Dr. Ernie Ward joins Dr. Andy Roark to discuss the challenges of discussing pet obesity with clients and practical strategies for creating urgency and motivating pet owners to take action. This episode of the Cone of Shame Veterinary Podcast dives deep into the psychology of weight loss conversations, emphasizing the importance of permission, framing the discussion around quality of life, and focusing on actionable steps. Dr. Ward shares his insights and experiences, offering valuable tools for veterinary professionals to navigate these difficult conversations with compassion and achieve better outcomes for their patients.
Check out the downloadable team training worksheet and follow along together! Empower your team to educate clients using the notes and discussion questions.
This episode is brought to you ad-free by Hill’s Pet Nutrition.
Intended for Veterinary Professionals. Opinions expressed within this content are solely the speaker’s and do not reflect the opinions and beliefs of Hill’s or its affiliates.
You can also listen to this episode on Apple Podcasts, Amazon Music, Soundcloud, YouTube or wherever you get your podcasts!
LINKS
Pet Obesity Prevention Organization
Dr. Andy Roark Exam Room Communication Tool Box Team Training Course
Dr. Andy Roark Charming the Angry Client Team Training Course
ABOUT OUR GUEST
Dr. Ernie Ward is an award-winning veterinarian, internationally known speaker, impact entrepreneur, author of several books, columnist, and media personality. A 1992 graduate of the University of Georgia, he was voted Speaker of the Year at both VMX and WVC conferences, the 2018 Veterinary Journalist of the Year, the recipient of the US National Veterinary Practice of Excellence Award, and has received many veterinary and civic recognitions.
Dr. Ward is involved on the Boards of many animal organizations, including the World Small Animal Veterinary Association (WSAVA), Morris Animal Foundation’s Scientific Advisory Board and Animal Welfare Advisory Board, Grey Muzzle Society, CATalyst Council, and the Southern European Veterinary Conference’s Scientific Committee and Practice Management Chairperson.
Dr. Ward is the founder of the Association for Pet Obesity Prevention (APOP) and the World Pet Obesity Association. He is also the editor of the forthcoming textbook titled Veterinary Clinical Obesity: A Multidisciplinary Approach to Causes, Consequences, and Interventions, First Edition, which Wiley will publish. He is known for improving veterinary medical standards through his clinical education programs and promoting a higher quality of life and healthier habits for pets and people.
When he’s not with family or pet patients, he can be found contemplating solutions for both the veterinary profession and the planet during endurance athletics, meditation, and on his award-winning weekly podcast, the Veterinary Viewfinder, or his regular column, “Opening Shots,” in NAVC’s “Today’s Veterinary Business.”
EPISODE TRANSCRIPT
Dr. Andy Roark: This episode is made possible by Hill’s Pet Nutrition. Welcome, everybody, to the Cone of Shame Veterinary Podcast. I am your host, Dr. Andy Roark. Guys, this is a great episode. I’m not kidding with you. . I’ve got my friend, Dr. Ernie Ward on and we are talking about pet obesity and having a hard conversation in the exam room. And guys, this is really good.
I gushed to Ernie after we were done recording because I was like, man, you validated so many of the things I have wrestled with so hard. Like, I have never felt like I have gotten traction when I talk to owners of obese pets about limited mobility or osteoarthritis or even decreased lifespans.
I’m like, you know, Ernie was like, yeah, you know, I’ve never gotten good traction with that. Here’s what I talk about that has been the best approach that I’ve found and it was like Oh, man this is a good tool in the toolbox. We talk about opening up the conversation again. He’s much more subtle than I am and again, it’s a very pragmatic, practical, realistic approach. This one you’re gonna wanna share with the team. This one, you’re gonna wanna get the techs and, and the, and the doctors to listen to.
But anyway, great episode. Super short. I’m gonna shut up so it doesn’t get any longer. Let’s get into this episode.
Kelsey Beth Carpenter: This is your show. We’re glad you’re here. We want to help you in your veterinary career. Welcome to the Cone of Shame with Dr. Andy Roark.
Dr. Andy Roark: Welcome to the podcast. Dr. Ernie Ward. Thanks for being here my friend. How are you?
Dr. Ernie Ward: Oh, man, I am great. I’m better now that I’m here with you.
