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Simple Summary: Obesity is a disease of rapidly increasing prevalence in dogs and cats, with significant and often lifelong implications for animal welfare. Veterinarians are expected and mandated to protect animal health and welfare, and provide informed consent. We provide an overview of the causes, risk factors, and consequences of pet obesity; evidence regarding veterinarian compliance in diagnosing and discussing obesity in small animal practice; and outline recommendations to prevent and address overweight and obesity in companion animals. We argue that small-animal veterinarians are not meeting their ethical and professional obligation to speak up about obesity, which is a One-Health problem. Obesity is a modern-day epidemic in both people and companion animals. A summary of the current research on the causes, risk factors, consequences, and implications of overweight and obesity, and the compliance of small-animal practitioners in recognizing and addressing pet obesity, is provided. Ethical and animal welfare concerns are raised regarding these findings. We argue that a patient advocacy posture compels the veterinary profession to confront this issue more reliably. Evidence is presented to support obesity as a One-Health problem, and discrete and practical recommendations for preventing and addressing companion animal obesity are proposed. The One-Health perspective encourages coordinated action by veterinary healthcare professionals in order to address overweight and obesity in companion animals as a public health concern. Many veterinarians are concerned that the prevalence of pet overweight and obesity is increasing, and this is supported by recent data, albeit not from peer-reviewed publications. For example, over a 10-year period, Banfield® pet hospitals reported a 169% and 158% increase in the prevalence of overweight cats and dogs, respectively, while the prevalence of obesity in a five-year period in the United Kingdom increased by 37% in dogs and 90% in cats [6]. Alternatively, these changes may reflect an increased recognition of overweight and obese pets by veterinary practitioners, rather than an actual change in the disease prevalence.
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