How I approach... Pet obesity

Introduction

“Progress, not perfection.” This is my mantra for keeping obesity consultations rewarding and successful for everyone involved – the patient, the client, and the veterinary team. Obesity is a delicate topic in veterinary practice as it is tightly intertwined with the human-animal bond, involving complex emotions; addressing it may feel insurmountable to pet owners and even to veterinary professionals. Yet obesity is also one of the most prevalent diseases in dogs and cats (1), and most certainly a daily topic of discussion in general practice. Approaching these cases with a positive and pragmatic mindset is crucial for keeping both clients and the veterinary team engaged and motivated, resulting in success and, ultimately, in healthier pets.

Getting started

Introducing the obesity conversation with a client requires diplomacy, compassion, and finesse. Change is much more likely to occur if the client perceives the need for weight management in their pet as their idea, not by us lecturing the client or, worse yet, using scare tactics to try to convince them that their pet needs to lose weight (2). Asking open-ended questions (“How do you feel about Charlee’s weight?”) and leveraging tangible information (“Morty has gained a kilogram since we saw him last year; tell me about what has changed in his daily routine.”) brings the client into the conversation and gives them the opportunity to share their thoughts while minimizing judgement. Chances are they are concerned too, but perhaps too embarrassed or ashamed to bring up the subject themselves.

Once the topic of obesity is on the table, a more in-depth discussion can occur. Educating the client on the concept of body condition score (BCS), first explaining what a pet in ideal condition looks like and then involving the client in assessing their own pet (“What body condition score would you give Jasper?”) is an effective way to reduce judgement (Figure 1). If your evaluation and the client’s opinion aren’t quite aligned, further discussion using tangible data may be helpful. Looking back through the pet’s weight history (“When Amber weighed 4.5 kg, her medical record indicates she was in ideal body condition.”), leveraging breed standards (“The average healthy male Golden Retriever should weigh around 32 kg.”), and simply asking the client what weight they think would be healthier for their pet (“How much weight do you think would be reasonable for Tom to lose?”) can help you come to a consensus – or at least a compromise (Box 1).

Figure 1. Involving the client in the BCS assessment is helpful for initiating a conversation around pet obesity.
© Dr. Kirsten Graham

For some clients, addressing their pet’s obesity may seem pointless or impossible due to various household circumstances. Troubleshooting with the client to identify the hurdles that need to be overcome is paramount to getting them to a point where they are willing to commit to change. Perhaps there are other pets in the home, and feeding them separately may not seem feasible (Figure 2); maybe there are family members who aren’t willing to change their feeding habits or routines; perhaps the pet is able to access other sources of calories in its environment. In such cases, starting off with lifestyle changes before even considering prescribing a weight loss diet may make sense so that when the full nutritional program is eventually introduced, the pet and client are already set up for success. 

Figure 2. Technology such as a microchip pet feeder can make feeding pets separately significantly easier.
© Dr. Kirsten Graham

Leveraging house calls and telemedicine audio-visual platforms, depending on your jurisdiction’s regulations, can be immensely helpful in this stage of approaching obesity cases (Figure 3). By seeing the home environment, in person or virtually, you may discover issues – and be able to come up with reasonable, creative solutions – that can be addressed ahead of embarking on a weight management program, allowing you to tailor the plan to the patient’s and client’s individual needs (Box 2). You may also be afforded the opportunity to meet with other household members to uncover additional concerns and to help communicate the importance of addressing the pet’s obesity.

Figure 3. Leveraging teleconsultation, where jurisdictions allow, is very helpful in assessing the household circumstances. 
© Dr. Kirsten Graham

Weight loss diets

Sending home a prescription diet prematurely could easily lead to the perception of diet failure (“I tried the weight loss diet you gave me last year and it didn’t work!”), not due to the formulation itself but rather due to feeding it improperly. In addition, there can be various extraneous factors that may have thwarted the program. If an owner has had previous unsuccessful experiences, this may erode their trust in your recommendations or contribute to their perception that reducing their pet’s weight is hopeless. It is imperative to take the time to explore their concerns first (3) and to then put into place the changes needed to maximize the likelihood of results. If the client is not fully engaged and ready to address their pet’s obesity, focusing on smaller changes that they are willing to make will still bring them one step closer to eventually embarking on a weight management program. Give them “homework” to create healthier habits: simple changes such as shifting from free-feeding to meal-feeding, replacing a coffee mug with a measuring cup or (better yet) digital kitchen scales (Figure 4) or streamlining the treat selection to just a few consistent lower-calorie options will not only set the client and pet up for success later on but will also build their confidence in addressing this seemingly-insurmountable problem and build their trust in your expertise.

Figure 4. Making small changes, such as introducing the concept of weighing the food – or at least using a proper measuring cup – can have a significant impact on the success of a weight management program.
© Dr. Kirsten Graham

Maintaining momentum

When the client is ready to address their pet’s obesity, sending them home with a weight loss diet and advised feeding amounts is simply not enough; this is where many weight management programs fail. Every pet is different and feeding amounts will most likely need to be tailored and adjusted throughout the weight loss journey. The client may also need support in overcoming challenges such as begging behavior and scavenging or they may need emotional support to maintain their willpower. Regular follow up and open two-way communication is imperative to success. Monitoring patients while on a weight management program is an excellent way to involve the entire veterinary team (4). Many practices have individuals who are particularly passionate about nutrition and weight loss; leveraging these talents not only helps support weight loss journeys, but also creates a sense of purpose for the team, improving staff engagement, providing leadership and learning opportunities, and impacting overall job satisfaction (5).

