Crohn's disease and ulcerative colitis are examples of inflammatory bowel diseases (IBDs), chronic inflammatory conditions that affect the gastrointestinal tract. Clinical and experimental evidence is growing suggesting visceral adiposity, in particular, plays a significant role in the aetiology of inflammatory bowel disease (IBD). Obesity appears to be a significant risk factor for the severity of IBD disease and clinical outcomes. Visceral adipose tissue is a metabolically active organ with multiple functions that plays a role in lipid synthesis, immune function, and endocrine function. Along the mesentery, bowel inflammation seeps into the nearby adipose tissue. Mesenteric fat regulates immunological reactions to the movement of gut microorganisms and acts as a barrier to inflammation. At the same time, the main source of the cytokines and adipokines that cause the inflammatory processes linked to IBD may be mesenteric adipose tissue. This review focuses in particular on the probable function of adipokines in the pathophysiology of IBD and the prospective application of these molecules as attractive treatment targets.