Dr. Andy Roark: Oh, you’re very, very kind. I do, I appreciate it. I appreciate you making time to be here. I know you, you do so many things for those who don’t know you. You are Dr. Ernie Ward. You are a prominent speaker, writer. You write for today’s veterinary business. I read your column today called Opening Shots. You lecture all over the place.
You are a Certified Veterinary Physician Food Therapist. You are the person that I think about when I think about pet nutrition, obesity, weight loss, exercise, all of these sorts of things. You just, you’re such a strong advocate for pets. You are such an excellent practice management and communications lecturer.
I just, I can’t say enough good stuff about you. So, I am thrilled that you are here today. I want to talk to you about an area that I I know you have a lot of interest in and you’re passionate about and so, you know I was I was working recently with with a dog owner And I felt a bit of frustration that I haven’t I haven’t felt this level of frustration in some time But this person has got this young labrador retriever and the dog is it’s overweight and it’s getting more overweight. And I’m talking to them about, about weight loss and nutrition and keeping their dog healthy.
And I just could not create a sense of urgency in this person. You know what I mean? I, I, I sort of said, you know, we need to work on this. And she kind of chuckled. She’s really nice and I really like her. But I just I felt like she thought this dog is young we’ll figure this out later on. This is not this is not the thing we need to talk about right now. And I kind of thought it is the thing to talk about right now. And so let me bring this to you and say Dr.
Ernie ward Talk to me a little bit about about how you frame this the weight loss conversation and how do you create urgency around this so that people actually feel motivated because it’s just it’s frustrating and challenging to feel like you can’t motivate pet owners here.
Dr. Ernie Ward: Yeah, well, welcome to the last 25 years of my professional life. It’s a series of ups and downs and frustrations in the moment. And the exam room is a perfect example of an area where, you know, too often we are compressed with time and then emotion enters into the conversation. And suddenly now we’ve lost everything. And this is an emotionally charged topic for many people.
You know, In fact, they feel judged. They feel in some way blamed. And those are all things that we have to number one, acknowledge as a veterinarian and then try to say, okay, how can we compassionately continue this conversation? And to that end, you know, Andy, the first thing I’ve told everyone, again, you know, I’m not the first person to say this, but I certainly discovered it the hard way.
You’ve got to have permission to have this conversation. I think that too often, you know, as a veterinarian, we’re used to kind of coming in and laying out the didactics. You know, your dog has a mass, you know, there is a murmur, there is a pain in the joint, right? So it’s very descriptive, prescriptive, and really unilateral.
And when you get into topics like obesity, the first thing you got to do is say, is that something you’d like to talk about today? And so, you know, and you’ve got to also be prepared and the to accept that no, you know, and sometimes it’s a hard, no sometimes it’s a rude, no but most of the time it’s a soft noncommittal no.
And so that’s where you’ve got to also be nuanced because what I find vets, when they say I’m frustrated with this, they typically are, are endeavoring into something that the client doesn’t want.
Dr. Andy Roark: Yeah, and so right.
Dr. Ernie Ward: Yeah. So I think first and foremost, just to set the table, getting permission is where I start.
And again, if you look at the psychology, I mean, the literature on this, the last, you know, 30 years with this topic specifically, especially in the human arena, you know, there’s going to, that’s going to be the first thing that everybody’s going to say, get permission. So I typically, if I had that young owner with that young lab, younger, like, Hey, you know, I am concerned about the weight gain and there’s a lot of reasons why, you know, we want to make sure that we maintain a lean, healthy mass for your dog.
Is that something you’d like to talk about today? I mean, maybe we can talk about the food choices, the treats, you know, exercise, that’s something that you’re interested in pursuing. And again, a lot of times, you know, people throw their hands up and say, you know, Dr. Warren, I’d love to, but I’m too busy today.
Yeah. And that’s a soft non committal and I get it and I say, you know, no problem. I totally understand. We’re all busy. And then I usually will do that second nudge. Yeah. What if I send you something, you know, we’ve got some great resources, some handouts. What if I just send you a link or two and you kind of let it go where it lays, but I want to tell all of our colleagues and you don’t get frustrated. Don’t take this personally.
Dr. Andy Roark: It’s hard not to.
