The 3th Annual Online Veterinary Nurse and

Technician Conference

Obese Patients: Have Your Cake and Eat It

Too!

With Vicky Ograin MBA RVT VTS (Nutrition)

Education Specialist Hills Pet Nutrition

October 2014

Proudly brought to you by Vet Education Pty Ltd (www.veteducation.net) and Hills Pet Nutrition (Australia)
Obese Patients-Have your cake and eat it too!
Vicky Ograin, MBA, RVT, VTS (Nutrition)
Education Specialist
Hills Pet Nutrition, Inc.

Hyperadiposity Its Not Just a Cosmetic Issue, Its a Health and Welfare Issue
Hyperadiposity is defined as the abnormal accumulation of adipose tissue. This disease is more
commonly referred to as overweight or obesity. Regardless of the name, the statistics are staggering;
the global incidence of overweight or obese pets has steadily increased in recent decades. Current
estimates suggest that globally 30 -50% pets are overweight or obese.1,2 Over the last five years the
incidence of hyperadiposity in dogs has increased by almost 40% in the US.3 Over the same time period
the number of overweight or obese cats has increased by an astonishing 90%.3
Health risks associated with hyperadiposity are well documented. Obesity has been associated with a
shortened lifespan as well as a variety of diseases including insulin resistance/ diabetes mellitus,
lameness, osteoarthritis, dermatopathy, lower urinary tract disease, cardiovascular and kidney disease,
and pancreatitis.4 In cats, it is estimated that nearly one third of cases of diabetes mellitus and lameness
could be eliminated if cats achieved ideal body condition.5 In dogs, being overweight shortens lifespan
by an average of 2 years and increases the incidence of clinical signs of osteoarthritis and other chronic
diseases.6,7 Results of a recent study confirm that overweight dogs suffer as a result of this disease, and
successful management relieves suffering. Overweight dogs that successfully lost weight had significant
improvement in vitality and reduced pain and emotional disturbance compared with dogs that failed to
complete a weight management program.8 Hyperadiposity is not simply a cosmetic issue; it is both a
health and a welfare issue. Overweight pets are suffering, often in silence.
Accurate Diagnosis is Critical
It has been estimated that less than 10% of veterinary recommended weight
loss programs succeed.9 This means that more than 90% of veterinary
recommended weight loss programs fail. Often this failure is related to an
inaccurate initial assessment of the presence and severity of the disease.
Basing feeding recommendations on an inaccurate estimate of ideal body
weight will result in overfeeding, which leads to unsuccessful weight loss
programs and frustrated owners. For weight loss to occur, pets must
consume 30% or fewer calories than the amount required to maintain their
ideal body weight. Despite the fact that adipose tissue is metabolically active, hyperadiposity does not
significantly increase resting energy requirement. Consider Chloe for example, her current weight is
37 pounds. (16.8 kg). (Figure 1) Her ideal weight, as determined by dual x-ray absorptiometry (DEXA) is
16.5 lbs (7.5 kg). At her ideal weight, approximately 20% of total body weight is fat and 80% is lean body
mass (muscle, bones and organs). The resting energy requirement for Chloe
at her ideal weight is 310 kcal/day. Based on dual x-ray absorptiometry
(DEXA) examination at her current weight of 37 lbs (16.8 kg) approximately
65% of her total body weight is now fat mass and only 35% is lean body
mass. Despite her increased total body weight, the resting energy
requirement for this 37-pound (16.8 kg) version of Chloe remains
approximately 310 kcal/day. Failure to accurately diagnose Chloes ideal
weight will result in overestimation of the calories required for weight loss.
Chloe will be set up to fail from the start of her weight loss program.
Current Diagnostic Tools are Inaccurate
For the veterinary health care team, the diagnosis and management of overweight and obese pets is
complicated by the lack of a readily available, objective diagnostic test to confirm both the presence and
extent of the disease. The most accurate method of assessing body condition is DEXA, which provides an
objective assessment of the lean versus fat body mass. However, this method is not readily available in
clinical practice. Body weight is an objective measurement that is useful for following weight changes, but
it fails to provide any indication of body composition (lean-to-fat mass ratio), which is essential
information for determining ideal body weight.

