Approximately two-thirds of US children and adolescents have either obesity or overweight status, with almost 24% of adolescents (ages 12–19 years) afflicted with severe obesity, defined as >1.2 × the 95th BMI percentile for age/gender. Despite the increasing disproportionate rise in severe or extreme childhood obesity, many children in weight management programs do not achieve a healthy weight. Most often, these patients will go on to require metabolic and bariatric surgery (MBS), but challenges and limitations may prohibit MBS on adolescents. Thus, tertiary care pediatric weight management centers are compelled to treat select pediatric obesity subtypes presenting with disease progression and disability with the available adult FDA-approved therapeutic modalities, specifically pharmacotherapy, in order to alleviate the disease state and provide relief to the patient. Here, we describe a case of severe pediatric obesity where a dedicated multidisciplinary pediatric weight management team at a tertiary care center utilizes a progressive pharmacotherapeutic approach with enormous benefits to the patient, highlighting the urgent gap and clinical care needs of this special population niche of severe adolescent obesity.

About Express Lane Eligibility Express Lane Eligibility (ELE) is a relatively simple concept. There are millions of uninsured children eligible for Medicaid and enrolled in other public programs, like school lunch or food stamps. Since they serve the same populations and families have already submitted relevant information, ELE creates connections between the programs in order help more children access affordable health coverage. Options for States The Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA) provides states with new tools and flexibility for implementing ELE. In general, state Medicaid and CHIP agencies can partner with other public programs, such as school lunch, food stamps, or WIC, to conduct outreach and enrollment activities. 1 A state may also obtain and use information directly from state income tax records or returns. Under the legislation, states can:

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