Impact case study database

Obesity is a prevalent animal (dog and cat) disease, associated with many comorbidities, such as shortened lifespan, and poorer QOL [5.1]. Besides the welfare issues, the financial burden of obesity-related disease was estimated using 2009 data {USD05-2017} to be USD1,804/dog/year and USD1,049/cat/year; adjusting these figures for inflation (using a 12.3% inflation rate) would be equivalent to approximately USD2,026/dog/year and USD1,178/cat/year today [5.2]. This financial burden is corroborated by data from MORE TH>N Insurance, where obesity was a significant factor in approximately 50% of claims ( **[5.2]**); this one UK insurance company paid out >GBP8,000,000 on 9,203 claims for obesity-related illnesses in 2018, with the average cost of a claim being 20% more from pets with obesity (GBP900/claim vs. GBP722/claim **[5.2]**). UoL has addressed this by changing veterinary practice in the clinical management of canine and feline obesity, as evidenced by (a) global veterinary use of novel patented therapeutic weight loss diets and (b) adoption of evidence-based weight management protocols by veterinary professionals. As a result, there is evidence of (c) improved health and wellbeing of dogs and cats with obesity.

1. Global veterinary use of novel patented therapeutic weight loss diets

UoL demonstrated the effective physiological and clinical performance of a novel therapeutic weight loss diet (combining high protein and fibre, with 0.5% w/w psyllium) that defined the point of novelty for successful patent applications protecting Royal Canin’s Satiety Diet product range [5.3, 5.4]. This enabled marketing as a ‘therapeutic diet’ for the management of obesity, with such diets only being sold by veterinarians. Evidence of efficacy [3.1-3.6] supports the promotion of these diets globally through on-package claims, information in product books and educational materials for veterinary professionals [5.4,5.5]. Satiety Diet has replaced Royal Canin’s previous formulation ( Obesity Diet) worldwide (Fig 1) [5.4, 5.6] and, as a result, Royal Canin therapeutic weight loss diets now outperform sales of competitor diets in most global markets (Fig 2: example: Canada) [5.6]. Independent market research confirms Mars Petcare (including Royal Canin) as the leading player in the global pet obesity market, exceeding the combined share of the next 3 largest companies [5.7].

[graphs removed for publication]

Adoption of evidence-based weight management protocols by veterinary professionals

(i) Educating veterinary professionals about obesity and tailored weight management protocols

Educational materials developed for veterinary professionals, based on evidence-based protocols designed at the UoL WMC, have trained veterinary professionals in running successful weight management programmes, including the concept of tailoring the plan to the individual dog or cat [5.1]. Worldwide, face-to-face training (over [text removed for publication] training sessions from UOL staff in 34 countries to approximately [text removed for publication] people) and online training packages (e.g., Royal Canin UK’s Weight Management Online, a suite of 6 online training modules, approximately [text removed for publication] people trained in 2017) have been implemented [5.6]. Following the face-to-face training of veterinary professionals in Canadian practices, Satiety diet use increased by [text removed for publication] [ 5.6], whilst Satiety diet use increased by [text removed for publication] in practices whose staff completed Weight Management Online modules [5.6].

(ii) Electronic tools enabling veterinary professionals to implement weight management regimens

UoL-WMC-defined dietary energy requirements for successful weight loss, and recommendations on monitoring weight management regimens (e.g., timing of rechecks and dietary adjustments) [3.3-3.6] has enabled the development of veterinary weight management software to assist veterinary professionals with running tailored weight management programmes (e.g. calculating daily food intakes, graphically monitoring weight loss, adjusting plans according to response, and preventing regain). Slim Fit is a bespoke Canadian package used by approximately [text removed for publication] practices per annum, whilst the Vet Follow-Up online platform is used globally [text removed for publication] countries) by approximately [text removed for publication] veterinary practices per annum. Use of this software is associated with increased use of weight management regimens by veterinarians. For example, in [text removed for publication] [5.6]:

Evidence of a clinical benefit is demonstrated in available data from the Vet Follow-Up online platform: examining data from [text removed for publication] dogs and cats with obesity from [text removed for publication] veterinary clinics across [text removed for publication] countries managed with the software, average weight loss was [text removed for publication] [5.8].

(iii) Policy changes addressing pet obesity and raised public awareness

German co-authored the position statements for veterinary professional bodies the Global Pet Obesity Initiative (GPOI) calling for the formal definition of obesity as a disease and for the British Small Animal Veterinary Association (BSAVA) providing guidance on treating cats and dogs with obesity [5.9]. The former is endorsed by 24 national and international veterinary associations and cites 13 UoL references, whilst the latter provides guidance to UK veterinary professionals and cites 18 UoL references. Raising awareness of pet obesity within the pet-owning public is also critical to ensure uptake of the interventions. Advice from UoL WMC has featured heavily in global media, including 5 television documentaries (combining viewing total approximately 6,830,000 viewers) [5.10].

c. Improved health and wellbeing of dogs and cats with obesity**

The adoption of * **novel patented therapeutic weight loss diets and evidence-based weight management protocols has led to successful weight loss in dogs and cats with obesity, as evidenced by published studies [3.3-3.6], client testimonials (154/185 [83%] 5* reviews; 171/185 [92%] 4* or 5* reviews **[5.5]**) and data gathered from the Vet Follow-Up online platform [5.8]. The impact of obesity comorbidities is also seen in clinical studies that have demonstrated improved mobility, respiratory function, renal function, insulin sensitivity and the reversal of other metabolic derangements [5.1, 5.5], all of which lead to better QOL [3.5,3.6]. Satiety diet is now used in [text removed for publication] countries across [text removed for publication] continents [5.4] for approximately [text removed for publication] animals (cats and dogs) per annum, and approximately [text removed for publication] [5.6]. Consequently, veterinarians and pet owners have been given the tools to enable successful weight loss in animals greatly improving the welfare of pet dogs and cats with obesity, globally.