Body composition in dogs and cats is most

commonly assessed using a 5- or 9-point body
condition score (BCS). Body condition scoring is
a subjective system based on visual
assessment and palpation findings. Body
condition scoring is an appropriate screening
tool to determine if additional testing is
needed to assess body composition. (Figure 2)
Once pets are classified as overweight or
obese based on body condition scoring more
accurate tests are required to determine the
severity of the disease.
Body condition scores can be used to
estimate percent body fat in dogs and cats.
For an ideal BCS (45/9 or 3/5) percentage
body fat averages 20% and ranges from 15%
to 25% of body weight. With the 9-point
scale, each 1-point change from ideal
represents an increase or decrease of 5%
body fat. With the 5-point scale, each point
represents a 10% change.10-12 (Figure 3) One
limitation of these scales is that body fat
percentage at the upper limits is not precise.
Although a maximum percent body fat (45%)
is assigned to the maximal BCS (5/5 or 9/9), in
actual patients with these body condition
scores the magnitude of obesity varies. In
reality, the maximal amount of body fat compatible with life is unknown. Studies have shown that the
correlation between BCS and percentage of body fat is only significant for pets with 45% body fat or
less.13 Today, the sad truth is that not only are more pets overweight, the severity of the disease is also
increasing resulting in more pets having greater than 45% body fat so more accurate diagnostic tests
are necessary.
Accurate Diagnostic Tools: Healthy Weight Protocol Validation Studies
In a series of recent studies, researchers at the University of Tennessee College of Veterinary Medicine
compared a variety of diagnostic tests used to assess body composition with DEXA- scans in dogs and
cats presented for weight management programs.14,15 The primary goal of these studies was to develop
practical methods to better diagnose body composition in obese pets. The hypothesis was that a more
accurate diagnostic test would promote more effective weight loss in client owned pets. In addition to
current BCS methods, pets were assessed using bioelectric impedance, morphometric measurements
and a newly developed Body Fat Index (BFI) Risk Chart.

Eighty-three client-owned dogs, representing 27 breeds weighing from 11 to 162 pounds (5 73.6 kg),
and 39 client-owned cats, representing 9 breeds ranging from 6 to 25 pounds (2.7 11.4 kg), were
enrolled in the studies. Bioelectric impedance was found to be an unreliable tool for predicting body
composition. Body condition scoring was inaccurate in 60% of pets.15 Based on these studies, when
traditional BCS was used to estimate ideal body weight and consequently food dose, over half of the pets
would receive a recommendation to consume excess calories. By incorporating expanded definitions,
using the BFI Risk Chart improved the accuracy of prediction of ideal for both dogs and cats, particularly
those pets with greater than 45% body fat. These studies confirmed that the most accurate and practical
diagnostic test was morphometric measurements. Using proprietary software, four simple body
measurements in dogs and six in cats accurately predicted ideal body weight, within 10% of DEXA
determined values, in over 80% of patients.

Accuracy of Morphometric Measurements

predicted ideal weight compared to dual x-ray
absorptiometry predicted ideal weight in
overweight and obese dogs and cats

Accuracy of BFI Risk Chart predicted ideal weight

compared to dual x-ray absorptiometry
predicted ideal weight in overweight and obese
dogs and cats
 Hills Pet Nutrition has incorporated the learnings from
these University of Tennessee studies into the Healthy
Weight Protocol Tools that are now available to veterinary
health care teams. The Healthy Weight Protocol online
tool allows the veterinary health care team to input body
measurements into the proprietary software, which then
provides the pets percent body fat, ideal weight, and
recommended caloric intake for weight loss, as well as,
tools to discuss health risks of abnormal body conditions
with pet owners. If body measurements are unavailable,
the BFI Risk chart is a practical diagnostic test that
increases the accuracy of estimating both percent body fat
and ideal body weight in dogs and cats. Using the current
weight and estimate BFI ideal weight is easily determined.

Why Ideal Weight Matters

Appropriate reduction in caloric intake is required for successful weight loss. Small inaccuracies can
make big differences, particularly in smaller pets. For example, a 10-pound (4.5 kg) cat consuming just
10 kcal/day more than RER will gain nearly 1 lb (0.5 kg) or 12% of body weight per year. To put that in
perspective, eating the equivalent of 10
extra kibbles of a typical dry cat food will
cause weight gain in a cat that is the
same as a 150-pound (68 kg) person
gaining almost 20 pounds (9 kg) in a
year.16 Overestimating ideal weight will
lead to feeding recommendations that
may actually promote weight gain rather
than weight loss. Again, consider Chloe,
at 37 pounds (16.8 kg) she is correctly
judged to be a 5/5 or 9/9 BCS. Based on
BCS, her ideal weight would be 24 lbs (11
kg). The feeding recommendation for
weight loss for dogs is 1.0 x RER for ideal
weight. For a dog with an ideal weight of
24 lbs (11 kg) the recommendation would be to feed approximately 430 kcal per day. But we know the
real Chloe is actually a 16.5 pound (7.5 kg) dog. The feeding recommendation for Chloe at an ideal
weight of 16.5 lbs (7.5 kg) is approximately 310 kcal/day. Basing Chloes feeding recommendation on the
BCS estimation of ideal weight will provide calories that are 40% in excess of the amount required for
Chloe to lose weight.

