Sally is a six year old Labrador who weighs over 50kg. Ideally, she should weigh more like 35kg, making her over 40% overweight. That’s like a ten stone person weighing over 14 stone.
s you can imagine, she suffers from the consequences of her excessive weight, with arthritic joints, poor fitness, continual tiredness and a risk of other associated illnesses. We know now that obesity is a chronic state of inflammation in the body, with increased levels of toxic metabolites in the bloodstream, leading to poor general health,and mental depression. Overweight pets have a reduced quality of life, and shorter lives. It’s not a good state for Sally, yet it’s surprisingly difficult to tackle this problem.
New research tells us that between 59 and 65% of dogs are overweight or obese, along with between 12 and 52% of cats. However only 18% of dog owners, and 22% of cat owners identify their pets as being too heavy. There is a serious issue with owners not recognising that their pets have a problem, and this does not help the animals involved.
You might think that conversations about pets’ weight would happen regularly in veterinary consultation rooms, but studies show that this is not the case. It’s too easy for vets to avoid this uncomfortable topic, and that’s exactly what tends to happen. There must be parallels in the human medical world: if a doctor keeps telling someone that they must lose weight, it must be tempting for the patient to decide to go to a different doctor who is more “accepting”. And perhaps the same applies to vets with our patients: we do not want to alienate anyone, so it can be easier just to avoid the topic. This does not serve our patients well: we need to find better ways to solve this complex issue.
A recent study published in the UK “Vet Record” explored veterinary professionals’ experiences of weight-related discussions during companion animal consultations.
A novel aspect of the topic was investigated: the idea that vets could have unconscious bias against overweight clients. This idea is in line with the twenty first century trend (unhelpfully labelled by some as being “woke”) to look for unconscious bias against a wide range of characteristics of humans, including race, gender, sexual orientation and social background. The theory is that most of us consciously believe that we are fair and unbiased, but when certain psychological tests are carried out, they prove that we are, in reality, far more prejudiced than we like to believe. If this bias can be demonstrated by tests, people can then take conscious action to work against this bias, creating a fairer, more just society. As Carl Jung said, “when the unconscious becomes conscious, the unconscious stops directing our fate”.
The results showed that most vets in the study had an unconscious negative bias towards people who were overweight. This is consistent with similar studies in other healthcare professionals. The bias is perceived by overweight people, and they feel stigmatized, leading to a poorer relationship with doctors, nurses and others, followed by decreased trust, poorer communication and reduced engagement with care. It’s important to recognise this, because the bias has been linked to poorer health outcomes in human healthcare. Studies have not yet been done on the parallel topic of the possibility of unconscious bias against owners of overweight pets, but it seems likely that this does happen at some level. It’s so easy for humans to be “judgey”, and indeed, for us to feel “judged” by others. This discomfort does not help to resolve challenging problems that need to be tackled for the sake of the animals.
The researchers in this study went on to examine the type of language that was used when discussing pets’ weight. Words are important: 97% felt that the term “overweight” was acceptable, 77% said that it was OK to say “obese” and while only 12% agreed that it was acceptable to use the word “fat”, even though 99% said that they would use this term to describe an animal when the owner is not in the room.
In human medicine, the term “unhealthy weight” is used instead of “obese” or “fat” to avoid making people feel uncomfortable. Perhaps vets should move in that direction too, to foster better engagement from owners.
The study concluded that there are various ways to make it easier to have conversations about overweight pets. Longer consulting times help (so that vets are under less pressure to fit everything into a short space of time), as well as making better use of the knowledge and skills of others in the veterinary team (such as nurses and receptionists). A so-called “relationship centered approach” is said to be the ideal way to move things forwards. What does this mean? It’s psycho-babble for having a good general relationship with the owner, getting to know them, and taking their concerns into account when making suggestions.
So when I see Sally’s owner next time, my focus will be on getting on well with them, and hopefully, in a very natural and helpful way, with help from my nursing team, we’ll talk about creating a better, healthier weight for Sally.
