When you see a fat pet, what goes through your mind?
I've been watching the recent discussion about the FDA's investigation into a veterinary drug for treating obesity. Most people are reacting with a big ole "HUH?" to the very idea:
"A pill for fat pets? All they need is a new owner, one who gets up off his fat ass and takes them for a walk sometimes."
"Sheesh. Every single fat pet has an owner who feeds them too much. It's not rocket science, and it's not a disease and it doesn't need a pill."
"Instead of asking your vet for a pill, why don't you try feeding less and getting your pets up and moving?"
"Is the pill for the owner? Because they're the one with the problem."
Those people aren't questioning the specific mechanism of action of this particular drug, nor its risks and efficacy, all of which are certainly open for debate. No, they're objecting to the
very idea of treating obesity medically.
To them, there is only one diagnosis: too much food, not enough exercise. And that diagnosis has only one treatment: eat less, move more.
Around half of America's dogs and cats weigh more than they should. And for most pets -- and people -- who are merely overweight and not obese, eating less and moving more is a good place to start -- just ask anyone who's put on a few pounds over the holidays and taken them off with a little portion control and increased exercise.
But it's misleading to try and extrapolate from that experience to believe that obese people just need to do the same longer and harder to get the same result. For those who are obese, that prescription is likely to be as spectacular a failure for pets as it's been for humans over the decades it's been doled out.
Consider a study like
this one, which found that even under strict medical supervision -- on a liquid diet, and devoting an hour a day, every day of the week, to exercise -- people only lost between 22 and 27 pounds in a year. And it was a short-term study, so it didn't tell us what happened when they got off the medically supervised program, and went back to normal eating. (Although I think we all know what that was.)
Obesity is a disease in which the systems that regulate fat burning and appetite have failed. And that's why, despite the chorus of "OMG, a PILL for being fat?" that greeted the story about the drug in question, it makes perfect sense to look for a medical solution to what is a medical problem.
If you're thinking I'm wrong, ask yourself these three questions.
One, if a person or a pet is fat because of an endocrine system disorder such as Cushings or hypothyroidism -- well-recognized diseases with known diagnostic tests and therapies -- do you think if you yelled at them a lot about how they need to eat less and move more, their malfunctioning adrenal or thyroid glands would one day wake up and start doing their jobs properly again?
Two, if you tried, if you set out to do it deliberately, could you get your weight up to 400 or 500 pounds?
And the last question: Do you think that Cushings and hypothyroidism are the only endocrine sytem disorders that can cause obesity?
What we've learned from studying obesity is that it's accompanied by a number of endocrine problems, including those that disrupt the body's ability to regulate appetite and fat-burning. In some cases, body fat becomes "invisible" to the endocrine system, disabling the body's ability to burn that fat and making the obese person (or pet) feel as if he or she is starving -- even with all that fuel on board.
The insatiable hunger of obesity, which we also see in people and dogs with Cushings as well as those on high doses of corticosteroids, is not the "Oh, hmmm, guess it's time for dinner now" sensation we're all used to, but an all-consuming sense that you're truly starving.
I've had two dogs get diagnosed with Cushings over the years. One was my cattle dog mix, Scarlett, who needed surgery to remove a fatty growth from her adrenal, and the other was my Deerhound Rebel, who was easily managed on medication for years.
It was their weight gain and insatiable thirst and hunger that sent me to the vet, and both of them quickly dropped the pounds and were restored to normal appetite levels when their Cushings was treated. Should I have instead just made them "eat less, move more"? Was treating them medically some sign of moral weakness on my part?
So why would we want our pets who are obese but don't have Cushings to suffer from feelings of starvation if they don't have to? Wouldn't it be nice if they weren't constantly seeking and begging for food? Didn't act obsessed with it, like dogs with Cushings do? Or if their bodies were easily able to "see" their fat stores, and burn them?
If a drug or, in some cases, surgery, is the answer to Cushings, and hormone supplementation is the answer to hypothyroidism, why not explore similar treatments for other endocrine disorders, including those we haven't fully described and named yet?
Safe, effective drug therapy for obesity, which enabled the body to "see" and burn fat stores while correcting the hormonal malfunction that causes excessive hunger, would not only make it easier for people (who are in charge of their own kitchens and running shoes) to eat and exercise appropriately, but for us to put our pets on healthy eating and activity regimens without suffering on their parts.
If you think this seems a bit personal, well, it is. I've struggled with weight my whole life, and around 7 years ago I lost 187 pounds, and I've kept off all but 35 of those. And I know, absolutely, that the systems in my body that regulate appetite and fat burning are broken.
Believe me, I'd give anything to be able to take a pill and get them re-regulated, just as I was able to do for Rebel.
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