Revealing the Secret Behind Pet Obesity

Join MM Nutrition and Wellness’ Morgan Medeiros and Dr. Sugerman as they shed light on the impact of obesity on pet health in this informative episode. Delve into the science behind excess weight and its effects on joints, mobility, and overall well-being in pets. Discover effective strategies for managing pet obesity, from choosing the right diet to implementing gradual weight loss techniques, all aimed at ensuring a happier, healthier life for your beloved pets.

What you will learn:

• Understanding of the impact of excess weight on pets' health
• Explore parallels between human and pet nutrition and weight management
• Discuss the importance of portion control for pets
• Highlight the significance of early intervention in managing pet obesity
• Offering of practical tips for pet owners to promote healthy weight management

Resources:
MM Nutrition and Wellness
Firehouse Pet Shop - Puyallup
Association for Pet Obesity Prevention - Body Condition Scoring (BCS)

View This Episode on the Vetsplanation Website:⁠ 
https://bit.ly/43TJkQ8

Transcript

Dr. Sugerman: 0:00

What do you think the most common question I get in the exam room is? So even though I strictly do emergency medicine, the most common question I get is, is my pet overweight? I feel like with pet parents, we don't always know or understand how to tell if our pet is overweight because pets come in all different sizes and shapes, right? Plus it's a really sensitive subject. You want them to feel like family by giving them people food at the table, or you want to make sure that they feel loved. And sometimes that means that you want to give them extra treats, right? We met with Morgan Medeiros today from MM Nutrition and Wellness at the Firehouse Pet Store in downtown Puyallup to discuss nutrition. If you're in the area, you should definitely check out the Firehouse Pet Store. It has a huge selection of foods and lots of necessities for your pet. It was really amazing to be in there. One thing that Morgan said that really resonated with me. Is that in our heads, as humans and as pet parents, we think of all of the things that we really need to fix, right? You're like, I really need to fix my diet. I need to exercise more. I need to lose this much weight. I need to stop going to fast food. Like you're just thinking about all of these things that you need to do. But for a nutritionist and for a veterinarian, that's like the really exciting part because those are all ways that we can help. So it's not just that we're thinking strictly only of, these are the things that we want you not to do anymore. We're thinking of oh, there's so many things that we can do to help this pet, or there's so many things that we can do to help ourselves. And there's lots of baby steps that we can take to do that. So, welcome to Vetsplanation, the podcast that helps pet parents understand the complexities of veterinary medicine and gives you the tools to keep your pet happy, healthy, and safe. Now, let's dive in so we can compare human obesity to pet obesity. All right. So there's not a lot of people that understand obesity with pets. It was really interesting. They did a study in 2019 that showed that over 1.9 million pets that went to a thousand different hospitals worldwide, that 50 percent of those pets were either obese or overweight. They had actually done a study where they decided to educate the pet parents and say, Hey, this is how you can help your pet lose weight. But unfortunately, only about 10 percent of those people actually helped their pet lose weight. And of those 10%, 40% of them actually gained that weight back. That means only roughly about 5 percent of dogs actually lost the weight and kept the weight off. So obesity is a really big problem, and I feel like sometimes we just don't understand obesity in terms of pets because we typically think of it more as in terms of people. So we invited a nutritionist, a human nutritionist here today, who's going to help us talk about it in people and we're going to compare and contrast. What it's like in our pets. So Morgan, can you show me like, what do you do?

Morgan Medeiros: 2:52

Yeah. So first those statistics were really interesting for me to hear. I've never personally heard those statistics on pet obesity. And it is interesting when we look at human populations, at least in the United States, we know that over 70 percent of the population is either overweight or obese. And like you noted in pets, weight management strategies are difficult. It's definitely possible, but the number of individuals who successfully lose weight and then manage that weight long term is very small. So I practice medical nutrition. I am a medical nutrition specialist and I practice in the field of obesity medicine. And like you said, obesity is a complex issue. Not just in so far as addressing it with the patient, which, of course, in your case, you're having to work through the pet parent. It's difficult to address and it is difficult to manage in the long term.

Dr. Sugerman: 3:45

Absolutely. So what is a medical nutritionist?

Morgan Medeiros: 3:49

Yeah. So when we look at nutrition as a field, it is a large field.

Dr. Sugerman: 3:54

Huge.

Morgan Medeiros: 3:54

It is a huge field. And so we have nutritionists who work in everything from food service, to direct patient care, like in a hospital setting. And then we have nutritionists who work in like long term care management. And so specifically with medical nutrition, this refers to functions of the nutritionist that have direct patient contact and direct patient care rather than something like food service or maybe like product development because whenever you are going to be working with a with food. There's, of course, the initial. Okay, we have the actual food item itself. Then, hopefully, unless that item is wasted, it is consumed. And so then you have the byproduct of that consumption, right? The byproduct of that consumption consistently over time is the health of the individual. So when the health of the individual is what is being addressed, that's when we're when medical nutrition is concerned.

