As the problem of obesity becomes more prevalent, with over 30% of the population meeting the definition of obesity as defined by a body mass index of 30 or greater, we are seeing an increase number of patient requiring joint replacement who are obese. Current numbers indicated that increasing number of patients requiring joint replacement meet this definition of obesity. This increases the complication rate with regard to infection and thrombophlebitis among others. More importantly, it is putting an increasing strain on our health care system with a rising incidence of hypertension and diabetes associated with this condition. As we strive to improve access to health care of all of our citizens we should have another goal of improving the over all health of the American public by emphasizing healthy diets and appropriate exercise so that we can minimize some of the deleterious effects of excessive weight, both on our bodies, as well as our joints in particular.