Date of Conferral

7-30-2026

Date of Award

July 2026

Degree

Doctor of Nursing Practice (DNP)

School

Nursing

Advisor

Melissa Rouse

Abstract

Obesity is a growing health concern that affects many people. In recent years, the use of glucagon-like peptide-1 (GLP1s) has become increasingly popular to combat obesity. The use of GLP1s has shown successful outcomes, yet there are inconsistencies when prescribing the medication for weight loss. The practice problem identified at the organization was the lack of consistent and evidence-based guidance for providers to utilize when prescribing GLP1s for weight loss. The practice-focused question was to determine whether education on structured guidance tools for clinical staff who prescribe GLP1 medications improves their knowledge and intent to use these tools when prescribing them to patients. This is quality improvement, evidence-based practice implementation project focused on the impact of education. The purpose of the project was to educate about standardized guidance tools when prescribing GLP1s for weight loss to improve patient outcomes. There were seven participants. I used descriptive strategies to analyze the data. The preeducation survey mean score was 84, and the posteducation survey mean score was 100. All seven participants stated their intent to utilize the guidance tools. This project has implications for nursing practice because providers were more knowledgeable about GLP1s after the education session. By educating prescribing providers, the project positively contributes to social change by improving obesity management in the community. The project addresses health equity by reducing variation in treatment care. Background Obesity is a chronic condition that continues to affect more people each year, leading to further health complications. Despite new developments in healthcare, obesity continues to affect more than 1 billion people (World Health Organization, 2025). In recent years, the use of a medication class called GLP1s, changed how obesity was treated. As a result, there has been a significant change in weight loss. Injectable GLP1s have become the drug of choice for weight loss; however, the lack of knowledge from prescribing providers leaves room for adjustments to improve outcomes. Primary care providers (PCPs) have the primary role in identifying and treating obesity, but few may be prepared to implement such a complex treatment (Smith et al., 2026). Whether due to time management or a lack of knowledge, PCPs need training and support when prescribing GLP-1s. A study showed that only 49% of PCPs are comfortable prescribing GLP1s (Campos et al., 2025). This number is likely to be higher among PCPs considering that PCPs are the first to diagnose obesity in patients. This knowledge gap directly connects to the need for guidance tools for prescribing providers as a practice change. The project question was: Among clinical staff who prescribe GLP-1 medications, does education on structured guidance tools improve knowledge and intent to use these tools when prescribing for patients? The purpose of the project was to provide the prescribing providers with knowledge that will make them feel better prepared to standardize weight loss with GLP1s. Having structural guidance can lead to improved patient outcomes, greater efficacy, and reduced provider burnout. Staff Education Project Development The targeted participants were prescribing providers who directly prescribe GLP1s for weight loss. This project was intended to increase their knowledge and to aid the prescribing process, aligning it with patients’ lifestyle to improve weight-loss outcomes. Although this project was intended for providers, it was important to include all staff who interact with patients and were involved in their care. Medical assistants were included in the project to increase their knowledge of follow-up schedules and proper patient data collection. I developed the project based on a literature review and evidence analysis. The educational material was created using the analyze, design, development, implementation, and evaluation model. The model helped me analyze the practice gap and identify guidance tools. During the design phase, I developed learning objectives to increase provider knowledge and tools to improve weight-loss management. During the development phase, an evidence-based PowerPoint presentation was created that includes a GLP-1 dosing chart, clinical decision-making algorithm, and calorie-count example. Appendix A includes a content outline for the PowerPoint presentation. Pre- and posteducation surveys (Appendix B) were created to measure participants’ knowledge and posteducation intent. The implementation phase consisted of delivering educational material to the prescribing providers. I gave a GLP-1 dosing chart (Appendix C) to participants to use after the training for prescribing. During the evaluation phase, a posteducation survey was administered. Data were analyzed using descriptive statistics. Results Seven members of the project site organization participated in the educational presentation. There were three prescribing providers, two medical