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The growing proportion of patients with IBD and obesity (15 to 40%) makes their management a critical therapeutic challenge. Obesity has a negative impact on the natural course of the disease, leads to an attenuated response to biotherapies, and favors surgical complications. A nutritional assessment is therefore essential, and physicians should be aware of the importance of screening patients for malnutrition (even in cases of obesity), sarcopenia, and obesity-related complications. A multidisciplinary approach must be proposed to the patients: supervised changes in eating habits to avoid causing or worsening deficiencies, especially during inflammatory flare-ups, as well as practicing regular physical activity. Drug treatments for obesity, particularly GLP-1 analogs, can be proposed, although their impact on the development of inflammatory bowel disease has yet to be demonstrated. Bariatric surgery, when indicated, should be proposed to patients, as it has a demonstrated benefit on post-operative IBD development.