Before prescribing, providers need to consider the whole patient, including the childs physical and emotional health and the environment they live in, says Sarah Hampl, MD, a coauthor of the AAP guidelines, pediatrician at Childrens Mercy Kansas City, and professor of pediatrics at University of Missouri-Kansas City School of Medicine
This is a summary of: Xie, Y., Choi, T
Medical Necessity Checklist for Formulary Exception If you're requesting a formulary exception, gather this documentation first: Required Documentation for Exception Request Current BMI documentation (30 or 27 with comorbidity) Documented comorbidities with ICD-10 codes (medical diagnosis codes): Obesity Class I/II/III (E66.811, E66.812, E66.813) Hypertension (I10) Type 2 Diabetes (E11) Dyslipidemia/high cholesterol (E78.5) Obstructive Sleep Apnea (G47.33) Failed alternative treatments documented trials of: Phentermine or diethylpropion Qsymia or Contrave Semaglutide (Wegovy/Ozempic) for 6+ months Lifestyle modification records (diet/exercise program participation) Weight history showing chronic obesity (past 1-2 years) Letter of Medical Necessity from your Kaiser provider For more on prior auth documentation, see our Wegovy prior authorization guide EXCEPTION PATHWAYS How Some Members Get Coverage While standard coverage is limited, some Kaiser members do get Wegovy covered
Nonlinear fitting method for determining local false discovery rates from decoy database searches
Department of Health and Human Services Physical Activity Guidelines and American College of Sports Medicine recommend resistance training at least two to three times weekly, targeting all major muscle groups
