近年来，与人类健康和疾病相关的肠道微生物多样性和复杂性受到了广泛的研究。我们对代谢性疾病和肠道微生物组之间的双向交流的理解不断增长，也突显了肠道微生物组失调在肥胖相关癌症的发生和发展中的重要性。因此，了解肠道菌群在肥胖和结肠直肠癌（CRC）之间的相互作用的可能角色是至关重要的。通过诱导肠道微生物失调、肠道上皮屏障受损、代谢紊乱、慢性炎症或能量收获调节失调，肥胖可能促进结肠直肠肿瘤的发展。众所周知，在癌症的预防和治疗策略中，健康的饮食、体育锻炼和积极的生活方式选择是最有效的。最近的研究还表明，更好地理解肠道微生物组与各种癌症以及代谢性疾病之间的复杂联系，有可能改善癌症治疗和整体预后。在此背景下，我们在此回顾和总结了支持肥胖及其代谢相关因素在CRC发病和进展中肠道微生物组的功能作用的临床和实验证据，这可能为CRC预防的新预测工具的开发铺平道路。本文还讨论了在癌症治疗中恢复肠道微生物组平衡的治疗方法。

The complexity and variety of gut microbiomes within and among individuals have been extensively studied in recent years in connection to human health and diseases. Our growing understanding of the bidirectional communication between metabolic diseases and the gut microbiome has also highlighted the significance of gut microbiome dysbiosis in the genesis and development of obesity-related cancers. Therefore, it is crucial to comprehend the possible role of the gut microbiota in the crosstalk between obesity and colorectal cancer (CRC). Through the induction of gut microbial dysbiosis, gut epithelial barrier impairment, metabolomic dysregulation, chronic inflammation, or dysregulation in energy harvesting, obesity may promote the development of colorectal tumors. It is well known that strategies for cancer prevention and treatment are most effective when combined with a healthy diet, physical activity, and active lifestyle choices. Recent studies also suggest that an improved understanding of the complex linkages between the gut microbiome and various cancers as well as metabolic diseases can potentially improve cancer treatments and overall outcomes. In this context, we herein review and summarize the clinical and experimental evidence supporting the functional role of the gut microbiome in the pathogenesis and progression of CRC concerning obesity and its metabolic correlates, which may pave the way for the development of novel prognostic tools for CRC prevention. Therapeutic approaches for restoring the microbiome homeostasis in conjunction with cancer treatments are also discussed herein.