Archives: February 2026

Think Colon Health Before It Thinks About You

In your early 30’s, you’re probably thinking about career, kids, an advanced degree, or otherwise finding your footing in adulthood, not about your risk of colon cancer.

For decades, colorectal cancer was considered a disease of older adults, and screening began at 50 because that’s when risk historically increased. But colorectal cancer is now the leading cause of cancer death in adults under 50 in the United States, according to an analysis from the American Cancer Society.¹

Emerging adulthood is still a formative period when lifelong habits form – it’s a critical window for both weight gain and long-term health risk. There has been a steady trend in the prevalence of obesity in the United States, and it coincidentally runs parallel to growing research on ultra-processed foods and their impact on long-term disease.

Ultra-processed foods (UPFs) are industrial formulations made largely from refined ingredients, additives, and preservatives, and they make up a hefty portion of too many American diets. What’s scary is that oncology researchers are publishing findings describing a 45% increased risk of early-onset conventional adenomas (precancerous colon polyps) before age 50 with diets high in UPFs.²

Obesity is traditionally associated with body weight. In actuality, it’s a chronic metabolic disease characterized by excess adipose tissue (fat) that actively releases inflammatory cytokines (chemical messengers that promote inflammation), alters insulin signaling (the way the body regulates blood sugar), and disrupts hormones that regulate cell growth. This comes full circle with another study: measures of abdominal fat, such as waist circumference, were associated with a substantially higher proportion of colorectal cancer cases than body mass index (BMI) alone.³

For patients living with obesity and considering bariatric surgery, this conversation is truly about your health as much as it is about your weight.

What’s the Deal with Processed Foods?

UPFs are exactly what they sound like: processed. They contain little to no intact whole food and are packed with refined carbohydrates, extracted oils, added sugars, stabilizers, emulsifiers, flavor enhancers, and preservatives. To get an idea of what that looks like at the grocery store, think packaged snack foods, sweetened breakfast cereals, fast food, processed meats, sugary beverages, and many shelf-stable “ready-to-eat” meals.

These foods are engineered to be hyper-palatable. High in refined starches and added sugars, low in fiber, and calorie-dense, they are specifically designed to stimulate reward pathways in the brain. Fiber, the indigestible component of plant foods that supports gut health and regulates digestion, is imperative to maintaining a healthy colon. If you aren’t getting enough fiber out of your diet, your gut microbiome (the trillions of bacteria living in the digestive tract) suffers, and you start paving a path to inflammatory responses all over the body.

Remember that 45% increased risk of precancerous colon polyps we mentioned earlier? That number remained relevant even after adjusting for factors like body mass index and type 2 diabetes. Researchers followed more than 29,000 women for over a decade and focused on comparing high versus low UPF intake, accounting for outlier variables.

Even if we take colorectal cancer out of the equation, processed foods promote rapid blood sugar spikes, leading to increased insulin release. Over time, repeated metabolic stress contributes to insulin resistance (when the body no longer responds efficiently to insulin), chronic inflammation, and weight gain. Add the cancer factor back in: chronically elevated insulin and insulin-like growth factors can promote cellular proliferation (rapid cell growth), which is a hallmark of cancer development.

A Direct Correlation Between Obesity and Cancer

Adipose tissue is metabolically active. What does that mean? Basically, it communicates with the rest of the body. It releases hormones, growth factors, and inflammatory cytokines, and, in small amounts, this system works as designed. In excess, the entire internal ecosystem is altered.

One of the defining features of obesity is chronic low-grade inflammation. Unlike the inflammation you feel with an injury, this is more subtle and persistent. Over time, inflammatory signaling alters how cells grow, divide, and repair themselves. It changes the microenvironment of surrounding tissues – including the colon.

Visceral fat (around internal organs) is particularly vicious. Along with waist circumference and waist-to-hip ratio (both measures of abdominal fat distribution), they account for a greater proportion of colorectal cancer cases than BMI alone.3 Two people can have the same BMI, but very different metabolic risk depending on where fat is stored.

Disruption of hormone signaling, insulin dysfunction, increased inflammation, and alterations in the gut microbiota accumulate over time. An environment that favors tumor development emerges.

Reducing visceral fat reduces inflammatory signaling, improves insulin sensitivity, and shifts the metabolic environment in a protective direction. It changes biology, and biology is what drives risk. Processed foods may help initiate the metabolic imbalance, but excess adipose tissue sustains it.

Screen Proactively

Colorectal cancer is increasingly diagnosed in people in their 20s, 30s, and 40s, and it is now the leading cause of cancer death in adults under 50 in the United States. Even more concerning, three out of four patients under 50 are diagnosed at an advanced stage. Screening starts at 45, and it’s one of the most accessible cancer screenings we have.

At the same time, the prevalence of overweight and obesity has steadily increased over the past several decades, particularly in young adults. The parallel is uncanny. Obesity, physical inactivity, and diets heavy in ultra-processed foods are consistently identified as contributors to rising colorectal cancer rates in younger populations. The colon does not suddenly become vulnerable at 50. The groundwork is laid years earlier through chronic metabolic stress, inflammation, and hormonal disruption.