Dr. Sugerman: 4:50

Got it. Okay. Thank you for that introduction. Can you tell me like lets start with what is obesity?

Morgan Medeiros: 4:55

Yeah, so when we look at obesity, I think when people think about obesity whether it's in a dog or a cat or whether it's in a person I think so often in large part because we are visual creatures and in part because of a lot of the societal stigma that we have about overweight and obesity. I think people very much focus on like the aesthetics of obesity. They look at somebody who maybe has a larger body shape or a larger body size than we might anticipate. And they think about overweight or obesity. And they are different things as a condition that is characterized by this benign excess of fat mass, or in other words, they're looking at this animal or this person, and they're seeing this very large animal or large person, and they're just assuming that they have this extra weight, this extra fat. And it's not, necessarily a huge problem. They think that, there's some extra fat, but it's mostly aesthetic. It's mostly just, I don't like the way it looks. They probably know on some level. Yeah, it's not good for my heart and maybe it's not good for my joints. And they have some kind of vague assumptions about or a low level of awareness on the ways in which that excess fat tissue might be impacting them. But they're primarily focused on how it looks on that person. Just from a visual aesthetics perspective. But when we actually look at what overweight and obesity are, it's much more complex than that. So when we talk about someone who is overweight or obese, Someone who is overweight simply has a higher level of weight than we would anticipate. That weight could be from a variety of things. It could be from having too much fat mass, in which case they would be obese. Or they may have a higher than anticipated body weight. They may be overweight because their higher weight is attributed to excess muscle.

Dr. Sugerman: 6:55

Yeah.

Morgan Medeiros: 6:56

We have the summer Olympics coming up. And you are going to have a lot of people who, if you were to screen them just based off their weight, a lot of Olympians to say, if you were to screen them just based off their weight, they would present as overweight, but it's not because of an excess of fat mass in most cases. In most cases, it's going to be because they have a high degree of body muscle. If you look at them, they are going to look chiseled. They are going to look ripped because they're athletes. And so although they have a higher than anticipated body weight, they're very healthy, despite being technically overweight off what we would anticipate. However, if you have somebody, just the average person, even the average person who's fairly active. Oftentimes, if they are overweight, it is because they have an excess of fat tissue. They may also be very strong. They may also be very active, but oftentimes it is because of a higher than anticipated level of body fat. And so when somebody is over their anticipated body weight and they have that higher than anticipated level of body fat. This is when we know this person now is not just overweight. They are also obese. They have the disease of obesity. And I think a lot of people might become surprised to hear me say the disease of obesity, because again, really up until about maybe about 10 years ago, I think 2015 was around the time that obesity was first classified as a chronic disease. And when we look at what defines something as a chronic disease, what we're really describing is something that impacts multiple organ systems. Something that is lifelong and something that requires then that lifelong management. And so one of the reasons people get really frustrated with managing obesity in particular, but also overweight is that lifelong aspect. The diet industry thrives off of this idea that we can find some perfect regimen. And..

Dr. Sugerman: 9:01

For everybody.

Morgan Medeiros: 9:03

Yes. And if you just, you know, implement this one strategy, somehow we're going to fix the issue and I'm never going to have to deal with it again versus something that needs to be managed long term. And I'm sure you see probably the same thing with pets that you can't just, limit or reduce the food for a short period. We have to do this for the rest of the pet's life.

Dr. Sugerman: 9:23

Absolutely. It's definitely a lifelong process for cats, dogs, doesn't matter any type of animal. It's a lifelong thing, especially for those dogs that were already obese or overweight. They're more prone to it, and so we really have to manage those really well. Can you tell me, what are the things that, what kind of health conditions does obesity cause then?

Morgan Medeiros: 9:43

Yeah, and so I think when we talk about obesity, I think it's really important, and one thing I just really want to emphasize is that it's not a personal choice. We always have personal choices around how we manage our health, the things that we do, or the things that we don't do. But nobody is like waking up one day and deciding to make a bunch of choices that are negatively going to impact them in some way. We know that there are many causes of obesity. We know that certain individuals have a high degree of genetic propensity. And I've heard that the same is true of pets that certain breeds..

Dr. Sugerman: 10:17

Absolutely.

Morgan Medeiros: 10:17

are more prone to obesity and we know that the same is true for certain people and there's a variety of reasons for that. We know that there are multiple phenotypes for obesity we know that certain individuals have a lower basal metabolic rate than anticipated.