In fact, Chloe had been on a weight loss program that included feeding Hills Prescription Diet r/d
Canine based on an ideal weight of 24 lbs (11 kg) for about 2 months when she presented to the
University of Tennessee Veterinary Teaching Hospital. Not surprisingly she had not lost any weight and
the owner was becoming frustrated. Luckily for Chloe, she was enrolled in the clinical studies evaluating
the Healthy Weight Protocol Tools. Once Chloes owners began offering her r/d Canine in an amount
based on her accurate ideal weight of 16.5 pounds (7.5 kg), she began to lose weight. In about 10
months, Chloe had lost almost 18 pounds (8 kg) and was well on her way to reaching her ideal weight.

Developing a weight loss plan based on an inaccurate ideal weight will set your patients up for failure.
Use an accurate tool to diagnose the severity of hyperadiposity and base feeding recommendations on
an accurate estimate of ideal weight. As with any disease, an accurate diagnosis means increased
treatment success.

Weight Management: Real World Challenges

For decades pet food manufacturers have assured practitioners that therapeutic weight loss foods work.
Numerous studies document the efficacy of currently available therapeutic weight loss foods in
controlled laboratory conditions or rigorously controlled clinical trials in client-owned pets. 17-21 Since
most veterinary recommended weight loss programs include a recommendation for a therapeutic
weight loss food, the expected success of these programs should be high. So why do 90% of weight loss
programs fail? The inconsistency between the effectiveness (results in typical conditions) and efficacy
(results in controlled conditions) of therapeutic weight management foods is often attributed to owner
behaviors that are beyond the control of the veterinary health care team. In a recent survey, veterinary
practices reported that they believe 97% of obesity cases are the result of human specific factors such as
diet, exercise and owner attitudes.22

Since owner behavior plays such a critical role in both the pathophysiology of hyperadiposity and the
success of weight management programs, it is not surprising that foods that work under strictly
controlled conditions may not work as well in typical circumstances. Reducing calories through portion
control is the basis of most weight management programs. This means owners must accurately measure
portion sizes. Today many people have a distorted view of portion sizes. This distorted view of portion
sizes is often applied to pets as well. Even the size of the serving bowl affects the amount of calories
consumed. Studies show that people eat more when they are confronted with larger portion sizes and
this may also be true for pets.23 Not surprisingly, pet owners are more likely to provide a larger portion of
food when they serve kibble in a large bowl or used a large scoop to measure.24 Although owners
may believe they are being kind to their pets by being generous with portion sizes, the cost to their pets
health may be higher than most people realize.

Perhaps even more discouraging is the significant margin of error associated with measuring portions
even when owners try to follow appropriate recommendations and use manufacturer provided cups. A
recent study documented considerable variability in both the accuracy and precision of measuring
portion sizes when manufacturer provided cups are used.25 While the tendency was for all portions to
be greater than the recommended amount, this was most evident when small portions were measured.
The accuracy of portion size varied and could be more than 80% greater than the desired amount. Over
the long term, these inaccuracies could predispose pets to weight gain and may be a significant factor in
the failure of some weight management programs using currently available therapeutic weight loss
foods.

Given the variability inherent in measuring portions, the increased likelihood of additional treats and
people food in the home setting, it is not surprising that even the best designed and implemented
weight loss programs fail in the home setting. Until now, there has been little hope of managing these
owner behaviors to increase the success of weight management programs.

NOW THERE IS HOPE:

Hills Prescription Diet Metabolic Advanced Weight Solution works the way people feed their pets
In a landmark in-home study, Hills Pet Nutrition determined the effectiveness of a novel therapeutic
weight management food. Over 350 overweight or obese pets (159 dogs and 155 cats) completed this 2-
month feeding study.26 This study is unique for several reasons; 1) research was conducted by a third
party, the veterinary health care teams and owners were blinded to the sponsor of the study and
manufacturer of the food; 2) owners were unaware that they were participating in a weight loss study
for their pet; 3) owners were allowed to feed the test food to up to 3 additional same species pets;
and 4) the feeding recommendations were based on the pets ideal weight as determined by a non-
branded version of the Healthy Weight Protocol tool. Once enrolled, owners were told how much to
feed their pet, provided the test food and a measuring cup, and asked to return for the 1- and 2-month
recheck evaluations. Feeding amount recommendations were not adjusted at the recheck visits.
Remarkably, even without strict protocols and precise measuring, 88% of these pets lost weight at an
average rate of 0.7% of initial body weight per week. The majority of pet owners agreed that Hills
Prescription Diet Metabolic Advanced Weight Solution was an easy way for their pet to lose weight,
while keeping their pets feeling full and satisfied. Perhaps most impressive is that 80% of pet owners
said they would recommend Metabolic Advanced Weight Solution to a friend with an overweight pet.