assistants, the office manager, and the receptionist. The preeducation survey mean score was 84, and the posteducation survey mean score was 100. All participants stated their intent to use the tool. This result demonstrates participants’ improved knowledge, acceptance, and willingness to use the guidance tools for weight-loss management. Figure 1 Aggregate Mean Outcomes Following Provider Education (N = 7) Table 1 Comparisons of Preeducation Knowledge and Posteducation Intent Outcomes Outcome measure Preeducation Posteducation Change Average knowledge score 84% 100% 19% increase Participants with score higher than 80% 6/7 (86%) 7/7 (100%) 16% increase Intent to use GLP1 guidance tools Not measured 7/7 (100%) Increase provider knowledge Confidence using guidance tools Not measured 7/7 (100%) Increased provider confidence Planned incorporation into daily practice Not measured 7/7 (100%) Increased likelihood of adoption Belief that tools improve patient outcomes Not measured 7/7 (100%) Increase acceptance of intervention   The project has the potential to address the obesity management gap beyond the organization for which it was created. I intended to ease in the process of prescribing GLP1s and create consistency among providers. The project can serve as a model for other organizations to incorporate when managing weight loss and expanding provider knowledge. The project has the potential to be a protocol for obesity management. The project not only incorporates medication dosages but also lifestyle modifications that must be incorporated into patient care. One of the limitations identified was the setting. The project was conducted in a single clinic. Data reflected only that specific organizational environment and were based solely on their specific needs. Another limitation identified was the sample size. The sample included only seven participants, which is relatively small, but the improvement in participant knowledge and 100% intent are clinically significant. Another limitation is that the intent answers were self-reported. Conclusions This Doctor of Nursing Practice quality improvement project positively impacted the organization by increasing provider knowledge and intent to use guidance tools when prescribing GLP1s for weight loss. The evidence-based education intervention was developed to improve outcomes for patients. The standardized GLP1 guidance tool can promote consistency in prescribing and improved weight-loss management for patients. My further recommendations to consider include long-term evaluation. I recommend that the organization leadership monitor use of the tool and compare it to patient outcomes. The implication for nursing practice is that the project has strengthened providers’ knowledge about GLP1s, enabling them to deliver evidence-based care. The project has also helped standardize care, which is a positive implication for social change by improving consistency. The project addresses health equity by reducing variation in treatment care.   References Campos, A., Fantasia, K. L., & Rizo, I. (2025). Knowledge, attitudes, and practices in obesity among trained and in-training primary care providers in an urban safety-net hospital system. Obesity Pillars, 15, 100185. https://doi.org/10.1016/j.obpill.2025.100185 Despain, D., & Hoffman, B. L. (2024). Optimizing nutrition, diet, and lifestyle communication in GLP-1 medication therapy for weight management: A qualitative research study with registered dietitians. Obesity Pillars, 12, Article 100143. https://doi.org/10.1016/j.obpill.2024.100143 Duncan, J., Stevens, P. L., Bigby, E., Floyd, C., Malina, J., Nickens, J., Lambert, A., & Kantor, T. (2025). Weight reduction and treatment adherence with tirzepatide using the Individualized Virtual Integrative Medicine (IVIM) protocol. Obesity Pillars, 17, 100236. https://doi.org/10.1016/j.obpill.2025.100236 Johnson, B. V. B., Milstead, M., Green, L., Kreider, R., & Jones, R. (2025). Diet quality and nutrient distribution while using glucagon-like peptide-1 receptor agonist: A secondary cross-sectional analysis. Obesity Pillars, 16, 100195. https://doi.org/10.1016/j.obpill.2025.100195 Johnson, B., Milstead, M., Thomas, O., McGlasson, T., Green, L., Kreider, R., & Jones, R. (2025). Investigating nutrient intake during use of glucagon-like peptide-1 receptor agonist: A cross-sectional study. Frontiers in Nutrition, 12, Article 1566498. https://doi.org/10.3389/fnut.2025.1566498 Keating, S., Wild, C., Scragg, J., Dixon, S., Treadwell, J., Hinton, L., & Jebb, S. A. (2025). GPs’ perspectives on GLP-1RAs for obesity management: A qualitative study in England. British Journal of General Practice, 75(760), e759–e767. https://doi.org/10.3399/BJGP.2025.0065 Li, P., Varghese, J. S., Shah, M. K., et al. (2025). Prescribing trends of glucagon-like peptide 1 receptor agonists for Type 2 diabetes or obesity. JAMA Network Open, 8(10). https://jamanetwork.com/journals/jamanetworkopen Mozaffarian, D., Agarwal, M., Aggarwal, M., Alexander, L., Apovian, C. M., Bindlish, S., Bonnet, J., Butsch, W. S., Christensen, S., Gianos, E., Gulati, M., Gupta, A., Horn, D., Kane, R. M., Saluja, J., Sannidhi, D., Stanford, F. C., & Callahan, E. A. (2025). Nutritional