MANAGEMENT OF OBESITY - THE CLINICAL NUTRITIONISTS EXPERIENCE

Overweight patients are common in veterinary medicine, just as they ar e in human medicine. Although animals also suffer from diseases in the general categories of cancer, hypertension, diabetes, and digestive d iseases, many of the specific problems of obese humans do not afflict obese pets. Of tumors, only adenocarcinoma of the breast is a signific ant problem in dogs and cats. Moreover, a high intake of dietary fat a nd table food has been reported to be protective in adult dogs; in wom en, increasing dietary fat has been associated with increased breast c ancer risk. Two experimental studies in dogs notwithstanding, no publi shed data have been provided suggesting that hypertension accompanies obesity in companion animals currently. Hyperinsulinemia and glucose i ntolerance has been reported in diabetic obese dogs as well as in huma ns. Whether or not weight reduction would correct these abnormalities has not been reported. In humans, central distribution of fat may be m ore pathological than a peripheral distribution, increasing morbidity due to cardiovascular disease, diabetes, and hypertension. The presenc e of differences in fat distribution have not been described in compan ion animals, even though they may influence the risk of obesity-relate d diseases in pets as well. No studies of investigation of the success of maintenance of the lost weight in client animals exist. Recently r eported studies of obese women suggest that maintenance of lost weight may be better maintained with continuous care programs, and support t he view that obesity should be treated like other chronic diseases, by providing ongoing care for the rest of the life of the patient. Due t o the low probability of success of obesity therapy found in humans, v eterinary attention might be better directed toward aggressive attempt s at obesity prevention. Clients can be educated to recognize normal b ody condition in their pet, and to exert portion control to maintain t he desired body condition. Feeding based on the animal's body conditio n may expand the role of reduced calorie pet foods, using them in comb ination with portion control to avert weight gain by decreasing the ca loric density without reducing the amount fed. Life-time portion contr ol is essential for proper weight maintenance; in both dogs and cats c ompensation for caloric dilution, by whatever method, occurs after a p eriod of a few weeks to months. Although the success of obesity therap y in companion animals appears to be as dismal as it has been in human s, obese dogs and cats may have something to offer to obesity research . Contributions in at least four areas may be feasible; the genetics o f obesity, adrenergic receptor activity in obesity, drug therapy, and pet-facilitated behavior therapy.