Prior to the introduction of Metabolic Advanced Weight Solution, the most successful weight
management programs occurred in strictly controlled situations, either in laboratory settings or as part
of a rigorously controlled weight
management program. In two
recent studies, the results of
rigorously controlled weight
management programs using typical
commercially available therapeutic
weight loss foods, the rates of
weight loss were 0.8% for dogs and
0.6% for cats.20,21 To achieve this
level of success, ideal weight was
based on DEXA evaluations and
owners were required to weigh food
portions on calibrated scales for
each meal. Recheck evaluations
were scheduled at 7-21 day intervals
and feeding amounts were decreased at each evaluation as needed to achieve the desired weight loss
rate. With Metabolic Advanced Weight Solution and Healthy Weight Protocol Tools, pets lost weight
even when their owners were not trying to put them on a diet. In real homes, with real owners who
didnt even know they were trying to get their pet to lose weight, Metabolic Advanced Weight Solution
performed as well as typical therapeutic weight loss foods under strictly controlled conditions. Now
there is hope for pets who suffer from hyperadiposity, even if they dont participate in a rigorously
controlled study.

Because weight management

programs work best if owners see
results in the short term,
Metabolic Advanced Weight
Solution was designed to provide
safe weight loss in as little as 2
months. Metabolic Advanced
Weight Solution outperforms
typical therapeutic weight loss
foods in controlled clinical
studies. Metabolic Advanced
Weight Solution is clinically
proven to safely provide 28%
body fat loss in dogs and 29% body fat loss in cats in just 2 months.27,28 In comparison, Hills
Prescription Diet r/d pet food27,28 is clinically proven to provide 22% body fat loss in dogs in 2 months
and 17% body fat loss in cats in 3 months.

Yo-Yo Dieting: What happens after successful weight loss?

Even when initial weight loss is successful, long-term success of weight management is discouraging.29-31
This weight-cycling or yo-yo dieting is well documented in humans.32 Although not as extensively
studied in pets, weight regain is common. One study documented that like humans, dogs allowed to
regain weight after successful weight loss will do so more rapidly the second time. Importantly, they
regain weight while consuming approximately 40% fewer calories than were required to create obesity
initially.31 This may be the result of metabolic down regulation secondary to reduced caloric intake
during weight loss.31 Even more discouraging is that these dogs maintained their regained weight at a
lower total caloric intake than needed to become overweight initially. With traditional weight loss foods,
owners typically switch their pet to a maintenance food once the diet is over. Unfortunately, a recent
survey of nearly 100 commercially available foods with direct or implied weight management claims
documented a greater than 2-fold difference in caloric density based on both volume and weight.33
Because of the marked variability in caloric density of weight management foods, owners may
unintentionally double the calories they are offering simply by switching foods, even if they continue to
feed the same amount of food. This discrepancy will contribute to rebound weight gain. A recent study
of client owned dogs documented that over an average 2-year follow up (range 4 months 5 years),
weight regain occurred in about half of the obese dogs that had successfully lost weight during the initial
rigorously controlled weight loss program.20 Dogs were more likely to regain weight if they were
transitioned from a therapeutic weight loss food to a typical commercial food marketed for weight
control after reaching target weight.

The challenge for the veterinary health care team is that even when owners receive careful feeding
instructions and have a greater awareness of their pets body condition, over half the pets that lose
weight will regain it over time. Just like humans who struggle to stay on a diet, pet owners struggle to
maintain a strictly controlled diet because they worry that their pet is hungry and they love their pet
too much to deprive them of food.34-36

NOW THERE IS HOPE:

Hills Prescription Diet Metabolic Advanced Weight Solution works the way people feed their pets
The success of weight management programs can be increased by providing a therapeutic food that is
appropriate for both weight loss and long term maintenance and can be fed at volumes close to the
recommended amount for normal adult pets. Metabolic Advanced Weight Solution is specifically
designed to be appropriate for both weight loss and long term weight management in dogs and cats
without deprivation.
Metabolic Advanced Weight Solution is clinically proven to support maintenance of lean muscle and
prevention of weight regain in overweight or obese dogs and cats. In the weight maintenance phase of
the 4 weight loss studies (2 canine and 2 feline) dogs and cats were fed to maintain body weight for 4
months. Dogs and cats were transitioned to the weight maintenance phase after reaching ideal body
weight or at the end of the 4 month weight loss phase. In all groups there was no statistical difference
between body weight at the end of the weight loss phase and the end of the weight maintenance phase.
However, on average dogs and cats consumed approximately twice the calories of Metabolic Advanced
Weight Solution during the weight maintenance phase compared to the weight loss phase. This means
that pets were fed amounts that are typically recommended for normal adult pets, not restricted
amounts generally recommended for obese prone pets. Interestingly, during the weight maintenance
phase body composition continued to improve. In both dogs and cats with 5% or less change in body
weight there was a trend for fat mass to continue to decrease while lean body mass stabilized or
increased.