Dr. Sugerman: 10:30

And what does that mean?

Morgan Medeiros: 10:30

And so basal metabolic rate is simply the number of calories that your body is going to burn at rest just for being alive. And we know that certain individuals, they just require fewer. We also know that certain individuals burn fewer calories in things like exercise than we would anticipate. We know that certain individuals have more excitability in the brain around certain types of food. Just the cue of a food will make their brain more excited. And then..

Dr. Sugerman: 11:00

Same thing for pets, for sure. Like the cue of going to the bowl or cue of going to hearing a bag open.

Morgan Medeiros: 11:05

Yeah. And so I'm sure many people will have the experience of having a pet and you have, maybe multiple pets in your lifetime. And you will find that certain pets are more food motivated than other pets. And the same is true of humans and there are so many factors that influence or impact or increase someone's propensity for developing obesity and also individuals are impacted differently by their obesity. So, you know, you asked what kind of conditions can obesity cause. Honestly, it really depends on the person. Some people will have certain conditions that develop as a result of their obesity and certain individuals won't have that exact same set of conditions. And we don't really, to be honest, understand why. I know that's not an answer that anyone wants to hear. It's definitely something that's very important and interesting and that people are continuing to study. We think that diet the scope of the diet as a whole. Whole plays a role. We think that genetics play a role. One of the things that we do know is that someone becomes obese. And as they continue to develop health conditions, those secondary health conditions. So these are the things like the pre diabetes, which can then become type two diabetes or things like high cholesterol. Things like low HDL cholesterol, which is your good cholesterol. Things like high blood pressure. We know that once somebody develops one of those conditions, it increases their risk for developing yet another condition. And once somebody has usually about two to three of these kind of secondary conditions, we can actually diagnose them with something called metabolic syndrome. And so metabolic syndrome is simply a condition that refers to the presence of these risk factors. So if you think about holding. Each of these risk factors and you have your hands out like this. So I'm just going to pretend that I am somebody who presents with obesity and I'm holding my hands out like this. And somebody comes over and they say we noticed that you have a lot of fat around your midsection. They're going to put one risk factor into my hand. And then they say, and we noticed that you, your, your blood sugar is a little high. You're pre diabetic. We're going to put, a second cluster into your hands. And then they say, and we also noticed that your good cholesterol, that's a little bit low. And so we're going to put that. So once I have those three risk factors from, our list of risk factors in my hands, I have metabolic syndrome. And so not only is it going to be easier and easier and easier for me to rack up additional syndromes and conditions, it's also putting me at higher risk for things like cancer. A higher risk of things like heart disease. In addition to a number of other conditions. And so it really is dominoes falling. It's like each domino is a little easier and a little quicker to fall.

Dr. Sugerman: 14:01

Yeah. We have a lot of those similar things in pets. It does increase a lot of risks for our pets as well. It definitely increases things like diabetes and cancer. And people don't think about it increasing the odds of cancer, but really this is an inflammatory condition.

Morgan Medeiros: 14:16

Absolutely.

Dr. Sugerman: 14:17

The whole body is just going through this really slow inflammation and causing a lot of these problems.

Morgan Medeiros: 14:21

Obesity is a pro inflammatory condition, and the reality is that inflammation, it's a natural process. It's something that we all have, and it's something that we encourage just as a natural consequence of being alive. And our immune system is meant to manage that inflammation. But, as we engage in certain lifestyle factors and lifestyle choices and as we manage or don't manage our health, that really impacts our immune system's ability to manage the influx of that inflammation. And if that inflammation builds too high, then our immune system just isn't able to keep up with the demand.

Dr. Sugerman: 14:58

Yeah.

Morgan Medeiros: 14:58

And that starts to play out, in various ways, for humans as well as pets. And I think one of the things. I think two things to keep in mind with this are number one, that frog in the pot metaphor that maybe you've heard before, which is, you put this frog in this pot of water and you turn the pot on, you put it over heat, but you increase the heat very, very slowly. And so the frog is not really noticing. It's starting to get a little toasty in here. We're starting to get a little bit warm. And then eventually over time, that water starts to boil. And it's a sad end for the frog. But oftentimes, I think people just don't really realize with themselves or, with their pets until you're looking at them and it's like they look the way they've always looked. But they they might not and oftentimes a lot of the the secondary conditions that we see as a result of the obesity, they're not noticeable. They don't necessarily have you know, pre diabetes for example Somebody isn't necessarily going to be noticing the symptoms. They might not have any symptoms at all. It's not even that they're not noticing right they might not have any symptoms of that pre diabetes until they get screened. So I'm curious to know how do you screen for obesity in pets because pets don't have the same ability to self report, obviously, as a human would, which is, I think, something that I think lots of pet parents have experienced. Feeling very helpless because you're like, what's wrong? Just tell me. How do you screen for obesity impacts?