Setting up a structured program with regular weight rechecks, ideally every two weeks, will help identify problems quickly and maintain weight loss momentum (6). Better still, monetizing weight management programs by putting together a package or bundle will add value to the services provided (Box 3). Clients who pay into a weight management program for their pet are likely to be more invested and feel more accountable, increasing the likelihood of seeing favorable results.

For some clients, regular weight checks can be inconvenient or even a deterrent to addressing their pet’s obesity. Depending on the circumstances, it may be possible to intersperse in-clinic or mobile visit weight rechecks with weigh-ins done at home by the client. Suitable platform-style scales may be purchased for domestic use (Figure 5) or, for cats and small dogs, pairing a digital luggage scale with a pet carrier makes for an inexpensive option to weigh the pet at home. Note that bathroom scales are not optimal as they are not sensitive enough to weigh smaller pets accurately and, for larger pets, they pose a number of safety risks such as dropping the pet, the client injuring themselves when lifting the pet, or a fearful pet biting or scratching the owner. In-clinic or mobile visit weight rechecks are still required to validate progress and to reassess BCS.

Figure 5. Platform scales are recommended for monitoring the pet’s weight at home.
© Dr. Kirsten Graham

Measuring success

Keeping clients engaged and motivated is the final key feature of a successful weight loss journey. Setting realistic goals and milestones helps to break down an otherwise daunting weight management plan into smaller, manageable stages, particularly in severe obesity cases. 

Regularly sharing the pet’s data with a weight loss “progress graph” is helpful for clients to be able to visually appreciate the outcome of their efforts but the numbers should be put into context. If a cat has lost 0.2 kg in two weeks, the owner may not understand the significance of what they perceive to be a tiny amount of weight. Taking the time to explain the optimal weight loss rate and relaying the data in this context will give the client a better perspective (“Nia’s ideal weight loss rate is 1 to 2% per week and, over the past two weeks, she’s been losing at a rate of 1.8% per week, nicely within the ideal range!”). As much as anthropomorphizing has the potential to make pet obesity conversations awkward, it may also help to frame the data in a more relatable manner, using units the client can understand more easily (“Lucky’s ideal healthy weight is roughly one tenth the size of a 150-pound human; as such, when we see that Lucky has lost 0.4 pounds, that’s equivalent to a person losing 4 pounds!”).

Weight loss progress is much more than just the number on the scale. Educating your client about body condition and reassessing the BCS together can help them to visually appreciate the progress they are making with their pet. Periodic top- and side-view BCS photographs taken with the pet standing squarely on all four feet, ideally with a consistent, structured background (such as a tile floor), are very telling and motivating for clients to see (Figure 6). For pets with long, fluffy coats, taking these images following a bath or swim will better illustrate subtle changes.

Figure 6. Taking body condition photographs to document weight loss progress can be very motivating for clients. Use a consistent, structured background and place a standard item, such as a ruler, in the images for scale.
© Dr. Kirsten Graham

The best and most exciting milestones, however, are the quality-of-life changes that client will start to notice as their pet approaches a healthier weight (Figure 7). The day a pet can fit through their pet door to access the outdoors on their own, the day a cat can get back up onto the windowsill to watch the birds again, the day a dog can walk around the block without a rest, are all well worth celebrating! In addition, medical milestones are often achieved - such as a diabetic cat going into remission or a dog no longer requiring daily treatment for osteoarthritis. Arguably, these accomplishments are far more important than any data point on a graph.

Figure 7. The most significant successes in weight management are the positive changes seen in the pet’s daily life such as re-engaging in activities they enjoyed prior to developing obesity. 
© Dr. Kirsten Graham

Even when there is no tangible progress at a weight recheck, finding something to celebrate can keep everyone involved, motivated and optimistic. Perhaps the client was successfully able to complete a diet transition to the weight loss formulation without the pet rejecting the new food; maybe the client has found a way to reliably feed their cats separately; perhaps the client has managed to eliminate treats or table scraps from the dog’s diet. While not measurable progress, these important changes are all major accomplishments that should not be overlooked.

Conclusion

The bottom line with any weight management program is simply improvement in quality of life. The terminology used throughout this article – with a focus on “weight management” rather than “weight loss” – is very intentional. In some cases, it may only be reasonable to mitigate further weight gain but even this will still have some form of positive impact on quality of life. Redefine success and remember: progress, not perfection!

References

1. Montoya M, Péron F, Hookey T, et al. Overweight and obese body condition in ~4.9 million dogs and ~1.3 million cats seen at primary practices across the USA: Prevalences by life stage from early growth to senior. Prev. Vet. Med. 2025;235:106398. doi: 10.1016/j.prevetmed.2024.106398. Epub 2024 Dec 3. PMID: 39644829.
2. Sutherland KA, Coe JB, O’Sullivan TL. Assessing owners’ readiness to change their behaviour to address their companion animal’s obesity. Vet Rec. 2023;192(3):e1979. doi: 10.1002/vetr.1979. Epub 2022 Sep 8. PMID: 36073659.
3. Sutherland KA, Coe JB, Janke N, et al. Veterinary professionals’ weight-related communication when discussing an overweight or obese pet with a client. J. Am. Vet. Med. Assoc. 2022;260(9):1076-1085.
4. Fraser-Celin VL, Boulton A, Keil K, et al. When veterinarians treat plus-sized pets: Insights for veterinary practice. Can. Vet. J. 2024;65(9):920-926.
5. Cline MG, Burns KM, Coe JB, et al. 2021 AAHA nutrition and weight management guidelines for dogs and cats. J. Am. Anim. Hosp. Assoc. 2021;57(4):153-178.
6. Brooks D, Churchill J, Fein K, et al. 2014 AAHA weight management guidelines for dogs and cats. J. Am. Anim. Hosp. Assoc. 2014;50(1):1-11.