Metabolic Advanced Weight Solution makes weight management in client owned pets safe, easy and
effective. Using Metabolic Advanced Weight Solution for weight loss and weight management means
pets are no longer on a diet. Now owners can make the change to a healthier lifestyle for the life of
their pet. Metabolic Advanced Weight Solution is clinically proven to work with each pets unique
metabolic response to activate the bodys natural ability to burn excess body fat and affect calorie
utilization. The unique blend of wholesome ingredients naturally influences the genes that change
metabolism. This change in metabolism increases fat burning and changes calorie utilization while
sparing lean muscle mass. But most importantly, Metabolic Advanced Weight Solution works with
each pets unique metabolic response to help maintain satiety and decrease the risk of excess calorie
intake when owners overfeed.

Summary:

Hyperadiposity is not a cosmetic issue; it is both a health and a welfare issue. Overweight pets are
suffering, often in silence. The solution to the epidemic of hyperadiposity in pets lies in overcoming the
barriers to pets attaining and maintaining a healthy weight for life. The first barrier to success is making
an accurate diagnosis. Having an accurate diagnosis will facilitate meaningful discussions and optimize
the formulation of a treatment plan. The Healthy Weight Protocol Tools are practical and accurate.
Implementing the use of these tools in practice will increase the success of weight management
programs. Since human feeding habits play a primary role in the success or failure of weight management
programs providing a weight management food works the way owners feed their pets and is proven to
help maintain weight loss over time is key to ending the epidemic of pet obesity. Metabolic
Advanced Weight Solution works the way clients feed their pets for both weight loss and long term
weight management.
Tip the scales in favor of success, start using the Healthy Weight Protocol Tools and Metabolic Advanced
Weight Solution in your practice today.

References:

