Obesity. The Real Cause. The Real Fix.

By Juliet M. Getty, Ph.D.

Obesity is an epidemic problem with domesticated horses. Although we most easily attribute the problem to overfeeding concentrates combined with too little exercise, the underlying cause is much less apparent. It has to do with the horse’s brain and his response to stress -- a chronic low-grade, inflammatory stress.

Stress tells the horse that he is not safe

Discomfort, from any source, induces a biochemical response in the brain that triggers the horse to do whatever he can to survive. Research with a variety of species has repeatedly shown[i] that stress tells the body to hold on to fat; the chemical changes that occur are similar to those produced during a famine. This is based on a primitive need to feel safe. Therefore, stress “tricks” the horse’s body into gaining weight just to survive.

Stress can come from many sources – stall confinement, isolation from buddies, sleep deprivation, change in environment, travel to strange locations, excessive training and performing, pain and illness, exposure to toxins, and the most stressful of all – not being allowed to graze on forage at all times. Forage restriction is incredibly stressful.[ii] Putting the horse on a “diet” by limiting the amount of hay he can have will create a chain of chemical reactions that prevent the very outcome the “diet” was meant to ensure. Let’s look at more specifics…

Stress, cortisol, insulin, and leptin

Stress causes the adrenal gland to release the hormone cortisol. Cortisol tells the tissues to ignore insulin’s attempts to get glucose into the cells.[iii] So insulin increases to try to overcome this, but not very successfully. When insulin is elevated, the cells hold on to body fat. And when body fat increases, it releases a hormone called leptin. Normally, leptin is a good thing, but not in this case.

The brain can become resistant to leptin. Under normal circumstances, leptin (secreted from fat tissue), goes to the satiety center in the hypothalamus portion of the brain to tell it that the horse has had enough to eat and is satisfied.[iv] This is the body’s way of maintaining normal weight: fat increases, leptin rises, the brain says the body has had enough to eat, and weight comes down.

The excess body fat of obese horses promotes inflammation through its secretion of substances known as cytokines.[v] Cytokines can damage the areas within the hypothalamus that recognize leptin.[vi] Leptin is high, but the brain is not responding to it. The result? The appetite does not decrease; instead the horse keeps on eating, getting more obese, producing more cytokines, increasing inflammatory damage to the hypothalamus, resulting in greater leptin resistance.  

Perhaps you’ve had your horse’s cortisol level checked and it is normal. You assume that stress is therefore not an issue. But this can lead to a false assumption. Cortisol can actually be elevated inside the cell and not in the bloodstream, due to the overexpression of an enzyme called 11-beta-hydroxysteroid-dehydrogenase-1, present in fat, liver and brain cells that produces active cortisol. This has been shown in several species, including horses,[vii] and leads to the vicious cycle resulting in hypothalamic damage.

The over-use of thyroid medication

Elevated cortisol can reduce T4 levels leading one to believe that thyroid medication is necessary. But reduced T4 under this circumstance is not an indication that the thyroid gland is underactive, nor is it an indication that more thyroid medication is needed to help the horse lose weight. Furthermore, adding T4 to the diet will not do any good if the horse is stressed, simply because excess cortisol interferes with the conversion of T4 to T3, the active hormonal form.

Horses with a history of long-term forage restriction

Some horses have suffered from forage restriction for so many years that their metabolic rate has become severely impaired. For these, modest, short-term weight gain can be a consequence of free-choice feeding. Be patient. The transition can take several months. Allow your horse time to become accustomed—both physically and psychologically—to this new way of eating. Healthy weight loss takes time. When fed following the steps outlined below, the large majority of horses, even those grossly overweight, will adjust, lose weight and in time, arrive at a healthy body condition.

Is your horse leptin resistant?

The leptin resistant horse will, first and foremost, have excess body fat. His appetite will seem insatiable and he will rarely lift his head from eating. His metabolic rate is sluggish, causing him to pack on the pounds very easily. He is reluctant to move and his energy level is low.  

