What Actually Makes Nutrition Conversations Work

Pet food advice is everywhere, but the hardest part is what happens when an owner walks into the exam room already convinced they’ve found the “right” answer. We sit down with repeat guest Drs. Janice O’Brien to dig into what veterinarians say actually blocks effective pet nutrition communication during small animal appointments and what helps break through without shaming clients.

Janice shares insights from a large survey of 500+ veterinarians across the US and Canada, including why the top barrier often isn’t time, it’s owner preconceived notions. We talk behavior change and the pre-contemplation stage, why nuance is tough when people want certainty, and why veterinarians often feel like the last voice in a long chain of breeders, shelters, pet store conversations, online searches, ads, and influencers.

We also get highly practical: when handouts work and when they end up in the trash, how to start weight and obesity conversations with an invitation, and what “direct yet compassionate” sounds like in real life. We cover shared decision making, building trust in short visits, writing specific nutrition and calorie recommendations owners can follow, and how cost and prescription diets can affect adherence. We close with the growing impact of social media misinformation and why a whole veterinary team approach including technicians, nurses, assistants, and client service staff may be key to better outcomes.

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Transcript

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Why Nutrition Talk Feels Hard

Lisa Fortier 0:31

Welcome to Epic Award-winning Veterinary Vertex, the AV Made Journal's podcast where we delve into behind-the-scenes look with manuscript authors. I'm editor-in-chief Lisa Fortier, joined by Associate Editor Sarah Wright. Today we're discussing the very difficult topic that none of us are taught enough of in veterinary school. We're discussing veterinary perceptions and barriers and solutions to pet nutrition communication during small animal appointments with our repeat guest and newly minted double doctor, Janice O'Brien. Thank you for joining us, Janice. Thanks.

SPEAKER_03 1:04

I'm really excited to share this study with people.

Lisa Fortier 1:06

Janice, as I open to say, like, you know, none of us are taught enough, and you might know I'm an equine vet. Talking about nutrition and weight and all those things is really difficult for us as veterinarians. What motivated your team to study the veterinarians' uh perceptions on pet nutrition communication?

SPEAKER_03 1:24

Yeah, so I know that this study was a follow-up to a previous publication that did some like structured interviews of veterinarians to help specifically design this survey. And it was a collaboration with Dr. Megan Shepard, who's a veterinary nutritionist, as well as Dr. Sophie Wenzel, who's kind of an expert at survey research. And I think, yeah, it was just really interesting, they were really interested in focusing on the veterinary perspective on things.

Sarah Wright 1:54

Well, Janice, we love having you on the podcast because I feel like I learned something new about companion animal medicine every time I talk to you, especially as far as like client and owner perceptions, et cetera. So, like we said, today we're talking about nutrition and nutrition conversations can sometimes become surprisingly challenging in practice, as many of us know. So, why do you think this topic is so emotionally charged for many pet owners?

SPEAKER_03 2:16

Yeah, I think there were a lot of responses uh from veterinarians in this uh data set that kind of really talk to this, which is that people do seem to really want certainty and clear answers. And a lot of the answers that we have in nutrition are, you know, nuanced or they're kind of like hard, harder things to implement. We're talking about like behavior changes. Um, and so I think that's why it can be so, so emotionally charged. We're asking people to make big changes.

Lisa Fortier 2:47

Yeah, it's not just in veterinary medicine, right? For humans and equine as well, not just companion animal. It's a really tough, tough subject. Uh, was there a particular gap in the literature? Um, we have already talked about clinical practice, but was there a particular gap in the literature that you felt this study would address?

SPEAKER_03 3:06

Yeah, so this one was really focused on trying to get the veterinarian's perspective about um barriers in the nutrition communication space in the clinic. Um, because there has been previous research that focused on kind of what were the owner factors and owner receptivity that kind of influenced adherence to the veterinary recommendations. Um so the study was more like, okay, well, we we see the owner the owner client side of things, how how is this on the veterinary side and the veterinary perspective?

Survey Design And Big Sample

Sarah Wright 3:39

So, Janice, your survey included more than 500 veterinarians across the US and Canada. What were some of the advantages of using a large survey-based approach for this topic?

