December 12, 2017

Feline Obesity: The Elephant in the Exam Room

Video analysis reveals that veterinarians have much to learn about how best to communicate with clients when it comes to this sensitive topic.
By JoAnna Pendergrass, DVM
Patient-Directed Speak
Veterinarians and clients spoke through and to the patient. As with humor, patient-directed speak had several uses:
  • Project humor
  • Express empathy
  • Realign communication
  • Introduce, or reintroduce, a sensitive topic

As an example, a veterinarian used patient-directed speak to counter a client’s resistance about discussing her cat’s obesity. In another visit, a veterinarian spoke to the cat to comment on the cat’s weight gain.

This type of speaking, the investigators noted, allows the client to listen to sensitive information without having to respond. This in turn can encourage communication between the veterinarian and the client.

Oblique or Absent Messaging
Discussions on weight and dietary management were typically unclear or absent. For example, in multiple visits, veterinarians did not give a clear weight assessment unless a client persistently asked for one; after the assessment, though, the weight discussion was often dropped without recommendations on weight-loss strategies.

Exercise was recommended in only 2 of the 25 appointments, both of which involved outdoor cats. In one of these appointments, the veterinarian implied that weight loss would occur once the weather was warm enough for the cat to go back outside. However, the veterinarian did not develop a clear weight-loss plan.

In the 6 obesity prevention appointments, veterinarians were usually oblique. They warned against further weight gain, but did not provide clear obesity prevention or weight management strategies.

Bringing It Together
Given the qualitative nature of the study, the investigators acknowledged that the findings are not easily generalizable. In addition, the appointments were recorded in 2006 and thus may not reflect advancements and current trends in veterinary education and practice.

Nevertheless, because “many discussions fell short of clear assessment, strategies, or identification of the client’s perspective,” the authors emphasized that “there is a need for a dynamic and individualized response to obesity management in veterinary medicine.” They proposed several recommendations for veterinarians to better facilitate feline obesity discussions:
  • Share thoughts out loud with the client to encourage discussion of perspectives.
  • Consider the patient and the client when developing a weight-loss treatment plan.
  • Be intentional when asking about a client’s home environment and perspective.
  • Provide clear direction to clients regarding weight-loss treatment plans and assessments.

Through future research and updated veterinary curricula that can unravel the complexities of feline obesity communication, the investigators believe that veterinarians can better communicate with their clients regarding feline obesity, dietary management, and weight loss.

Dr. Pendergrass received her Doctor of Veterinary Medicine degree from the Virginia-Maryland College of Veterinary Medicine. Following veterinary school, she completed a postdoctoral fellowship at Emory University’s Yerkes National Primate Research Center. Dr. Pendergrass is the founder and owner of JPen Communications, a medical communications company.
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  3. White GA, Hobson-West P, Cobb K, Craigon J, Hammond R, Millar KM. Canine obesity: is there a difference between veterinarian and owner perception? J Small Anim Pract. 2011;52(12):622-626. doi: 10.1111/j.1748-5827.2011.01138.x.
  4. Lue TW, Pantenburg DP, Crawford PM. Impact of the owner-pet and client-veterinarian bond on the care that pets receive. J Am Vet Med Assoc. 2008;232(4):531-540.
  5. Phillips AM, Coe JB, Rock MJ, Adams CL. Feline obesity in veterinary medicine: insights from a thematic analysis of communication in practice. Front Vet Sci. 2017;4:117. doi: 10.3389/fvets.2017.00117.

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