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Obesity not recognised as a disease by BVA

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By Josh Loeb

Obesity is not a disease, BVA council has decided.

The position runs contrary to a decision by the British Small Animal Veterinary Association (BSAVA) to classify obesity as a disease.

The American Medical Association also classifies it as a disease but the NHS does not.

Vets and vet nurses with differing views on whether obesity should be formally classified as a disease in dogs, cats, horses, donkeys and rabbits aired their views at a BVA council meeting last week.

The debate was followed by a vote, and the majority of council members supported BVA’s policy position stating that, while obesity ‘can result from disease and often causes secondary disease processes’, formally classifying it as a disease could have unintended negative consequences.

The BVA will therefore retain its position of not recognising obesity as a disease. However, the association does ‘strongly support’ the position that obesity should be considered a ‘legitimate clinical condition and serious health and welfare concern in all animals’.

Whether obesity should be classified as a disease has been subject to debate within Vet Record recently (see VR, 30 November 2019, vol 185, p 667; 14 December 2019, vol 185, p 735). It was also discussed at a British Veterinary Nursing Association (BVNA) council meeting earlier this year.

At last week’s BVA council meeting, vet nurse Jo Oakden, from the BVNA, said her association ‘strongly opposed’ classifying obesity as a disease.

Is it just giving it a title that could, in the long run, cause barriers to beating obesity?

She questioned whether such a move would ‘actually change anything’ in terms of weight management, adding: ‘Is it just giving it a title that could, in the long run, cause barriers to beating obesity?’

RVNs who currently lead weight management clinics and nutrition consults independent of vets could be adversely affected, Oakden said.

‘If obesity gets classed as a disease, does that then put it back under the Veterinary Surgeons Act?’ she asked. ‘Will it mean that I cannot tackle obesity first hand because it’s classified as a disease, and I cannot diagnose as a nurse? Does that then create another barrier?’

In addition, she said she was concerned that classifying obesity as a disease might relieve owners of their responsibility for tackling their pet’s weight.

‘They need to take ownership and successfully get their pets to lose weight,’ she said. ‘If we’re giving them “obesity as a disease” to hide behind, I think that would have a dire impact.’

Liz Mullineaux, from the BVA’s policy committee, said: ‘We’ve spent quite a lot of time in policy committee discussing this, and I’d like to think we’ve really thought about it – and I’m not suggesting other people haven’t.

‘We’ve spoken to people in the NHS, to specialist endocrinologists and diabetes specialists, and to be honest they didn’t understand where we were coming from because they don’t classify it [obesity] as a disease.

‘Coming at it from a UK perspective, those people I spoke to from the medical profession actually wondered what on earth we were talking about. They were like, of course it’s not a disease – and in dogs it definitely isn’t. It’s [something that happens] because of overfeeding and lack of exercise.’

However, BSAVA president Sue Paterson begged to differ.

‘I’m sorry to spoil the party,’ she said. ‘I have to be guided by scientific input from my scientific committee, for which we’ve been guided by [Royal Canin professor of small animal medicine at the University of Liverpool] Alex German.

‘Alex tells me very strongly that it is a disease for lots of different reasons. He says that, although fat – adipose – initially is laid down and is a physiological abnormality, that does go on to form a pathological abnormality.’

Paterson added: ‘There is a very well defined pathological process suggesting this is a disease process.’

She also said that classifying obesity as a disease could help ‘destigmatise’ it and lead to more pet owners seeking help and advice.

As well as refraining from classifying obesity as a disease, BVA’s new policy position on obesity in dogs, cats, horses, donkeys and rabbits recommends supporting the use of body condition scoring – alongside routine monitoring of weight gain and physical measurements – to identify, prevent and manage weight gain.

The association also hopes to encourage joint working with the pet food industry to increase animal owner understanding of the importance of maintaining a healthy weight.

The position will be reviewed again in 2022. ●

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