Low Calorie Food* for Weight Loss in Dogs

-1.7-1.6

-37.9 -40.4

2.5 -2.0

-39.0

-7.6

-47.0

-8.6

-30.4

-39.0

-50

-40

-30

-20

-10

0

10

Weight, g/d Fat, g/d Muscle, g/d %BW/wk

Tis

su

e C

ha

ng

e (

gra

ms

/d)

Test 1 Test 2 Test 3

* Prescription Diet Canine dry r/d Fed at 1.0 x RER at ideal weight

Treating obesity

Typical Energy Metabolism

Treating feline obesity

Metabolic Control for Weight LossTreating feline obesity

Treating feline obesity

Ketones are normal metabolites produced in mitochondria as a by-product of fatty acid metabolism

Ketone levels when fat metabolism is increased (benign dietary ketosis)

Ketones can be measured in the serum.- beta-hydroxybutyrate (BHBA)- acetoacetate- acetone

Magnitude of Ketogenic Effects

Condition Quantity of Ketones

Fed State 0.1 mmol/L

Overnight Fast 0.3 – 0.7 mmol/L

Low CHO diet 1-3 mmol/L

Diabetic Ketoacidosis >15 mmol/L

Treating feline obesity

Treating feline obesity

Treating feline obesity

Preventing Recurrence

Maintain lifestyle changes – exercise helpful

Monitor weight Portion control

– Lower energy food

– Limit treats

Summary

Obesity is most common form of malnutrition

Body condition scoring is a useful clinical tool

Body composition is controlled by energy balance

An ounce of prevention is worth a pound of cure

Summary

Health risks associated with

obesity are reversible Effective obesity treatment

requires a team effort – vet, technician, owner

Dietary fiber enhances satiety

Feline obesity can be managed via traditional reducing diets or low CHO diets