Dr. Sugerman: 16:27

Yeah, it's really interesting because we do it a little bit different than you do. So I'll have you describe yours in a second, but we go off of what's called body conditioning scoring. And I'll put a link to like what exactly body condition scoring is, but it's basically if you stand over your pet, and if you see them going out, like this, in their stomach area, that's definitely too big. If you have them going a little bit in this pretty normal. And then if you have them going really in in their stomach area, that's too small. But an easier way to even do that is to call it the hand test.

Morgan Medeiros: 16:57

Ok.

Dr. Sugerman: 16:57

So if you touch the back of your hand, this is what this is what the ribs should feel like. You should feel just a little bit of fat right over it. If it's if you touch your knuckles and you feel like their ribs feel like their knuckles, that is too skinny. We should not be able to feel the ribs like that. And if you touch the palm of your hand and over their ribs, feels like the palm of their hand. That is too much fat.

Morgan Medeiros: 17:19

That is such a great and accessible tool. I love that.

Dr. Sugerman: 17:23

Yeah.

Morgan Medeiros: 17:23

And I think it's difficult to tell as a pet parent..

Dr. Sugerman: 17:27

Especially with all that hair that they have. Right?

Morgan Medeiros: 17:29

Well and it's different breed by breed also. I was sharing with Dr. Sugaeman that I have a French bulldog. I've had him for just a little over a year now. And I was not familiar with the breed whatsoever. I'd always had Dalmatians, which are very svelte, lean dogs. And so when I..

Dr. Sugerman: 17:46

Very active dog.

Morgan Medeiros: 17:47

Very active dogs. And so I knew that my current lifestyle was not going to award a Dalmatian, the type of life, the type of activities, the type of attention that such a high need breed requires. And so when I was searching out what kind of breed might be best for me. I kept having French bulldog returns to me in all of the queries. And so I was like, I need to look into this, but I really didn't know what to expect or what this dog's needs even were.

Dr. Sugerman: 18:15

What their lifestyles typically were like.

Morgan Medeiros: 18:17

And so I started to try and educate myself. And even with a background in health, even as a nutritionist, it was really, really difficult to understand the information that was coming at me and really shift from a human thinking perspective to a canine thinking perspective and having to really look at okay, how many calories does he need? What is his body shape supposed to look like?

Dr. Sugerman: 18:43

Cause they're very barrel chested, which you're not as used to with dalmations. We call them like keel chest, but they have a triangle shape.

Morgan Medeiros: 18:49

Absolutely. And it's like he's got, that really big up top and then he's got the little teeny legs in the back. And I know that I saw the I think the body conditioning score that you were describing and, I was really seeing okay, we want like maybe a little bit of hourglass, but not too much.

Dr. Sugerman: 19:05

Exactly. Yeah. Yeah.

Morgan Medeiros: 19:07

And with humans, we, obviously, like I said, with obesity, we very much often, society at large, often focuses on kind of the aesthetic qualities of that. And so you never want to do that and you never want to make somebody feel judged. But one of the things that we do look for is what we call abdominal adiposity, which is basically just the idea that, everybody's shaped a little different. Everyone's body shapes are a little bit different, but as a whole, we really don't want to see a whole lot of, whether it's an adult or a child, and I'm not counting infants and toddlers. They're prone to being a little bit doughy and that's actually protective, right? Because they're learning to move around and things for the first time.

Dr. Sugerman: 19:44

Same thing in our animals too.

Morgan Medeiros: 19:45

Yeah. We don't want bits protruding at that stage of life. But once we get into our adolescence, our tweens, our teens, our adults, that's where we really don't want to see a lot of bowing out because what that means is that we've got fat in and around the visceral cavity, which is where our internal organs are. And so we talk about something called a metabolic strangle. And essentially, and I'm sure you see the same thing in pets. And essentially what that means is you have that fat and fat is pro inflammatory tissue. And now it is pressing up against and creating inflammation in and around our vital organs. Yeah.

Dr. Sugerman: 20:23

Absolutely. We have a very similar thing. So we talk about just all that fat and interestingly, like where we stand up and down. Versus dogs and cats. They're on all-fours, so it's not only just all the internal organs. We also have to worry about things like their back.

Morgan Medeiros: 20:39

Oh, yeah.

Dr. Sugerman: 20:39

And a lot of their joints, because they're, they're held differently. Their gravity is in a different place than ours.

Morgan Medeiros: 20:45

That is so interesting.

