Foreman CW, et al. - Via a retrospective analysis of 158 new individuals with BMI ≥ 40 kg/m² and moderate/severe OA of the hip or knee, researchers examined decision criteria that led arthroplasty surgeons to suggest nonoperative management vs total joint arthroplasty (TJA) and for those individuals who eventually received TJA, contrasted outcomes in this population to those with BMI < 40 kg/m². A majority of individuals with BMI ≥ 40 kg/m² and moderate/advanced OA would be lost to orthopedic follow-up. A comparatively lower BMI symbolized a greater likelihood of retention in care, and sequentially surgery, however, it does not impact surgeons’ suggestions to proceed orthopedic management. Patients who continue in seeking treatment, lose notable weight, and exhaust nonoperative alternatives may be fit for TJA irrespective of a BMI of ≥ 40 kg/m², with an overall complication rate of 4.3%. Nevertheless, at a 2-year follow-up, only 9% of patients attained BMI < 40 kg/m² and only 20% of surgeries were done on individuals who had accomplished this proposed cutoff.