SPEAKER_03 3:49

There were so many responses, and it which was it was great. Like it was a bit of a beast in terms of trying to do all of that qualitative quoting, but um, it was really great in terms of being able to get a lot of feedback and different perspectives and see how you know people might be answering the same question in different ways. And it, you know, like we had a whole range of veterinarians. Like we had veterinarians who did identify as not feeling comfortable in nutrition discussions versus those who felt very knowledgeable and to kind of see the whole gamut of uh opinions and experience

Preconceived Notions And Behavior Change

SPEAKER_03 4:27

and everything.

Lisa Fortier 4:28

I thought it was interesting that the top reported barrier, and again, for the listener, this is on the veterinarian's perspective, was that the pet owner's preconceived notion about nutrition. Were you surprised about that? Because I guess I would have thought it was the time constraint that the veterinarian had to give to the pet owner.

SPEAKER_03 4:45

Yeah, this finding um I felt was really interesting, but I think it does make sense when we kind of think about that idea of like we might be asking people to be me making major behavioral changes. Um, and in public health, there are these things called theories of change, which are frameworks for how people change their behaviors and how to help them change. And these frameworks are mostly directed at like getting people to like stop smoking or increase their exercising or something. And all of like all of these theories of change kind of identify that there are several steps to changing behaviors. And usually the very first step is this like pre-contemplation stage, um, where people are considering change or they might be unwilling to consider change and attempting to discuss change when people are at that stage is just going to be met with resistance and frustration for everybody. And so I think that that's kind of why this finding was really highlighted. I think it's that when when we're trying to have discussions with people who are in the pre-contemplation, I don't want to change area, um, it it can be frustrating for everybody. And I think that's why that was such a big finding.

Sarah Wright 5:58

Now I have a two-part question for you. The first part is I'm wondering if you can expand on what veterinarians meant by preconceived notions. The second part is, were there any common themes or misconceptions that repeatedly emerge from the data?

SPEAKER_03 6:12

Yeah, so the preconceived notions um is really just a broad,

Grain-Free Raw Diets And Being Last

SPEAKER_03 6:18

broad term because you know, we're a lot of a lot of things talked about in all of these responses. And it's just saying that this is something that the owners or the clients believe um to be true prior to discussing things with the veterinarian. Um and it was a lot of topics, like um particular topics that really came out in the data were things like grain-free diets, raw meat diets, uh, obesity. Um, but the biggest theme, I think, out of all of it was that veterinarians really felt last to the conversation. Like, you know, when people are getting a new pet, they're first gonna talk to either the breeder or the person at the shelter, and then they're gonna go to the pet food store and maybe discuss things with the clerk, and then maybe they're gonna do an internet search too, and then they're gonna see ads on TV from all these different companies. And so, like the very last person in this whole timeline is the veterinarian. And so, veterinarians, I think, really felt like they were having to push back on some of the ideas that were really established in people's minds.

Lisa Fortier 7:18

Yeah, I'm of course on the e-coin side, I'm thinking now add in the barn manager and the trainer, right? I can't tell you how many times I'm like, no, my horse doesn't need grain. He gets a balance, a ration balancer and a scoop of vitamin E. That's all, you know, he doesn't need that. He doesn't need that. And they're like, but everybody else gets it. I'm like, I don't care. I I thought it was also interesting uh that veterinarians felt that when they shared with their personally what their own pets ate that could build trust. Uh, why do you think that resonates so strongly with clients?

SPEAKER_03 7:51

Yeah. So I think if the veterinarian is already like a trusted person to that um owner or that client, um, saying, you know, they they do want to know what the veterinarian is feeding because they they feel like, well, the veterinarians can be making the best choice for their pet, you know. So it must be the it must be the best one for my pet as well.

What Free Text Comments Reveal

Sarah Wright 8:11

So as you mentioned, Janice, you analyzed free text responses too. What additional nuance did those qualitative comments add to the survey findings?