Dr. Sugerman: 20:46

Yeah. So we, we think about it in terms of the core inflammatory portions, but also in terms of like our joints and stuff, which I know is still a big concern in humans as well.

Morgan Medeiros: 20:55

It is. And it's actually interestingly enough, it was one of the ways that I actually transitioned into the field of obesity medicine. I was originally studying orthopedic surgery.

Dr. Sugerman: 21:03

Oh, funny.

Morgan Medeiros: 21:04

And so it was one of the statistics that really stuck with me as a student, was this Idea of pressure translation. And so what I mean by that is when you have an individual and you're looking at their body composition, you have what is going to be their anticipated body weight. And that's really what BMI does. BMI just describes the ratio of weight to height, and based off just what we consider averages with that, we're able to screen for obesity. BMI is not a diagnostic tool. It's a screening tool, and it's a very good screening tool. It's a terrible diagnostic tool, but it's a very good screening tool. And when we have this anticipated range of body weight for somebody, if we're just going to look at this person and say that, yes, they are obese. This is excess fat mass. Every one pound of excess fat mass over somebody's anticipated body weight exerts three pounds of pressure on a joint. So if someone is 10 pounds overweight, then that is essentially 30 pounds of extra pressure.

Dr. Sugerman: 22:06

Yeah.

Morgan Medeiros: 22:07

On their joints. And I wonder..

Dr. Sugerman: 22:09

That's a lot.

Morgan Medeiros: 22:09

Yeah. It does make me wonder because pets are smaller overall. I would imagine that it would be even potentially higher than. For animals in their joints.

Dr. Sugerman: 22:20

I would imagine so. I don't know if they've done any studies looking at like how much more fat impacts the joint.

Morgan Medeiros: 22:25

I don't know how you would quantify that.

Dr. Sugerman: 22:27

Yeah. But I would assume so, and especially it's not just like we think about for people are joints being like the hips, the knees, the ankles, right? We're not thinking so much in terms of like shoulders, your elbows, your wrists,

Morgan Medeiros: 22:41

Well, just like certain breeds are prone to or have a propensity for obesity, I would also imagine then that certain breeds, at least anecdotally what I have heard, is that certain breeds have a propensity for joint issues as well. And I would only imagine that then if you had a pet that potentially had both. That would be a problem.

Dr. Sugerman: 23:04

Absolutely. We have a lot of patients that have multiple risk factors. So things like small breed dogs, they tend to get collapsing tracheas very easily. And having them overweight makes that even worse. Because it's not just fat in your visceral area like you were talking about in the abdomen. It's also things like fat in their neck and around their trachea.

Morgan Medeiros: 23:23

And we see that with things like apnea and all of that as well. And I know that I'm sure snoring and apnea and all those things. And interestingly, and I Maybe you know, maybe you don't, one of the things that we see in individuals with overweight or obesity is, especially if they have that apnea or if they have those sleep disturbances it increases the risk for things like heart disease, things like dementia.

Dr. Sugerman: 23:46

Yeah.

Morgan Medeiros: 23:46

And so I would imagine with pets, too that that plays a role. And I think that's one of the things that at least for me personally, so fascinating about medicine, but especially obesity medicine is like understanding how all those little pieces of the puzzle can come together, right? And I think for a lot of people, it becomes like this almost defeatist catastrophic type of thinking. To me that's the exciting part because it's like this is all of the ways we can help and I think that..

Dr. Sugerman: 24:12

It definitely makes more options..

Morgan Medeiros: 24:14

It gives you so many options And I think so often and I'm sure you've seen this with like pet parents as well and I think this goes back to the idea of stigma. This idea of feeling bad like you've caused this problem, or like you're in trouble. Like you don't want to be sitting across from either like your physician or your veterinarian and like being told this is a problem and you need to fix this. It's no, these are all the ways that we can help. Like you love your pet. We see that you love your pet.

Dr. Sugerman: 24:41

You're here with them. You're asking the questions, right?

Morgan Medeiros: 24:43

We just want to help there's no judgment because we want you to have.. If I'm talking with a human patient or if I'm talking with the parent of a patient, it's not you're doing this wrong. You're bad. There's nothing moral or amoral about body weight or how we take care of ourselves. It's just we all want to have like healthy, full, vibrant lives, whether it's us or our children or our loved ones or our pets. So these are the tools. That we can have to do this. So if you have a pet parent come in and they come in with their dog or their cat and you notice that this pet is presenting with obesity. What are the next steps that you walk a pet parent through with that?

