According to Gallup, GLP-1 use for weight loss has nearly quadrupled since 2024, but for some patients the scale moves while they feel exhausted, lose hair, and lose strength.
— HRT University has launched GLP-1 Optimization, a new accredited course that teaches clinicians to treat the patient, not the scale. The scale says the medication is working. The patient says she is tired, her hair is thinning, and she feels weaker than when she started. Taught by Nico Misleh, MSN, FNP-C, it arrives as 11% of U.S. adults take a GLP-1 for weight loss, up from 3% in 2024, according to Gallup. Available now, it carries 6 CE credits for prescribing clinicians.
“GLP-1s are not just a gut hormone. They’re really a systemic hormone,” said Nico Misleh, MSN, FNP-C, founder of HRT University. “You gotta understand the climate first before you start messing with the weather.” In the course, the climate is the patient’s hormonal foundation: thyroid, sex hormones, and gut health.
That foundation explains much of how patients feel. With untreated hypothyroidism or low sex hormones, a GLP-1 still produces weight loss, but more of it comes from muscle. Clinicians learn to check thyroid and iron before blaming the drug for fatigue, to prepare patients for hair shedding after rapid weight loss, and to prevent most nausea with slow titration. It also covers benefits beyond weight, such as heart and kidney protection, and teaches investigational retatrutide as pharmacology only. The seven-module curriculum is at the GLP-1 course.
Stopping is part of the patient experience too. A JAMA Network Open study of more than 125,000 adults found most stopped their GLP-1 within a year. A Cleveland Clinic study of nearly 8,000 adults who stopped found many “restart the medication or transition to another obesity treatment,” according to Hamlet Gasoyan, PhD, lead researcher at Cleveland Clinic’s Center for Value-Based Care Research. The course sets a maintenance and regain plan before the first injection.
GLP-1 Optimization is built around patient physiology and the hormonal foundation.
About HRT University
HRT University® is a continuing education company that trains licensed healthcare providers in hormone and metabolic medicine. Founded by Nico Misleh, MSN, FNP-C, it offers the HRT Master Course, the annual HRTU Live conference, and GLP-1 Optimization. Its accredited activities are planned and implemented with Pinnacle Conference, LLC, which is jointly accredited by ACCME, ACPE, and ANCC. Learn more at hrtuniversity.com.
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