Dr. Ernie Ward: Oh, of course. Back in the day, you know, I was one of the first, you know, me and a couple others were pioneering kind of what is now known as senior care. And this is back in the mid nineties. And I remember going to one of the big diagnostics companies and they were like, Oh my gosh, this guy’s got this incredible senior plan down there.
And he’s just, you know, crushing it and I remember going into this group of, you know, academicians and a bunch of MBA types. And I remember going, okay, so here’s our plan and here’s how we present it. And here’s our outcomes. And I showed a chart that we had about 25 percent uptake. So that meant that about of the hundred folks that we said, Hey, your dog or cat needs senior wellness only about 25 percent took it.
And these, you could just see these guys go, what? And so, you know, what I learned number one was don’t be afraid to swing the bat, you know, because if you’re not in the batter’s box, you got no shot at ever hitting a home run or even a base hit. And the second thing I realized was that 25 percent is 25 percent more than the folks that never broach the topic.
So getting back to obesity, that’s how I’ve always, that’s how I’ve colored this conversation. So when people ask me, well, how do you accept all the no’s all day long? I’m going, well, because I know that I get to a yes in some, somebody. The other thing is, this isn’t you mentioned urgency I mean, this is to me a dire immediate need like, you know, obesity is a disease there are systemic Inflammatory effects happening right now and will continue until we get down to you know a normal level of adiposity or body fat. And so for me, you know, as a vet, I’m, that’s the personal part.
That’s the part that I have to let go of, but I have to realize that, well, I have to speak up and try to enter this conversation or else I’m actually doing a disservice to my patient.
Dr. Andy Roark: Yeah, no I, so I love it. I, and I really like your framing of this, how you sort of mentally frame it for yourself. I think that’s really valuable.
I have not. That whole asking for permission is that I’ve got to add that to my game. I think that you’re spot on when you say it. My question immediately was, how do you take it when they say no? I do, I really like your second nudge. I really like your, can I send you some information? I think that would make me feel good.
And then also lets me send them over something that’s sort of tailored to their specific needs. So I’ll. I like all that. I also really like your pragmatic approach to this if I can’t make people have this conversation. If I try to force the issue i’m going to drive them away more than set myself up for future success. So anyway, you’ve already been a huge help here When you get to sort of have this conversation about obesity Ernie, how do you frame this conversation?
What do you lead with here because there’s so many reasons that weight control or weight management weight loss are important for these pets. Like do you have a go where you go in with lifespan? Like how do you frame that up? So you can be impactful because you’re really good at taking a short amount of time and making really strong points that people hear. How do you frame this?
Dr. Ernie Ward: Yeah, it’s about quality of life and, you know, I’ve tried every tactic in the book. I’ve, I’ve made up stuff over the years to try it and, you know, and I’ve, I used to think that longevity, I mean, when people ask me, how did you guys get into obesity like this? It was because in my pursuit of longevity, I mean, that’s one of the things that, you know, even back when we started project 25, which I still have the goal of letting the average life expectancy of dogs and cats become 25.
So I think that’s still realistic you know, again, obviously breed exceptions, but so forth. Obesity is a way to, to get to longevity and I thought that would resonate with pet owners, but it really doesn’t. What I have found consistently works is quality of life. So now let’s get back to that young pet owner with the young lab.
See, they can’t see the future. And so we have to frame it in something that at least they can relate to today. And so let’s say that again, it’s a three year old lab and I see these all the time, just like you, and now it’s a, it’s a, it’s 95 pounds, and that dog should be 80, 85 pounds. Let’s just put him on the right side of the scale for labs.
But let’s say, you know, it’s 10 pounds overweight. That dog is perfectly fine to that person. It’s running around playing ball, hopping in the car, you know, doing all the dog things that it should do, but we have to make sure they understand that it cannot sustain. And so often I would say the person says, well, yeah, I mean, okay, doctor, what do I need to do about this?
Well, listen, you know, what I love about, let’s just say Buster, for the sake of this conversation. You know, what I love is Buster’s just love of life. I mean, this is a dog that you can tell is enjoying every moment of every day. And my goal is to preserve that for as long as possible. And there’s a lot of things that we can’t see, but one thing I can see, is that if he continues at this weight, and heaven forbid, if he continues to gain weight, that stops.