Dr. Sugerman: 25:23

Yeah, that's a great question. So there's lots of things that we talk about. First, we talk about what are the different types of people food that you're feeding? Cause it tends to be a lot of the times that they're like I feed my pet appropriately. I feed them what's on the back of the package. And I'm like, okay, so..

Morgan Medeiros: 25:36

Is there anything else?

Dr. Sugerman: 25:38

How many treats and how much people food and stuff are we feeding them? Cause really like the treats and stuff should only make up maybe 10 percent of what they're eating.

Morgan Medeiros: 25:46

And that's such an, so that is such an interesting number that you get. So one of the terms that we use in medical nutrition is this idea of what we call discretionary calories. And basically what discretionary calories are is the percentage of someone's total caloric intake that should be coming from things like saturated fat or added sugar, and it's 10%. So it's actually interesting. It's interesting that it's the exact same figure.

Dr. Sugerman: 26:15

Right? So we're also talking about things like they said, treats and human food and stuff. We're also talking about exactly how much are you feeding? Because a lot of times people think that this is portion control, a lot like with people. They are like I feed one cup and I say, what kind of cup it is. Is it? You say it's a big gulp cup. It's not a cup. We got to make sure. Yeah. You got to make sure it's like a measured thing. So we get a measuring cup for exactly one cup. And that's how we know exactly how much that pet eats.

Morgan Medeiros: 26:41

And portion control is a huge thing for animals, for humans. And I think portion distortion is such a thing, right? And I think so often humans will eat off of just like visual cues..

Dr. Sugerman: 26:53

Right.

Morgan Medeiros: 26:54

And so I think it's probably easy for a lot of pet parents, like I said, like I have a French bulldog and he is 23 pounds but I'm gonna tell you right now his bowls are not made for a 23 pound dog. I would imagine that if I was just to go off of a visual cue, I would overfeed him. I would. But I don't because I have in his actual dry food, there is a measured scoop. It is a quarter of a cup scoop, and he actually gets less than a quarter. He gets about three tablespoons of that mixed with some other things.

Dr. Sugerman: 27:28

And I'm sure that was really hard for you to be like a quarter of a cup, less than a quarter of a cup. Are you sure I'm not going to starve my dog?

Morgan Medeiros: 27:33

It was. Before I got him, I sat down with the formulas, the veterinary formulas. And I, I'm very confident I do this, in my own head with patient formulas all the time. So I'm like, but I want to be accurate because this is not the same formula. So I'm literally sitting down with pencil and paper and I do it and I'm like, okay, I'm going to do it with my phone now. I'm going to use my calculator and I'm like, I come out with the same figure. And then I finally went online and I used a veterinary calculator. It was the same thing being returned to me. And I was like, this dog needs 500 calories. It just did not seem right to me. And I'm looking at this food and I'm like literally looking at the tiniest little portion of food. And I'm thinking to myself, this doesn't make sense.

Dr. Sugerman: 28:18

So I have a very small dog and she has a very small bowl. It looks like you are filling it up as the correct amount. I measure her. She gets it weighed out even. She gets 30 or right now I think there she's at 29 grams. Yeah, 29 grams of food. And people are always like you, my pet sitters think I'm crazy because I weighed out, but she does have a problem with weight and she has been since being on a medication from before. And so it is that lifelong of just trying to make sure that we've gotten the correct portion control for her as well.

Morgan Medeiros: 28:45

And I think, it's so difficult because I think for most people, I think for most pets as well, food is enjoyable. Like we like to eat. We love to talk about food. We love to eat food. We love to interact..

Dr. Sugerman: 28:56

Share our food with the pets.

Morgan Medeiros: 28:57

Yes, exactly. Let's take our entertainment. Let's take all that. And let's make it the right size. So that we're still allowed to have our health also. And one of the things that I learned when I, first got my dog, was this idea that I had never really used before as a pet parent of almost making the food last longer by making it more difficult to eat. So things like a snuffle mat or one of the puzzle feeders. And I use that all the time now. He gets his puzzle feeder probably three or four days a week. He just gets his dinner in the puzzle. It's, you know, a smaller amount of food than I think a lot of people would probably anticipate, but it lasts longer and he has fun with it and he's interacting with it and his brain is being stimulated while he's eating it versus just eating it out of a bowl. So I think that might also be a good tool maybe for some pet parents who are maybe feeling like they're being fun suckers or taking some of their pets enjoyment away.

Dr. Sugerman: 29:57

Absolutely. A lot of people feel like I don't want them to eat the same food every day, but if you do things that make it enjoyable, like having them, especially food motivated dogs, right? Some dogs are just not food motivated. But doing things like that, or when people like, I want to share my meal with them, I just tell them share your green beans and share your vegetables, share your blueberries. Those are all great things that you can share with them.

