The article reviews limiting access to joint replacement surgery based solely on body mass index (BMI). Strong evidence shows safe outcomes and meaningful benefit of surgery in patients with higher BMI. Limiting it only by BMI risks stigma, inequality and unnecessary harm. The study analyzed data from the National Joint Registry from 2005–2016, comparing patients with higher BMI versus normal BMI for revision surgery within 10 years, mortality within 90 days, and pain/function. Overweight and obese patients had a lower risk of death within 90 days than patients with a normal BMI. Higher BMI increased the odds of revision surgery (HR 1.21 for grade II obesity and 1.13 for grade III), but the levels remained below accepted limits. All BMI groups showed an improvement in Oxford Knee Score of 18–20 points at 6 months, with no differences beyond minimally detectable change. The authors do not support the rationing of operations based on increased BMI.[1][3]