For patients whose BMI reflects obesity with potential technical challenge, weight loss approaches including glucagon-like-peptide 1 (GLP-1) receptor agonists and simultaneous liver transplant with sleeve gastrectomy are options to be considered to facilitate the technical aspects of transplantation, particularly in patients undergoing outpatient evaluation [20,21]. This evidence concerns the gene GLP1R and obesity due to melanocortin 4 receptor deficiency.