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The nurse practitioner (NP) role is more prominent now than ever before in primary healthcare, positioning them as providers who defend initiatives and ongoing health agendas. Obesity is among those agendas. The concept of instrumental role modeling was explained as a combination of understanding and physical presence that gives meaning and quality to inspire change. It implied that health professionals are not merely insightful clinicians but suggested their expertise is complimented by demonstrations of wellness in knowledge and practice. This topic of weight was perceived as sensitive but must be addressed. In this grounded theory study, the perspectives of NPs from clinical and academic settings were gathered. There was an overarching need for NPs to identify how they perceived themselves consequential to how others perceived them. Using a qualitative method gaps on the construct of instrumental role modeling as an emerging theory was addressed and revealed the ambiguities NPs encountered when challenged to identify their personal perceptions of obesity when counseling weight management. Using a grounded theory design, 11 NPs were interviewed and asked about how they reconciled perceptions of instrumental role modeling around discussions of obesity. Participant remarks produced theoretical constructs that instrumental role models: 1) are mindfully responsible when interacting with others, 2) need to balance accountability, approach and awareness to develop trust, and 3) need to be aware of the creative tensions that exist between accountability and approach when discussing illnesses and their co-morbid conditions. These findings provide evaluative dialogue for positive social change in clinical settings and valuable insight regarding the topic of obesity in academia.