And that is what I’m here to talk about. So I will typically kind of in my, you know, southern colloquialisms, that’s how I’ll kind of enter into that quality of life, right? Because look at how he is today. This will not be here. So you’re kind of softly saying this, we lose all this and now he’s suffering and I really do avoid, you know those terms. Those triggering terms like suffering.
I really don’t even get into a lot of pain discussion. I just say let’s try to preserve this look how happy he is. He’s loving life. Those are the little touch points I think that resonate with most folks. Now, obviously there can be dogs that come in that already have symptomology, right? So now I’ve got a dog who has a gait abnormality or maybe again, they’re tachycardic, you know, or, or maybe they have tachypnea.
I mean, all these things could be related to obesity or maybe I’m seeing a biochemical change, right? So in the lab tests, I’m starting to see some maybe the liver changes or whatever. And you know, those are areas that I’m going to dig into that comorbidity. But at the end of the day for me, Andy, It’s quality of life because people don’t really seem to care about adding another year or two to life because they seem to think of well, that’s just going to be miserable, you know at the end of his life or whatever you know, they think of them in a wheelchair, you know, and it’s like nope let’s let’s try to let’s try to keep these dogs happy and live in the life that they deserve.
Dr. Andy Roark: Well, I’m glad you brought that up. I remember when you were talking about the lifespan of 25 and I yeah that resonated with me Ernie like I I thought it was great.
I was like, this is cool like the idea of my best friend living to 25, like canine, feline, like, I was like, this is great. And then it was just, I was curious what your response was, how pet owners reacted to it. Cause for me, I was like, that’s super motivating. And so just hearing that wasn’t as motivating as you thought, I’m surprised by that.
I guess I have to process that a little bit, but you know, I just, I appreciate you sort of spoke to that, cause I, I thought it was really sharp.
Dr. Ernie Ward: Well, and I appreciate that. And let me tell you, I think it was about 15 years too early because now there are drugs that are being trialed for this.
So, I mean, you know, we obviously have the Morris foundation, which I, you know, I’m a board member of, you know, we’re doing the Golden Retriever lifetime study. So, I mean, there’s a lot of, you know, interest in it. I just think it was early, but I still think on the day to day, and again, when you look at the literature on the human psychology of obesity and longevity for human health, you know, you clearly see a break.
And most people like when you start saying, would you like to be lived to be 100? There’s a big question mark over that, right? Because they’re like, oh, you know, because their perspective and experience with hundred year olds is very decrepit, right? And frail and fragile and, and really not good. Yeah. It’s not a motivating picture.
And so for me, you know, it’s like, okay, let’s really roll this thing back into what, what am I looking for in life? And everybody will say, I want to be strong and viable. I want to be autonomous, independent, you know, and be able to live on my own. And those are the things that we want to preserve for our dogs because,
I will tell you this there is nothing more frightening to most pet owners than an animal that cannot relieve itself now. I hate to be frank, but you know, we’re talking to our colleagues on this podcast and so, you know, that is one of those things that quality of life, you know And obviously you don’t lead it, you know paint a picture like that. But the reality is you know, those are the quality of life deficits that really you know, that’s what ends in euthanasia
Dr. Andy Roark: That absolutely makes sense. Okay, what if you have a patron that’s coming along with you on this journey and you make this presentation, what information are you trying to gather from them so that you can start to make a good recommendation? So they’re open to hearing this. You’ve engaged them. All this talk about leading and really focusing on quality of life, that all makes sense.
That’s really super useful. They’re kind of nodding their heads. My assumption is that you’re going to start with sort of a bit of information gathering about how did we get here? What’s going on? Can you sort of walk me through what that part of the process looks like?
Dr. Ernie Ward: Yeah, and that’s a great great question because again now we’ve got to get salient information that we can act upon or change. And so there’s really three things that we’re going to focus on during that brief time we have in that exam room and the first is current diet, right?
So what food are they feeding and with today’s therapeutic weight loss diets, you know, the choices are number one expansive but they are very very good. They help with weight loss. I just this week I was dealing with a veterinarian and she was like, oh my gosh, you know I don’t like all these expensive therapeutic diets, you know, my clients can’t afford and blah, blah, blah.
And I really don’t have a good answer because, you know, when you go outside of, when you start to restrict calories, remember you’re restricting all macro and micronutrients. So you can’t just give a regular complete and balanced diet and expect to maintain everything that you need. The other thing is the adjustments that we make in proteins and fiber, for example, you know, when it comes to weight loss diet.