priorities to support GLP-1 therapy for obesity: A joint advisory from the American College of Lifestyle Medicine, the American Society for Nutrition, the Obesity Medicine Association, and The Obesity Society. Obesity, 33(8), 1475–1503. https://doi.org/10.1002/oby.24336 Smith, B. L., May, A., Lalani, F., Hasham, S., & Presnell, A. A. (2026). Challenges in the management of obesity. Journal of Clinical Lipidology, 20(1, Supplement), 126– 134. https://doi.org/10.1016/j.jacl.2025.09.023 Wilding, J. P. H., Batterham, R. L., Salvatore, C., Davies, M., Van Gaal Luc, F., Ildiko, L., McGowan, B. M., Rosenstock, J., Tran Marie, T. D., Wadden, T. A., Wharton, S., Koutaro, Y., & Niels, Z. (2021). Once-weekly semaglutide in adults with overweight or obesity. The New England Journal of Medicine, 384(11), 989-1002. https://doi.org/10.1056/NEJMoa2032183 Wilding, J. P. H., Batterham, R. L., Davies, M., Van Gaal, L. F., Kandler, K., Konakli, K., Lingvay, I., McGowan, B. M., Oral, T. K., Rosenstock, J., Wadden, T. A., Wharton, S., Yokote, K., Kushner, R. F., & STEP 1 Study Group. (2022). Weight regain and cardiometabolic effects after withdrawal of semaglutide: The STEP 1 trial extension. Diabetes, Obesity and Metabolism, 24(8), 1553–1564. https://doi.org/10.1111/dom.14725 World Health Organization. (2025, December 8). Obesity and overweight. https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight   Appendix A: Education PowerPoint Content Outline  Managing Obesity with GLP-1s Power Point Presentation  Chronic Disease  Overweight is BMI > 25  Obese is BMI >30  1 in 8 people in the world were living with obesity in 2022 (WHO, 2025).  Chronic, relapsing disease arising from genetics, eating behaviors, and the broader environment  It is preventable and manageable with GLP-1  Problem:  Only 87.5 % of PCPs considered obesity a disease (Campos et al., 2025)  Only 37.5% of PCPs reported confidence in overall obesity management (Campos et al., 2025)  GLP-1s: Triggers the hypothalamus in the brain to delay gastric empty which:  Increase feelings of satiety  Decrease hunger signals  Reduce food intake Approved for management of weight loss Contraindications:  thyroid carcinoma  pancreatitis  gastroparesis Typical weight loss:  Semaglutide: 12-15% of body weight  Tirzepatide: 15-22% of body weight Common Side Effects  Nausea/vomiting,  Diarrhea,  Constipation  GLP-1 indications:  Semaglutide  Week 1–4: 0.25 mg weekly (Wilding et al., 2021)  Week 5–8: 0.5 mg (Wilding et al., 2021)  Gradually increase to 2.4 mg maintenance (Wilding et al., 2021) Clinical tip: Slower titration = better adherence (Wilding et al., 2021)  Tirzepatide  Week 1-4: 5mg weekly (Duncan et al., 2025)  Week 5-8: 7.5mg weekly (Duncan et al., 2025)  Increase dosage 2.5mg every 4 weeks, 15 mg weekly (max dose) (Duncan et al., 2025)   Appendix B: Pre- and Posteducation Survey 1. Which medication is FDA approved for chronic weight management in adults with obesity? A. Semaglutide B. Metformin C. Insulin D. Sitagliptin 2. According to guideline-based criteria, which patient qualifies for pharmacologic weight loss therapy? A. BMI 24 B. BMI>30 C. BMI 25 D. Any patient requesting weight loss 3. What is the primary mechanism by which GLP-1 promote weight loss? A. A. increased basal metabolic rate B. delayed gastric emptying C. increased renal glucose excretion D. thyroid hormone stimulation 4. Which statement best reflects evidence-based obesity management guidelines? A. A. lifestyle modification alone is sufficient B. pharmacotherapy is appropriate when BMI are met and lifestyle changes are insufficient C. medication should only be used short-term D. only DM 5. Best practice when initiating GLP-1 treatment: A. Start high dosage B. Start low and titrate slowly C. PRN dosing D. Short-term use only 6. Which of the following best describes appropriate patient education when initiating GLP-1 therapy? A. No education is needed B. discuss medication cost C. injection technique D. lifestyle expectations and benefit 7. Which of the following best supports ongoing patient monitoring? A. No follow up needed B. weight, symptoms, and adherence C. weight only D. A1C 8. A daily calorie deficit of 500kcal typically results in: A. 0.25lbs/week weight loss B. 0.5lbs/week weight loss C. 1 lbs/week weight loss D. 2lbs/week weight loss 9. what is the expected average weight loss with GLP-1 therapy? A. 1-2% B. 3-5% C. 10-15% D. >25% 10. What best reflects appropriate follow up care after initiating GLP-1 therapy? A. Annual visit only B. 4-8 weeks C. no follow up needed D. weekly Intent questions added to Post Education Survey 1= strongly disagree 2= disagree 3= neutral 4= agree 5= strongly agree 1. I intend to use guidance tools when prescribing GLP-1 medications for weight loss 2. Guidance tools improve my confidence when prescribing GLP-1s 3. I am going to incorporate guidance tools into my daily practice 4. Using guidance tools will improve patient outcomes   Appendix C: GLP-1 Guidance Tool   Appendix D: AI Use Statement I used Grammarly to enhance my writing for grammar, formatting, and overall readability.

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