Obesity is an escalating public health concern that significantly impacts outcomes in orthopaedic surgery, particularly Total Joint Arthroplasty (TJA). As the number of obese patients seeking hip and knee arthroplasty rises, interest has grown in pharmacologic strategies for preoperative weight reduction. Glucagon-Like Peptide-1 Receptor Agonists (GLP-1RAs), initially developed for type 2 diabetes, are now commonly used for weight management. This review explores their mechanisms of action, evaluates clinical outcomes, and identifies perioperative risks relevant to orthopaedic surgery. Emerging evidence suggests GLP-1RAs may reduce periprosthetic joint infection, hospital readmission, and medical complications, especially in high-risk patients. However, gastrointestinal side effects, variability in patient response, access limitations, and uncertainty around perioperative protocols present important limitations. With appropriate patient selection and interdisciplinary collaboration, GLP-1RAs represent a promising tool for preoperative optimization in arthroplasty candidates.

Keywords:GLP-1 receptor agonists; Total joint arthroplasty; Obesity; Perioperative optimization; Weight loss; Total hip arthroplasty; Total knee arthroplasty; Surgical outcomes; Pharmacologic weight management; Postoperative complications

Abbreviations: GLP-1RA-Glucagon-like peptide-1 receptor agonist; TJA-Total Joint Arthroplasty; THATotal Hip Arthroplasty; TKA-Total Knee Arthroplasty; BMI-Body Mass Index; PJI-Periprosthetic Joint Infection; ED-Emergency Department; ERAS-Enhanced Recovery After Surgery; NPO-Nil Per Os (nothing by mouth)