So these therapeutic diets, you’ve got more choices than ever before and they work right. So that’s what I’m. Almost always, you know, when that dog, that lab that you presented, you know, that golden needs to lose 10 pounds. I am automatically now going to try to find a therapeutic weight loss diet for them.
The second thing we’re going to talk about is exercise, physical activity, and that’s a minor player, you know, and again, just going back to one of my first books on this in 2008 chowhounds. You know, and the, the literature, the research continues to hold up the weight loss equation for humans and dogs.
And again, our energy systems are very similar in many ways. It’s going to be about 60 to 70 percent diet and 30 to 40 percent physical activity exercise for cats. That equation though is 90 percent diet and only 10% aerobic activity and that’s makes sense because they use glycogen their anerobic blah blah blah. So, you know for me the exercise and diet component is to help really promote lean muscle mass and to give some type of motivation because again one of the things we’re looking at is quality of life improvements and if you can get that lab to lose five pounds in fact, Alex German’s you know, one of my colleagues and dear friends from the UK.
When they lose about 6 percent of their body mass, you see demonstrable improvements in quality of life. This is on a validated quality of life scale. So, you know, again, several people have duplicated this research. So we know that they don’t have to lose a ton of weight before the folks say, Oh, they’re better.
And so this is why physical activity is sort of my hidden little, little way to get into that conversation because suddenly now, two months later, three months later, that dog has lost three, four or five pounds. They’re coming back saying, Hey, things are better. I like this. And then the final part of the equation that I really need to uncover is treat behaviors, right?
Because we do know that most clients are guilty of overindulging their pets. And usually it’s. If you can just guide them towards healthier snack options. And this takes on a variety of different mechanisms. I mean, sometimes you can replace their treats with kibble. Sometimes you go to a different type of treat.
I mean, you know, you change the frequency, you know, again, dogs don’t do division. So we break them in half. I mean, there are lots and lots of tools and tricks you can use, but treats are also going to be part of the equation. But you know, when people say, what do you do first? It’s like focus on therapeutic diets.
Okay, that was exactly what my last question was going to be is so looking at these three things they totally make sense. What’s the current diet? What’s the exercise regime and then treat behaviors? My question for you is going to be I’m sure it differs a bit with the with the pets But how do you weight those?
Do you weight those things meaning if I come to you and go? Well, yeah, we get some treats and we don’t really exercise and we’re not really feeding and we’re juicing up the diet, you know in in by adding extra stuff. So, you know like table scraps to it things like that. I was like how do you prioritize those in your mind?
Without a doubt, it’s to get them on a therapeutic weight loss diet. And Andy, I keep going back to that because that’s the foundation, right? That’s the nutritional foundation, but also it’s going to be the way to reduce calories. So even when I have those, those folks that are like, you know, you know, they’re giving them pizza and ice cream, right?
Yeah. I mean, but I’m not going to start that fight today because I know if I can transition them on the first step of the journey, which is going to be to change the diet, then I’ve got a better shot at the next step. And it may take months, right? And I’ll tell you a lot of times what you’ll find is that these dogs and cats they start on the weight loss journey, you switch them to a diet and you know, they’re not kind of getting the results.
And that’s when you go to, to, to tier two, right? And you go, okay, now let’s talk about that pizza and ice cream that you guys have been sharing. And let’s, let’s start cutting that out. But again, if you don’t get them sort of committed, yeah. And on a path, then you really, you know, if you, if you lead with taking away treats, I have found that is a definite recipe for failure, right?
Dr. Andy Roark: Yeah I’m so glad you said that. Like, you’re blowing my mind. And, and like, this is such, this is why I ask you this, because you think about these things so deeply. To me the ice cream pizza is like a waving red, I’m like, well, of course that’s what we have to work on. And this idea of setting them up with a therapeutic diet, and then planning for the follow up, it’s just, it’s, it’s so much more subtle.
You’re saying this, like, again, I’m gonna, I’m just, this is gonna be one of those episodes, I’m gonna have to sit and process just coming out, and go,
Dr. Ernie Ward: Well, well, Andy, let me go back and let me tell you how this kind of, this whole ethos you know, and strategy came about because, you know, in addition to doing my vet work, you know, I go back, I mean, I guess I got my certified personal training certificate in 05.
