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Dissertation
Adult obesity: Medical management for sustained weight reduction
University of Iowa
Doctor of Nursing Practice (DNP), University of Iowa
Spring 2024
Abstract
Background Despite the growing obesity epidemic, contributing to 4.7 million annual deaths, FDA-approved anti-obesity medications (AOMs) for the medical management of adult obesity remain underutilized (Coutinho & Halpern, 2024; Dai et al., 2020). The first-line treatment is lifestyle modification, yet about 80% of individuals regain the weight they lose (MacEwan et al., 2021). Literature suggests that AOMs, in addition to lifestyle modifications, can result in 5-15% weight loss and provide cardiovascular and metabolic benefits (Coutinho & Halpern, 2024). Purpose The purpose was to increase utilization of FDA-approved AOMs in adults 18 and older with a BMI of 27 kg/m2 or greater in addition to lifestyle modifications by providing providers with a weight management guideline and resources in a rural family practice clinic. The secondary aims were to reduce body weight percentage by at least 3% and improve self-reported use of weight loss strategies. Methods The Iowa Model guided the project. A team was formed, and a weight management guideline and additional resources were developed. Providers were trained in selecting FDA-approved AOMs and lifestyle management for obesity. The practice change was piloted, and modifications were made for sustainability. Outcomes were evaluated using electronic medical record (EMR) queries, the Oxford Food and Activity Behaviors 20 item (OxFAB20) questionnaire, and provider feedback surveys. Findings An EMR query identified 132 patients prescribed FDA-approved AOMs from Oct 2 to Nov 24, 2023. Of these, 13 completed follow-ups beyond 12 weeks. AOM prescriptions increased by 2.2%. The mean weight loss was 4.5%, with a drop in mean BMI from 40.2 to 38.8 kg/m². Most patients (69%, n=9) achieved the weight reduction target of 3% or more. There was a 7.4% overall increase in self-reported lifestyle modifications. Discussion Implementing a weight management guideline and providing resources to assist providers in selecting FDA-approved AOMs has delivered promising results in terms of weight loss and prescription practices.
Details
- Title: Subtitle
- Adult obesity: Medical management for sustained weight reduction
- Creators
- Sherry Lynne Leitch - University of Iowa
- Contributors
- Amalia Gedney-Lose (Chair) - University of Iowa
- Resource Type
- Dissertation
- Project Type
- Poster
- Degree Awarded
- Doctor of Nursing Practice (DNP), University of Iowa
- Degree in
- Family Nurse Practitioner
- Date degree season
- Spring 2024
- Publisher
- University of Iowa
- Number of pages
- 1 page
- Copyright
- Copyright © 2024 Sherry Lynne Leitch
- Language
- English
- Academic Unit
- College of Nursing; Doctor of Nursing Practice Projects
- Record Identifier
- 9984627352102771
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