SPEAKER_03 8:20

The free text responses were amazing. I feel like that's a lot of the meat of this paper and this discussion. Um, they really helped to clarify a lot of those fixed choice answers from the survey. So, for example, um, let's talk about handouts. So giving people handouts or resources was helpful, but only when it was also being communicated in some other way. So, like just handing somebody like a pamphlet on the dangers of obesity without having that discussion face to face was a barrier. Like several respondents said that the pamphlets never make it out of the clinic, they'll just be left in the waiting room trash can. Um, but when there's a discussion and then it's a personalized plan made for the individual pet, uh, with those individuals instructions kind of written down, um, then that then that is helpful.

Weight Conversations With An Invitation

Lisa Fortier 9:14

One of the hardest things for all of us as veterinarians uh is to talk about nutrition when an animal is overweight or well covered, as my mother used to say. Uh does your findings offer any practical guidance for navigating those very difficult conversations?

SPEAKER_03 9:30

Yeah, um, I think there were several um things. The biggest one was invitation uh to conversation. So, you know, rather than just kind of walking in and going, like, you know, your your pet is fat, um, here's the here's the recommendation for a diet. Like just saying, like, are you open to discussing this today? Um, you know, I have some concerns, but do you are you open to discussion? And if they're not interested in discussing it today, then you know, they'll let you know that. And then that kind of saves the frustration for everybody. Um as well as kind of not demonizing third parties. Like this is a conversation between, you know, these, you know, you two people or three people, whoever's in the exam room, and you don't want to be attacking some other third party.

Sarah Wright 10:19

I like that, just opening up to see if they're even open to talking about it before trying to like have this be a big thing. I think that's a great idea.

Specific Plans Owners Can Follow

Sarah Wright 10:26

So your study emphasized the importance of direct yet compassionate conversations, as we talked about. What does this balance look like in a real clinical setting?

SPEAKER_03 10:36

Yeah, the respondents um themselves kind of really emphasized that making owners feel bad about their choices was not an effective way to communicate. Um so you know, a theme that come up here was finding common ground or shared decision making. So focusing kind of on the pet and their either medical needs or their preferences, because you know, like if the pet doesn't want to eat this particular thing, the recommending that they eat it might might not be the best way to go about it. So doing that and then seeing what their owner's goals are and seeing if you can come up with a plan to meet all or most goals for everybody.

Lisa Fortier 11:17

Another key finding in your study was that clients responded better to quite specific recommendations rather than vague guidance. Uh can you give us some suggestions on how that might happen in the clinic?

SPEAKER_03 11:30

Yeah. So I kind of like in the in the like pet obesity space, you know, doing doing the really like detailed calculations of like this is how much a pet currently weighs, um, this is what I would like them to be eating in terms of calories, please measure it out, like giving all of those kind of those detailed instructions. Or if it's like a diet switch, say this is the the particular diet, or you know, maybe an option of like maybe three, maximum three options for diets that you'd like them to change to. And and yeah, giving giving those kind of um detailed recommendations in person as well as writing those down to be able to take home and actually follow through on.

Trust Building In Short Visits

Lisa Fortier 12:15

When a veterinarian makes recommendations, do you think maybe it's not captured in your survey, but on the client side, do you think there's better response and uptake of the recommendation if it's commercially available versus prescription-based diet?

SPEAKER_03 12:30

That kind of, yeah, it did come out in several responses. Um, that either giving options um was important for clients to be able to pick, you know, amongst some options, or that yeah, um, sometimes the prescription diets like cost as a barrier was a was a another thing that was listed for some of the therapeutic prescription diets. And if there was a way to meet um, you know, maybe not have everything perfect, perfect, but you know, make make like a progress towards that goal with a with an over-the-counter diet, um, that was that was um listed as being helpful, if it was possible.

Sarah Wright 13:14

That should be interesting too. I was actually just at the University of Illinois last month talking to an animal nutritionist who is commenting on how the AFCO guidelines for like pet food labels are gonna be changing to mimic human food labels a little bit in the future. So when that change is made too, that should be interesting, I guess, on how that kind of also affects some of these conversations and client choices as well. Yeah, for sure. Anyways, back to your manuscript. So your manuscript also highlighted the importance of trust before giving detailed recommendations. How can veterinarians establish that trust, especially in shorter appointments?