The fix

Reduce inflammation! Three factors to consider:

1. Stress reduction will calm down the cascade of hormonal events that tell the body to hoard fat. 
2. Less body fat will create fewer inflammatory substances. Insulin (an inflammatory hormone) will also decline.
3. Less inflammation will help the hypothalamus return to a normal leptin response.

Important to understand: Once the horse loses body fat, the brain will initially remain leptin resistant, making the horse very hungry so he could gain back all the weight. Therefore, the approach must be to heal the inflammatory signaling in the hypothalamus.

To do this:

• Never let your horse run out of forage, not even for a few minutes. Not only is free-choice forage feeding critical to your horse’s overall health[viii] , it also increases the metabolic rate.[ix] Feed appropriate hay and/or pasture that is low in calories, sugar, and starch.[x]
• Add a comprehensive vitamin/mineral supplement to hay-based diets. It fills in nutritional gaps and reduces overeating to simply obtain enough nutrients.  
• Avoid processed foods. These can contain inflammatory preservatives and omega 6 fatty acids (typically from soybean and corn oils).
• Feed whole foods free of additives and toxins.[xi] Whole foods can include non-GMO beet pulp, alfalfa, hay pellets, copra meal, split peas, hemp seeds, ground flaxseeds, chia seeds, blue-green algae, and various fruits and vegetables. Limit soybean meal -- the long term impact of isoflavones (the phytoestrogen found in soy) on the thyroid gland is controversial.
• Feed a variety of protein sources by mixing grasses and adding whole foods. When only one or two sources of protein are fed, the excess amino acids can be converted to glucose, potentially increasing insulin.
• Eliminate excess sugar and starch. These include sweetened feeds, cereal grains, wheat middlings, and rice bran. They raise insulin as well as triglycerides. Triglycerides can bind to leptin in the blood stream and prevent it from signaling satiety to the brain.[xii]
• Avoid high-omega 6 oils. They are highly inflammatory (e.g., soybean, vegetable, corn, wheat germ, and safflower oils).
• Increase omega 3s. Feed ground flaxseeds or chia seeds. Fish oils can be included in cases of high levels of inflammation.
• Add antioxidants. These include vitamins E and C, beta carotene (vitamin A), lipoic acid, grapeseed extract, green tea extract, spirulina, as well as herbs including, turmeric, boswellia, and ashwaghanda (which is particularly useful in combatting stress).[xiii]
• Avoid prolonged use of H2 receptor blockers and proton pump inhibitors. They can interfere with the body’s ability to absorb nutrients and create rebound acid production upon removal.
• Add a probiotic for digestive health. Horses who graze on pasture will naturally consume a variety of microbes. Hay-based diets, however, may not offer enough microbes for proper digestion of forage.  Stress can also disrupt the horse’s normal microbial flora.
• Allow for movement. Exercise increases insulin sensitivity and lessens inflammatory cytokines.[xiv] It has also been shown to directly reduce hypothalamic inflammation.[xv]
• Limit grazing muzzles. They can defeat the purpose if they cause stress. They should be limited to no more than 3 hours per day because the digestive tract needs more forage than they allow.
• Consider slow feeders. Not all horses require them, but they are helpful initially to allow for slowing down intake.[xvi]
• Keep stall confinement to a minimum, if at all. Horses who have room to roam can be as fit as those who receive daily focused exercise, and they are under far less stress.

Free-choice hay costs less

Many barn owners are reluctant to feed hay free-choice because of the apparent expense involved in purchasing more hay. But in actuality, horses who are permitted to self-regulate their intake will eat less. It’s only when several hours lapse between feeding that they eat very quickly and consume everything in sight. But when they get the message that hay is always available, that they can walk away from it and it will still be there when they return – then, and only then will they eat just what their bodies need to maintain a healthy weight. They will actually eat less than before.

Can your horse ever graze on fresh pasture again?

