➢ Obesity is associated with increased postoperative complications and reoperation following total joint arthroplasty. ➢ Meaningful functional improvement can be achieved with appropriate measures. ➢ Preoperative measures include medical optimization, weight management, and consideration of bariatric surgery and glucagon-like peptide-1 receptor agonists. ➢ Perioperative optimization requires an experienced multidisciplinary team and awareness of technical considerations for patients with obesity undergoing total joint arthroplasty.