Morgan Medeiros: 30:18

One of the things that I have done and I've learned the hard way that you have to be careful on the amount of fiber that you give, that you give a pet all at once.

Dr. Sugerman: 30:27

Don't give them a ton of it.

Morgan Medeiros: 30:28

Yeah, don't, yeah, don't, don't make my mistake. But things like I've done even where a lick mat, just a little silicone mat with little bristles on it. And one of the things that I've done is, if I have bananas that have gone, they're not rotten, but they're past the stage of doneness that I prefer. If I can't freeze them to use in smoothies or something for myself, what I will do is I'll just take like the end of one, and I'll just mash it up really good and smear it on the lick mat. And that's a nice little treat to give him. I've even heard of pet parents doing this and freezing it ahead of summer to try and help keep their pets cool. So I think that it's important to remember that you're not robbing your pet of anything by not overfeeding them or not giving them too many treats. If anything, you're doing them a favor because they are vulnerable and they don't have that ability to advocate for themselves or understand the way that something is going to impact them. And I think it's such a helpless feeling to see a pet that is in pain. But nutrition is such a great tool to not just help them live a really long life, but also live a really healthy, pain free life. Do you see a big difference with that with aging, with pets, the pets who've had maybe a healthier weight or a healthy kind of dietary practice through their lives? Do you find that as a whole they age healthier?

Dr. Sugerman: 31:50

They do. They age healthier and we just have less problems that we have to deal with, less medical problems that we have to deal with when they're older.

Morgan Medeiros: 31:56

Which is nice too, obviously, from a financial perspective.

Dr. Sugerman: 31:59

Absolutely. Yeah. And for the pet, we don't want them to have to go through back surgeries or knee problems or have diabetes and things. And all those things being overweight or obese is going to predispose them to. So a lot of times you'll see like some older dogs. They might like my great dane, for example, she is a very nice lean weight. Which people don't often see in great danes or they always think that they should be really big dogs. But then again if you see them going, they do not have that hourglass figure that is not the correct weight for them. But, she's seven, which you wouldn't think is very old for some dogs and for a Frenchie that definitely not be old, but for a great dane that is a very old dog. But she doesn't have things like diabetes or knee problems or.. Only thing that she has is a neck problem, which she was born with. But it's a lot of those things like we just don't want them to have to deal with like her neck problem on top of being overweight. That's just gonna make things so much worse for her.

Morgan Medeiros: 32:51

And I think so often, and it goes back to the idea that things don't always present with this amazing like slow build up of symptoms. I think so often people think I'm gonna notice, right? Like one of the things that we often see in patients with overweight or obesity is they feel like they're going to have eventually some sort of symptom that's going to like, motivate them to take action. Sometimes, unfortunately, there's not some activating event until the activating event is something really significant, life threatening, something like a heart attack, something like a stroke, something like a diabetes diagnosis and a hospitalization. And I think, one of the things that I often see with pet parents is it's they'll have some horrible activating event, whether it's like something really horrible orthopedically happening to this pet or a cancer or something like that. And I think one of the things that we really talk about in human medicine, and I'm sure animal nutrition as well is early intervention let's just get on it as early as we can because the earliest, I always say, it's like cleaning the earlier you can tackle a mess, the easier it is to clean up. And if a pet parent is listening to this and they're thinking, my pet.. Are they the right weight? Are they not? Am I feeding them the right diet? Am I not? What's their next steps in assessing the problem?

Dr. Sugerman: 34:14

Yeah. The first thing is really just going and talking to their veterinarian about it and make sure it's about who's like a very honest vet.

Morgan Medeiros: 34:20

Yeah. It's hard sometimes to be honest with patients. You don't want to hurt anyone's feelings. Whether about themselves, their child, their pet.

Dr. Sugerman: 34:27

Exactly. Yeah. But you just tell them very upfront, I just want an honest opinion. Do think that my pet is overweight? It's just asking your veterinarian about it, I think is like the most helpful thing. And then after that, you can start looking at the diet. Is this a diet that has a really high calorie density? Does it have a lot of protein or does it have a lot of carbs and a lot of fat to it? It's just like with humans, you can have salads that are very low calorie density versus a Big Mac or some cheeseburger or something that has very high calorie density.

Morgan Medeiros: 34:54

And everything in between. It's a varied food landscape. And even as we stand here and thank you to our hosts also, Firehouse Pet Shop, Downtown Puyallup. They're awesome. They have the most amazing stock of product available. But even as we stand in front of just a small portion of said stock, I think so many pet parents will come over and just go, oh, I don't know.

Dr. Sugerman: 35:15

There's so much.