1. Bland IM, Hill J. Tackling dog obesity by tackling owner attitudes. Perspectives in
Agriculture, Veterinary Science, Nutrition and Natural Resources 2011;6:1-7.
2. McGreevy PD, Thomson PC, Pride C, et al. Prevalence of obesity in dogs examined by
Australian veterinary practices and the risk factors involved. Vet Rec 2005;156:695-702.
3. Klausner JS, Lund E. Banfield Pet Hospital State of Pet Health 2012, 2012.
4. Laflamme DP. Understanding and managing obesity in dogs and cats. Vet Clin North Am
Small Anim Pract 2006;36:1283-1295, vii.
5. Scarlett JM, Donoghue S. Associations between body condition and disease in cats. J Am
Vet Med Assoc 1998;212:1725-1731.
6. Kealy RD, Lawler DF, Ballam JM, et al. Effects of diet restriction on life span and age-
related changes in dogs. J Am Vet Med Assoc 2002;220:1315-1320.
7. Smith GK, Paster ER, Powers MY, et al. Lifelong diet restriction and radiographic
evidence of osteoarthritis of the hip joint in dogs. J Am Vet Med Assoc 2006;229:690-693.
8. German AJ, Holden SL, Wiseman-Orr ML, et al. Quality of life is reduced in obese dogs
but improves after successful weight loss. Vet J 2011.
9. Sanderson SL. Canine obesity: A new approach to a growing problem. Insights in
Veterinary Medicine 2007;5:1-12.
10. Laflamme DP, Kealy RD, Schmidt DA. Estimation of body fat by body condition score
(abstract). . Twelfth Annual Veterinary Medical Forum, American College of Veterinary Internal
Medicine 1994;985.
11. Laflamme DP. Development and validation of a body condition score system for cats: A
clinical tool. Feline Practice 1997;25:13-18.
12. Laflamme DP. Development and validation of a body condition score system for dogs: A
clinical tool. Canine Practice 1997;22:10-15.
13. Mawby DI, Bartges JW, d'Avignon A, et al. Comparison of various methods for
estimating body fat in dogs. J Am Anim Hosp Assoc 2004;40:109-114.
14. Toll PW, Paetau-Robinson I, Lusby AL, et al. Effectiveness of morphometric
measurements for predicting body composition in overweight and obese dogs Journal of Veterinary
Internal Medicine 2010;24:717.
15. Lusby AL, Kirk CA, Toll PW, et al. Effectiveness of BCS for Estimation of Ideal Body
Weight and Energy Requirements in Overweight and Obese Dogs Compared to DXA (abstract). Journal of
Veterinary Internal Medicine 2010;24:717.
16. Michel K, Scherk M. From Problem to Success: Feline weight loss programs that work. J
Feline Med Surg 2012;14:327-336.
17. Roudebush P, Schoenherr WD, Delaney SJ. An evidence-based review of the use of
therapeutic foods, owner education, exercise, and drugs for the management of obese and overweight
pets. J Am Vet Med Assoc 2008;233:717-725.
18. German AJ, Holden SL, Bissot T, et al. A high protein high fibre diet improves weight loss
in obese dogs. Vet J 2009;183:294-297.
 19. Bissot T, Servet E, Vidal S, et al. Novel dietary strategies can improve the outcome of
weight loss programmes in obese client-owned cats. J Feline Med Surg 2010;12:104-112.
20. German AJ, Holden SL, Morris PJ, et al. Long-term follow-up after weight management
in obese dogs: The role of diet in preventing regain. Vet J 2012;192:65-70.
21. Tvarijonaviciute A, Ceron JJ, Holden SL, et al. Effects of weight loss in obese cats on
biochemical analytes related to inflammation and glucose homeostasis. Domest Anim Endocrinol
2012;42:129-141.
22. Bland IM, Guthrie-Jones A, Taylor RD, et al. Dog obesity: veterinary practices' and
owners' opinions on cause and management. Prev Vet Med 2010;94:310-315.
23. Luedtke ES, Schmidt CW, Laflamme D. The effect of food bowl size on the amount of
food fed to cats. 11th Annual AAVN Clinical Nutrition & Research Symposium 2011;8.
24. Murphy M, Lusby AL, Bartges J, et al. Size of food bowl and scoop affects amount of
food owners feed their dogs. J Anim Physiol Anim Nutr (Berl) 2012;96:237-241.
25. German AJ, Holden SL, Mason SL, et al. Imprecision when using measuring cups to weigh
out extruded dry kibbled food. J Anim Physiol Anim Nutr (Berl) 2011;95:368-373.
26. In home weight loss study in dogs and cats. Hill's Pet Nutrition, Inc. Data on file, 2012.
27. Weight Loss No Regain Studies in Dogs. Data on File, Hill's Pet Nutrition Inc., 2012.
28. Weight Loss No Regain Studies in Cats. Data on File, Hill's Pet Nutrition Inc., 2012.
29. Laflamme D, Kuhlman G. The effect of weight loss regimen on subsequent weight
maintenance in dogs. Nutrition Research 1995;15:1019-1028.
30. Gossellin J, Peachey S, Sherington J, et al. Evaluation of dirlotapide for sustained weight
loss in overweight Labrador retrievers. J Vet Pharmacol Ther 2007;30 Suppl 1:55-65.
31. Nagaoka D, Mitsuhashi Y, Angell R, et al. Re-induction of obese body weight occurs more
rapidly and at lower caloric intake in beagles. Journal of Animal Physiology and Animal Nutrition
2010;94:287-292.
32. Amigo I, Fernandez C. Effects of diets and their role in weight control. Psychol Health
Med 2007;12:321-327.
33. Linder DE, Freeman LM. Evaluation of calorie density and feeding directions for
commercially available diets designed for weight loss in dogs and cats. J Am Vet Med Assoc 2010;236:74-
77.
34. Bland IM, Guthrie-Jones A, Taylor RD, et al. Dog obesity: owner attitudes and behaviour.
Prev Vet Med 2009;92:333-340.
35. Kienzle E, Bergler R, Mandernach A. A comparison of the feeding behavior and the
human-animal relationship in owners of normal and obese dogs. J Nutr 1998;128:2779S-2782S.
36. Kienzle E, Bergler R. Human-Animal Relationship of Owners of Normal and Overweight
Cats. Journal of Nutrition 2006;136:1947S-1950S.
 Low Res
3 Steps Step 1 Step 2 Step 3
Determine the pets Establish ideal weight using
To Determine Weigh the pet.
Body Fat Percentage chart on reverse side.
Ideal Weight using images &
descriptors below.

20
15-25% Body Fat
30
25-35% Body Fat
40
35-45% Body Fat
50
45-55% Body Fat
60
55-65% Body Fat
70
65-75% Body Fat

Ribs Ribs Ribs Ribs Ribs Ribs

Slightly prominent. Slightly to not prominent. Not prominent. Not prominent. Not prominent. Unidentifiable.
Easily felt. Can be felt. Very difficult to feel. Extremely difficult to feel. Impossible to feel. Impossible to feel.
Thin fat cover. Moderate fat cover. Thick fat cover. Very thick fat cover. Extremely thick fat cover. Extremely thick fat cover.
Shape From Above Shape From Above Shape From Above Shape From Above Shape From Above Shape From Above
Well proportioned lumbar waist. Detectable lumbar waist. Loss of lumbar waist, broadened Markedly broadened back. Extremely broadened back. Extremely broadened back,
Shape From the Side Shape From the Side back. Shape From the Side Shape From the Side bulging mid-section.
Abdominal tuck present. Slight abdominal tuck. Shape From the Side Marked abdominal bulge. Severe abdominal bulge. Shape From the Side
Shape From Behind Shape From Behind Flat to bulging abdomen. Shape From Behind Shape From Behind Very severe abdominal bulge.
Clear muscle definition, Losing muscle definition, Shape From Behind Square appearance. Square appearance. Shape From Behind
smooth contour. rounded appearance. Rounded to square appearance. Tail Base Bones Tail Base Bones Irregular or upside down pear shape.
Tail Base Bones Tail Base Bones Tail Base Bones Not prominent. Not prominent. Tail Base Bones
Slightly prominent. Slightly to not prominent. Not prominent. Extremely difficult to feel. Impossible to feel. Unidentifiable.
Easily felt. Can be felt. Very difficult to feel. Tail Base Fat Tail Base Fat Tail Base Fat
Tail Base Fat Tail Base Fat Tail Base Fat Very thick fat cover. Extremely thick fat cover. Extremely thick fat cover.
Thin fat cover. Moderate fat cover. Thick fat cover. Fat dimple or fold present. Large fat dimple or fat fold. Large fat folds or pads.
May have a small fat dimple.

