The metaphorical idiom ‘the white elephant in the room’ has never been truer than when working with the obese patient who has a number of medical and orthopedic problems. When it comes to the underlying causes of problems that patients encounter, obesity is a major contributor, yet we’re afraid to address this issue with our patients. Why is this the norm rather than the exception? We know that many research articles written on obesity and osteoarthritis of the weight bearing