Retrospective investigation of the energy requirements for weight loss and weight maintenance after weight loss programme in obese dogs

Obesity is a highly prevalent disease in dogs and is characterized by the excessive accumulation of adipose tissue that results in metabolic changes. Its treatment is based on a negative energy balance focusing on energy restriction. However, there are few studies in dogs that assessed the energy intake needed for adequate weight loss and to weight maintenance afterward. The aim of this study was to evaluate data about the treatment of canine obesity, with emphasis on energy restriction to induce weight loss and to maintain body weight (BW) and ideal body condition after weight loss. This was a retrospective study in which records of obese dogs from a veterinary teaching hospital were assessed between 2014 and 2020. Sixteen dogs were considered in the study according to inclusion and exclusion criteria and 10 of these participated in the maintenance phase after weight loss. The animals lost a mean of 23.2% their initial weight in a mean of 422 days. The mean weekly weight loss rate was 0.58% of BW, and the mean daily energy intake for weight loss was 59 kcal/kg current BW0.75. When the target BW was considered, which was defined as the current weight minus 10% for every point in the body condition score scale above 5, the mean energy for weight loss was 71 kcal/kg target BW0.75. In the maintenance phase, the animals were assessed for a mean of 134 days. The mean energy intake to maintenance BW was 70 kcal/kg BW0.75. The lower energy requirement of obese dogs during and after weight loss can work as an alert for the formulations of therapeutic weight loss diets to contain a high nutrient density focusing on the wellbeing, health, and quality of life of obese dogs, not just for the weight loss phase, but a diet for the weight maintenance phase.

Cost-effectiveness of habit-based advice for weight control versus usual care in general practice in the Ten Top Tips (10TT) trial: economic evaluation based on a randomised controlled trial

OBJECTIVE

Ten Top Tips (10TT) is a primary care-led behavioural intervention which aims to help adults reduce and manage their weight by following 10 weight loss tips. The intervention promotes habit formation to encourage long-term behavioural changes. The aim of this study was to estimate the cost-effectiveness of 10TT in general practice from the perspective of the UK National Health Service.

DESIGN

An economic evaluation was conducted alongside an individually randomised controlled trial.

SETTING

14 general practitioner practices in England.

PARTICIPANTS

All patients were aged ≥18 years, with body mass index ≥30 kg/m². A total of 537 patients were recruited; 270 received the usual care offered by their practices and 267 received the 10TT intervention.

OUTCOMES MEASURES

Health service use and quality-adjusted life years (QALYs) were measured over 2 years. Analysis was conducted in terms of incremental net monetary benefits (NMBs), using non-parametric bootstrapping and multiple imputation.

RESULTS

Over a 2-year time horizon, the mean costs and QALYs per patient in the 10TT group were £1889 (95% CI £1522 to £2566) and 1.51 (95% CI 1.44 to 1.58). The mean costs and QALYs for usual care were £1925 (95% CI £1599 to £2251) and 1.51 (95% CI 1.45 to 1.57), respectively. This generated a mean cost difference of -£36 (95% CI -£512 to £441) and a mean QALY difference of 0.001 (95% CI -0.080 to 0.082). The incremental NMB for 10TT versus usual care was £49 (95% CI -£1709 to £1800) at a maximum willingness to pay for a QALY of £20 000. 10TT had a 52% probability of being cost-effective at this threshold.

CONCLUSIONS

Costs and QALYs for 10TT were not significantly different from usual care and therefore 10TT is as cost-effective as usual care. There was no evidence to recommend nor advice against offering 10TT to obese patients in general practices based on cost-effectiveness considerations.

TRIAL REGISTRATION NUMBER

ISRCTN16347068; Post-results.