HillsVet.ca Clinical Nutrition to Improve Quality of Life

 Low Res
3 Steps Ideal Body Weight [lbs]
To Determine Current
Body Fat % Body Fat % Body Fat % Body Fat % Body Fat % Body Fat %
Ideal Weight Weight
20 30 40 50 60 70
10 10 8.8 7.5 6.3 5.0 3.8
Step 1 11 11 9.6 8.3 6.9 5.5 4.1
Weigh the pet.
12 12 10.5 9.0 7.5 6.0 4.5
13 13 11.4 9.8 8.1 6.5 4.9
Step 2 14 14 12.3 10.5 8.8 7.0 5.3
Determine pets Body 15 15 13.1 11.3 9.4 7.5 5.6
Fat Percentage using
20 20 17.5 15.0 12.5 10.0 7.5
images & descriptors on
25 25 21.9 18.8 15.6 12.5 9.4
the reverse side.
30 30 26.3 22.5 18.8 15.0 11.3
Step 3 35 35 30.6 26.3 21.9 17.5 13.1
Establish ideal weight 40 40 35.0 30.0 25.0 20.0 15.0
using this chart. 45 45 39.4 33.8 28.1 22.5 16.9
50 50 43.8 37.5 31.3 25.0 18.8
55 55 48.1 41.3 34.4 27.5 20.6
60 60 52.5 45.0 37.5 30.0 22.5
65 65 56.9 48.8 40.6 32.5 24.4
70 70 61.3 52.5 43.8 35.0 26.3
75 75 65.6 56.3 46.9 37.5 28.1
80 80 70.0 60.0 50.0 40.0 30.0
85 85 74.4 63.8 53.1 42.5 31.9
90 90 78.8 67.5 56.3 45.0 33.8
95 95 83.1 71.3 59.4 47.5 35.6
100 100 87.5 75.0 62.5 50.0 37.5
105 105 91.9 78.8 65.6 52.5 39.4
110 110 96.3 82.5 68.8 55.0 41.3
115 115 100.6 86.3 71.9 57.5 43.1
120 120 105.0 90.0 75.0 60.0 45.0
130 130 113.8 97.5 81.3 65.0 48.8
140 140 122.5 105.0 87.5 70.0 52.5
150 150 131.3 112.5 93.8 75.0 56.3
160 160 140.0 120.0 100.0 80.0 60.0

Ideal body weights are calculated using current weight and body fat index

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2010 Hills Pet Nutrition Canada, Inc.
/ Trademarks owned by Hills Pet Nutrition, Inc.
CPD-896 E Clinical Nutrition to Improve Quality of Life
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Hill's BFI Risk Chart Clinically proven to more effectively determine ideal body weight

20 30 40 50 60 70
16-25% Body Fat 26-35% Body Fat 36-45% Body Fat 46-55% Body Fat 56-65% Body Fat 65% Body Fat