Absolutely! Living, healthy grass is the best whole food around. Grazing in the open air is the best stress reducer your horse can experience. The amount of grazing depends on your horse’s individual condition. Yes, pasture can be high in sugar and starch but it can vary depending on the month, the time of day, level of rainfall, sunlight, etc. Get to know your pasture grasses.

Bottom line

Turn off the body’s fat-hoarding response by taking measures to reduce stress. Combine this with an anti-inflammatory diet and increased movement, and your horse’s brain will regain its ability to respond properly to leptin. Taking off weight will become much easier.

[i] Block, J.S., He, Y., Zaslavsky, A.M., et. al., 2009. Psychosocial stress and change in weight among U.S. adults. American Journal of Epidemiology, 170, 181-192. Also, Gabriel, J., 2008. The Gabriel Method. Atria Books.

[ii] Getty, J.M. 2014. Restricting forage is incredibly stressful. Choose a different approach to weight loss. 

[iii] Tiley, H.A., Geor, R.J., and McCutcheon, L. J., 2007. Effects of dexamethasone on glucose dynamics and insulin sensitivity in healthy horses. American Journal of Veterinary Research, 68(7), 753-759.

[iv] Freidman, J., and Halaas, J., 1998. Leptin and the regulation of body weight in mammals. Nature, 395, 763-770.

[v] Wisse, B., 2004. The inflammatory syndrome: The roles of adipose tissue cytokines in metabolic disorders linked to obesity. Journal of the American Society of Nephrology, 15(11), 2792-2800.

[vi] De Git, K.C., and Adan, R.A., 2015. Leptin resistance in diet-induced obesity: The role of hypothalamic inflammation. World Obesity, (16(3), 207-224.

[vii] Farias, F.H.G., 2007. 11Beta-Hydroxysteroid dehydrogenase activity in feline, equine, and Ossabaw swine adipose tissue. Master of Science Thesis, University of Missouri-Columbia. Also, Morgan, S.A., Sherlock, M., Gathercole, L.L., et al., 2009. 11Beta-Hydroxysteroid Dehydrogenase Type 1 regulates glucocorticoid-induced insulin resistance in skeletal muscle. Diabetes, 58(11), 2506-2515.

[viii] Getty, J.M., 2014. Equine Digestion – It’s Decidedly Different. 

[ix] Lestelle, LR., Earl, L.R., Thompson, Jr., et.al., 2011. Insulin-glucose dose response curves in insulin sensitive and insensitive mares and effect of overnight and long-term feeding regimen. Journal of Equine Veterinary Science, 31, 285-286.

[x] Getty, J.M., 2015. "Do you need to analyze your hay?"

[xi] Berkseth, K.E., Guyenet, S.J., Melhorn, S.J., et. al., 2014. Hypothalamic gliosis associated with high-fat diet feeding is reversible in mice: A combined immunohistochemical and magnetic resonance imaging study. Endocrinology, 155(8), 2858-2867.

[xii] Banks, W.A., Coon, A.B., Robinson, S.M., et. al., 2004. Triglycerides induce leptin resistance at the blood-brain barrier. Diabetes, 53(5), 1253-1260.

[xiii] Schell, T., DVM, 2015. Reducing the effects of stress and anxiety of health with ashwaghanda. Nouvelle Research www.nouvelleresearch.com

[xiv] Liburt, N.R., Fugaro, M.N., Wunderlich, E.K., et. al., 2011. The effect of exercise training on insulin sensitivity and fat and muscle tissue cytokine profiles of old and young Standardbred mares. Journal of Equine Veterinary Science, 31(5-6), 237-238.

[xv] Yi, C.X., Al-Massadi, O., Donelan, E., et. al., 2012. Exercise protects against high-fat diet-induced hypothalamic inflammation. Physiology & Behavior, 106(4), 485-490.

[xvi] Getty, J.M., 2014. "The correct way to use slow-feeders."

For Permission to Reprint

For permission to reprint this article, in part or in its entirety, or arrange for a private consultation, please contact Dr. Getty directly at gettyequinenutrition@gmail.com.