And so you’re going through all these, you know, and look, those it’s a whole different jam. So it’s not being veterinary medicine, but you know, I have an interest, you know, I’m a triathlon coach and all that stuff. So I, you know, I’ve got interests, as you know, in that world. And so I’m listening to these folks and, you know, you start to realize that.
Basically, the human weight loss world kind of goes on two different tracks, right? And I call this number one, it’s going to be the, the total, you know, aerobic activity. So you exercise your way, you walk your way to weight loss, right? All that kind of stuff. So physical activity is the way. So they’re in the gym and they’re doing this and that.
Right. And the other is what I used to call the starvation deprivation track, right? So now you’re going to eat, you know, green peas and drink, you know, lemon water or whatever. Right. And I realized. Wow, those are both bold choices and hard to adhere to. So I realized if I was going to take this to pet parents, I did not want to do starvation deprivation.
And I knew we couldn’t exercise our way to weight loss. Right? And so that’s where you kind of started to realize, okay, let’s get back to foundational principles. If I can get him to take that first step. You know of just changing to a diet and this so easy because they buy it in a bag or a can it’s much easier than humans then I’ve got a good first step, but if I lead with deprivation starvation removal of something then i’m probably going to fail in more cases
Dr. Andy Roark: Dr. Ernie Ward, this has been fantastic. I really love this like you’re speaking my language. I’ve got real pearls I’m gonna take away from this. Like, this is you’ve got so much experience and, and knowledge here and you’ve thought so deeply about this. It’s been really helpful. So I just gotta thank you.
Thank you, thank you for being here. You are a huge you’re, you, you’re an educator. Resources coming out of this, like, do you have favorite resources? Do you like to share? If we’ve got people who are veterinarians technicians they’re listening to this, they’re going, yeah. This is great stuff. What would you share with them sort of keep them motivated to give them some more tools in a toolbox? What are your favorite resources out there?
Dr. Ernie Ward: Yeah, and again, I think the best place to sort of gather is going to be at PetObesityPrevention. org, right? And we also have the World Pet Obesity Organization as well, which is actually facing outward for the global community. But if you go to PetObesityPrevention.
org, you know, we have a monthly newsletter. We typically, you know, talk about, you know, hot topics in obesity, whether it’s GLP drugs or our new therapeutic weight loss diets. You know, I mean, we try to keep folks kind of up to date on that. Yeah. Also, of course, we do our surveys and our prevalence surveys every two years.
I mean, so that’s a great way to kind of get involved with that community. We continue to grow our efforts. You know, again, this is such an encompassing broad topic. I mean, you know, let’s face it, you know, for me, this is the biggest health threat our patients face without a doubt. I mean, you know, we talk about dental disease.
We talk about heart disease or osteoarthritis, but you know, really, there’s a much larger problem that, you know, we need to discover a little more about. So obesity is really so go to the website for sure. You know, obviously, you know, we do a lot of outreach at different, you know, all the major conferences.
Typically I’m there along with other board members, you know, giving something. But, you know, again, Andy, I think that, you know, the main thing I want vets to understand is that this is a disease state, no different than cancer, no different than heart disease or osteoarthritis, right? I mean, this is a disease state.
It deserves our attention. It does deserve our urgency. We don’t need to shirk away from the conversation. We do need to get permission to start it. We don’t want to get frustrated if we don’t win every battle, if you will, or every conversation. And I do believe that we need to focus on getting those dogs on really good diets.
And for me, if it’s going to be weight loss, the conversation starts and ends with therapeutic weight loss diets. And, you know, that’s, that’s where I want to start. And then, you know, we’re going to hopefully end up at a better quality of life.
Dr. Andy Roark: You inspire me. I, I, anyway I agree. I love where your head’s at. I’m on board, Ernie. Thanks so much for being here. Gang, thanks for tuning in and listening and take care of yourselves, everybody.
And that’s what we got. Guys, I hope you enjoyed it. I hope you got a ton out of it. Thank you. Thank you to Hill’s Pet Nutrition for making this episode possible. Thank you to Dr. Ernie Ward for showing some knowledge and some insight into a very important and challenging part of our job.
So anyway, guys, I hope you enjoyed this episode as much as I did. Take care of yourselves. I’ll talk to you later.