Healthy Weight Mild Risk Moderate Risk Serious Risk Severe Risk Extreme Risk
Face Face Face Face Face Face
Minimal fat cover Slight fat cover Slight to moderate fat cover Moderate fat cover Thick fat cover Very thick fat cover
Prominent bony structures Defined bony structures Defined to slight bony structures Slight to minimal bony structures Minimal to no bony structures No bony structures
Head & Neck Head & Neck Head & Neck Head & Neck Head & Neck Head & Neck
Prominent distinction between Clear distinction between Clear to slight distinction between Minimal distinction between Poor to no distinction between No distinction between head & shoulder
head & shoulder head & shoulder head & shoulder head & shoulder head & shoulder Tight scruff
Loose scruff Loose scruff Loose to snug scruff Loose to snug scruff Snug to tight scruff Very thick scruff fat
No scruff fat Slight scruff fat Slight to moderate scruff fat Moderate scruff fat Very thick scruff fat Sternum
Sternum Sternum Sternum Sternum Sternum Not prominent
Prominent Defined, slightly prominent Minimally prominent Poorly defined Not prominent Impossible to palpate
Very easy to palpate Easy to palpate Palpable Difficult to palpate Extremely difficult to palpate Extreme pectoral fat
Minimal pectoral fat Slight to moderate pectoral fat Moderate pectoral fat Thick pectoral fat Extremely thick pectoral fat Scapula
Scapula Scapula Scapula Scapula Scapula Not prominent
Prominent Defined, slightly prominent Slightly prominent Minimally to not prominent Not prominent Impossible to palpate
Very easy to palpate Easy / very easy to palpate Easy to palpate Palpable Difficult to palpate Ribs
Ribs Ribs Ribs Ribs Ribs Not prominent
Prominent Not prominent Not prominent Not prominent Not prominent Impossible to palpate
Very easy to palpate Easy to palpate Palpable Difficult to palpate Extremely difficult to impossible to Abdomen
Abdomen Abdomen Abdomen Abdomen palpate Extremely heavy fat pad;
Loose abdominal skin Loose abdominal skin with minimal fat Obvious skin fold with moderate fat Heavy fat pad Abdomen indistinct from abdominal fat
Easy to palpate abdominal contents Easy to palpate abdominal contents Easy to palpate abdominal contents Difficult to palpate abdominal contents Very heavy fat pad; indistinct from Impossible to palpate abdominal contents
Tail Base Tail Base Tail Base Tail Base abdominal fat Tail Base
Prominent bony structure Slightly to minimally prominent bony Minimally prominent bony structure Poorly defined bony structure Impossible to palpate abdominal Bony structure not prominent
Easy to palpate structure Palpable Difficult to palpate contents Extremely difficult to palpate
Minimal fat cover Palpable Slight to moderate fat cover Moderate to thick fat cover Tail Base Extremely thick fat cover
Shape From the Side Slight fat cover Shape From the Side Shape From the Side Bony structure not prominent Shape From the Side
Moderate to slight abdominal tuck Shape From the Side Slight abdominal bulge Moderate abdominal bulge Very difficult to palpate Very severe abdominal bulge
Shape From Above No abdominal tuck Shape From Above Shape From Above Very thick fat cover Shape From Above
Marked hourglass Shape From Above Lumbar waist Broadened back Shape From the Side Extremely broadened back
Slight hourglass / lumbar waist Severe abdominal bulge
Shape From Above
Severely broadened back

HillsVet.ca Clinical Nutrition to Improve Quality of Life

 Low Res

3 Steps Ideal Body Weight [lbs]

To Determine Current
Body Fat % Body Fat % Body Fat % Body Fat % Body Fat % Body Fat %
Ideal Weight Weight
20 30 40 50 60 70
Step 1 8 8 7.0 6.0 5.0 4.0 3.0
Weigh the pet. 9 9 7.9 6.8 5.6 4.5 3.4
10 10 8.8 7.5 6.3 5.0 3.8
Step 2 11 11 9.6 8.3 6.9 5.5 4.1
Determine pets Body 12 12 10.5 9.0 7.5 6.0 4.5
Fat Percentage using images 13 13 11.4 9.8 8.1 6.5 4.9
& descriptors on 14 14 12.3 10.5 8.8 7.0 5.3
the reverse side.
15 15 13.1 11.3 9.4 7.5 5.6
Step 3 16 16 14.0 12.0 10.0 8.0 6.0
Establish ideal weight
17 17 14.9 12.8 10.6 8.5 6.4
using this chart. 18 18 15.8 13.5 11.3 9.0 6.8
19 19 16.6 14.3 11.9 9.5 7.1
20 20 17.5 15.0 12.5 10.0 7.5
21 21 18.4 15.8 13.1 10.5 7.9
22 22 19.3 16.5 13.8 11.0 8.3
23 23 20.1 17.3 14.4 11.5 8.6
24 24 21.0 18.0 15.0 12.0 9.0
25 25 21.9 18.8 15.6 12.5 9.4
26 26 22.8 19.5 16.3 13.0 9.8
27 27 23.6 20.3 16.9 13.5 10.1
28 28 24.5 21.0 17.5 14.0 10.5
29 29 25.4 21.8 18.1 14.5 10.9
30 30 26.3 22.5 18.8 15.0 11.3
31 31 27.1 23.3 19.4 15.5 11.6
32 32 28.0 24.0 20.0 16.0 12.0
33 33 28.9 24.8 20.6 16.5 12.4
34 34 29.8 25.5 21.3 17.0 12.8
35 35 30.6 26.3 21.9 17.5 13.1

Ideal body weights are calculated using current weight and body fat index

HillsVet.ca
2011 Hills Pet Nutrition Canada, Inc.
/ Trademarks owned by Hills Pet Nutrition, Inc.
CPD-970 E Clinical Nutrition to Improve Quality of Life