When sequencing the DNA of a child or adult with severe obesity because a syndromic or genetic cause is suspected, reporting of secondary pharmacogenomics variants should be considered. Increasingly drug/pharmacogenetic variant combinations are mentioned on drug labels. Sometimes, these drugs will be less effective in the standard dose and/or may cause adverse effects if patients carry gene variants. The sequencing data can be used to personalize future drug prescription. The expertise in pharmacogenomics is often found among clinical pharmacists, but clinical geneticists and other clinicians should at least be aware of this domain and consider looking for opportunities to include information on actionable pharmacogenetic variants in the health records of their patients. In due time decision support systems may be in place. A DNA medication pass, carried by parents or patients, may support personalized prescription for patients with obesity.