SPEAKER_03 13:47

There were a couple different things that were listed. Um of those were, you know, being able to, you know, fix, fix a different problem. Like a lot of times the nutrition discussion is not the primary concern that the that the owner had. And addressing that primary concern today, showing some sort of clinical progress can help um establish that trust. You know, you say, like, okay, they had a urinary tract infection, and we've, you know, resolved those clinical signs, but now we need to talk about the dietary aspects of that. Um, and being able to do kind of like a multiple, multiple step, seeing multiple visits type of thing. So it it still kind of does come back to more time sometimes and repetition of recommendations as well.

Lisa Fortier 14:32

I think one of the cool things about doing studies is when it changes your own behavior. Because you're clearly an accomplished veterinarian and communicator. Uh, so I'm curious, were there any findings in this manuscript that personally change the way you approach nutrition conversation in practice?

SPEAKER_03 14:50

Yeah, I think my biggest personal takeaway was that nutrition conversations don't have to be like one in a single appointment. Like sometimes uh people just need to hear the same thing multiple times and not and not just from the veterinarian. Like having other people um in the veterinary clinic staff um all say similar things can be really helpful to reinforcing recommendations and ideas. And so that was that was um for me the biggest takeaway because you know, you don't have you can make a recommendation at this appointment and you'll see that, you know, several weeks down the road actually come to fruition.

Lisa Fortier 15:29

Yeah, I think a marketing truism is something like somebody needs to see it six times before it might actually resonate and click with them. I like that.

Influencers Misinformation And Team Approach

Sarah Wright 15:39

Janice, we would be remiss if we didn't talk about influencers, especially since we're talking about pet nutrition. So, with the rise of influencers, how does social media affect the veterinarian client relationship around nutrition?

SPEAKER_03 15:51

Yeah, um, so online info information was one of the most frequently identified sources of misinformation regarding nutrition. And um several respondents noted that they uh kind of wish that veterinary professional organizations would actually kind of help step up and help fight this by putting out more evidence based in your information on the media. Um, and so if if kind of as a veterinary community, if we could try to try to help um each other with this and not just have it be on the individual veterinarian alone in the in the room.

Lisa Fortier 16:27

Yeah, we're doing our best, right? On social media, the podcast here. Uh it's just so much bad information out there, with especially now with Claude and Chat GPT. Anyway.

SPEAKER_03 16:40

Yeah, and that even like it gives you the answers you want to hear. Like it kind of does validate. So depending on the prompts, it might change the answer you get from it. Yes.

Lisa Fortier 16:50

I it's not uncommon, I'll say to a client, like, did you get that from Dr. Google? But looking ahead, Janice, uh, what are the research questions you think are the most pressing for improving nutrition communication?

SPEAKER_03 17:05

So yeah, I think the biggest um takeaway that I liked in for future research is that we had a lot of findings from the free text analysis regarding how important veterinary technicians, veterinary nurses, veterinary assistants, and client service representatives all can be in these conversations. Like the survey didn't ask a single question about anybody else in the clinic other than the veterinarian. Um, and it still came up in so many responses. So I'd really like to see future research that asks um veterinary technicians, nurses, everybody in the clinic about how what they feel um can also help with nutrition conversations and how to best implement a whole team approach.

Lisa Fortier 17:47

It's a great idea. You know, the fear-free folks would say that the only way that really works is if everybody from the very beginning, all the way, I mean, the entire team, if there's one person who isn't on board, it doesn't work in reducing stress and bite incidents and all those things. So that's a great idea. We'd love to see that

Final Thoughts And Closing

Lisa Fortier 18:05

manuscript.

Sarah Wright 18:05

Yeah, we had a podcast episode on that. So if you're interested, you should definitely go and find that episode. So, Janice, thank you so much for joining us. We're so excited to have you with us again today. And thank you as always for your great contributions to our journals. Thanks. And for our listeners and viewers, you can read Janice's article in Japan. I'm Sarah Wright here with Lisa48. Be sure to tune in next week for another episode of Veterinary Vertex. And don't forget to leave us a rating and review on Apple Podcasts or wherever you listen.