We read the very interesting and informative article by Bardou et al. 1 The authors reviewed important findings on obesity and colorectal cancer (CRC). The mechanisms linking obesity to CRC are still uncertain—metabolic syndrome, insulin resistance (IR) and adipocytokines play a role. Two questions related to prevention of CRC in obesity were formulated. Should preventive strategies specifically target obese patients? Is the risk of cancer great enough to propose prophylactic bariatric surgery in certain patients with obesity? While these questions are valid, research on the interaction between nutrition, adipose tissue and immune cells strongly suggests that it is not obesity per se …