Morgan Medeiros: 35:16

And then they'll just go off of a brand that they recognize the name of or something that they've maybe used in a previous pet, but maybe isn't the best for this pet. Like I know French bulldogs. I can't feed my French bulldog the same way that I fed my Dalmatian. One of our Dalmatians in particular had a skin issue and we ended up feeding primarily brown rice, chicken, it was like this blend of just like whole human food. And that worked out beautifully for that pet. Guess what? French bulldogs are prone to food allergies and guess what one of the number one food allergies is chicken. And so I was like, I don't know what I'm doing here. And so like I had so many conversations with our, we have wonderful vet at Sumner Veterinary and we had so many conversations and trying to figure out what the best things to feed this dog are because oftentimes it's not just the quantity of the food that the pet is eating. It also may be the quality or just the specific foods within that quality themselves. You could feed a dog a very high quality diet, but it doesn't necessarily mean it's the right diet for that dog.

Dr. Sugerman: 36:26

Exactly. And there's differences as far as life stages and stuff too. Just with babies versus kids versus, geriatric.

Morgan Medeiros: 36:33

Yep. Absolutely.

Dr. Sugerman: 36:34

We have the same things in pets as well.

Morgan Medeiros: 36:36

Yeah. So if you had one message for pet parents who know that they have a pet with obesity, is there just like one or two kind of takeaways you would like them to have for managing this long term?

Dr. Sugerman: 36:53

Yeah. One of the things is making sure it is done like weight loss is done over a slow period of time. We don't want it to be a very sudden thing. That still causes like a lot of inflammation and a lot of problems as well.

Morgan Medeiros: 37:04

Okay.

Dr. Sugerman: 37:05

And it's really difficult for that pet as well. So it's a slow process. And then the other thing is just a lot of things we've talked about, making sure that it's the right diet and it's the right amount of the diet.

Morgan Medeiros: 37:16

And consistency over time.

Dr. Sugerman: 37:17

Absolutely.

Morgan Medeiros: 37:18

I think anything it's so easy to be reactive, right? It's very easy to have this activating event and okay, I'm going to I'm going to like really rein in this dog's food.

Dr. Sugerman: 37:27

They do 10 things to fix the problem at once, right?

Morgan Medeiros: 37:30

Yeah, exactly. And it's I think, even with humans, one of the things I always, you know, really, really emphasize with my patients is consistency. Start with whatever you think you can do consistently. If you go to your physician and they, say, hey, is it okay if we talk about your weight and how this is presenting for you and you go home and you're very first step is to get online and read about the most extreme diet where you're, I don't know, ordering a juice cleanse or eating, one banana a day or something extreme like this. Is this something that you're really going to sustain longterm? You may need to have a pretty intensive intervention at first, not that intense. But really looking at what is something that I know I can start doing right now, not six weeks from now, not six days from now. What can I do right now? And how can I build consistency in that for the remainder of my life or my pet's life?

Dr. Sugerman: 38:26

Absolutely. Yeah. Same thing for us. Exactly. Like just really building consistency and don't do 10 things at once, do just small steps at a time. That's really going to be what's going to help bring things down slowly and help you be consistent as well.

Morgan Medeiros: 38:39

And help that pet adjust as well. Because regardless of whether it's a human patient or an animal patient, we also want to be thoughtful and attentive to that person or pets experience.

Dr. Sugerman: 38:51

Absolutely. Thank you, Morgan. I really appreciate you coming on and talking about the human portion of our nutrition so we can hopefully understand a little bit better for our pets as well.

Morgan Medeiros: 39:00

Absolutely.

Dr. Sugerman: 39:01

And thank you again to Firehouse Pet Shop. We really appreciate you letting us be here. And for all the pets that are here right now, we got to pet as well.

Morgan Medeiros: 39:07

Yes, absolutely. Thank you to all of the pets and people at Firehouse.

Dr. Sugerman: 39:11

All right. Thank you guys. I will see you next week. I hope this helps clarify that when we compare our way of thinking about obesity to how we think about pet obesity, that we can see a lot of those similarities and a couple of differences. So thank you again to Firehouse Pet Shop for allowing us to use their space in their fantastic shop. They have a wide variety of foods there, like I said, and I really appreciated how they ensure that the pet products are safe for pets. It was very interesting to learn about how they're very particular about what they get for the pets and it really shows like how much they love pets. And again, thank you to Morgan from MM Nutrition and Wellness for explaining such a complex process such as obesity. And also thank you to Shawn Hyberg for editing our podcast and Kelly Dwyer for making our website. In the next coming weeks, we're going to be talking about spaying and neutering for your pets, heartworm disease, and ophthalmology from a veterinary ophthalmologist. So stay tuned and we'll see you next week.