For some patients, lifestyle modification alone is not enough. Bariatric surgery is not a shortcut; it is a metabolic intervention. Procedures such as sleeve gastrectomy and gastric bypass alter gut hormone signaling, reduce insulin resistance, reduce visceral fat, and significantly lower markers of systemic inflammation. The downstream effect is not only meaningful weight loss but measurable improvement in the internal environment that influences long-term disease risk.

If you are living with obesity, you are not defined by a number on the scale. You are navigating a complex metabolic condition with real physiologic consequences AND real solutions. Whether through structured nutrition changes, medical management, or bariatric surgery, shifting the metabolic environment earlier in life may change the long-term story.

Your 30s and 40s are not too early to think about colon health – they may be the most important time to do so.

At SAMPA, our team understands that obesity is a disease, not a failure of willpower. We offer comprehensive evaluation, medical weight management, and advanced bariatric surgery options designed to improve metabolic health and reduce long-term risk. If you are overweight or living with obesity, now is the time to get your health in check. Schedule a consultation and take the next step toward protecting not just your weight, but your future.

References:

1. McKay, B. (2026). Colorectal Cancer Is Now the Top Cause of Cancer Death in Younger People. Wall Street Journal. https://www.wsj.com/health/healthcare/colorectal-cancer-is-now-the-top-cause-of-cancer-death-in-younger-people-02f08587?gaa_at=eafs&gaa_n=AWEtsqcEwBsyxYnRPuIaA0BgkgA9KirJGjZI_K1gAadxQOtg323VHFRSjSvZIdKqIZ0%3D&gaa_ts=69979a12&gaa_sig=jxTT6VEs8KZaGeg90WM95BJ_lNhQrBghZKXauUwIdDHsIC3zxom4I3KtbJKLZG64BvQ1e9_9_fyoPqpS6Yty6A%3D%3D.
2. Wang, C., Du, M., Kim, H., Nguyen, L. H., Wang, Q.-L., Drew, D. A., Leeming, E. R., Khandpur, N., Sun, Q., Zong, X., Gweon, T.-G., Ogino, S., Ng, K., Berry, S., Giovannucci, E. L., Song, M., Cao, Y., & Chan, A. T. (2025). Ultraprocessed Food Consumption and Risk of Early-Onset Colorectal Cancer Precursors Among Women. JAMA Oncology, 12(1). https://doi.org/10.1001/jamaoncol.2025.4777.
3. Safizadeh, F., Mandic, M., Hoffmeister, M., & Brenner, H. (2025). Colorectal Cancer and Central Obesity. JAMA Network Open, 8(1). https://doi.org/10.1001/jamanetworkopen.2024.54753.

Global Guidelines and the Evolution of Obesity Care

The World Health Organization (WHO) issued its first global guideline on the use of GLP-1 medicines for treating obesity, marking something bigger than just another weight loss headline.¹

Obesity treatment can seem like a fragmented and inconsistent gray space between lifestyle and specialty care. The recent WHO endorsement gives bariatrics and medical weight loss credibility and urgency, reinforcing what specialists have known all along. This is not cosmetic medicine. This is chronic disease management.

Global acknowledgement moves us further toward evidence-based care with tangible implications for patients and the way we structure that care moving forward.

A Turning Point in Obesity Care

We are definitely at the point where obesity is a worldwide health crisis. As such, weight loss messaging has seen a steady shift from aesthetic to medical legitimacy over the last few decades. More recent recognition of obesity as a chronic condition, alongside the health implications that come with it, instantly elevates the relevance of bariatric medicine and more structured programs.

Conversations stay superficial and demoralizing when obesity is framed as a personal failure. When it is framed as a chronic condition, conversations become clinical, and the disease becomes treatable. We begin discussing metabolic dysfunction, cardiovascular risk, cancer risk, surgical candidacy, medication management, and long-term follow-up.
For patients, this changes everything. One of the bigger touch points is that it replaces shame with structure, opening the door to comprehensive evaluation and validating the need for medical supervision.

Bariatric surgery, medical weight loss protocols, nutritional counseling, and behavioral health are core components of responsible obesity care. The case for comprehensive clinical programs as no longer optional add-ons has more weight to it than ever before. Obesity treatment must be strategic, longitudinal, and medically anchored.

GLP-1 RAs as Part of Integrative Care

GLP-1 receptor agonists (GLP-1 RAs) are medications that mimic hormones involved in appetite regulation and glucose control. These first-ever global recommendations say GLP-1 therapies can be used for long-term weight management, but integrated care is crucial. We knew that, but now it’s being said out loud worldwide.

GLP-1 RAs pharmaceutically reduce appetite, spur weight loss, and improve metabolic markers. What they don’t do is replace surgical evaluation or long-term monitoring. Bariatric care teams provide a framework for responsible use of GLP-1 medications. We assess candidacy, manage side effects, monitor progress, endorse adjunct therapies, and revise treatment plans.

Truly advanced obesity management and care continuity require more than prescribing. Coordination between providers and with patients is necessary, and that requires multidisciplinary teams with the infrastructure designed for chronic disease, not short-term results.

An Overlooked Connection

As obesity care becomes more structured and evidence-based, we are also expanding how we define outcomes. Success is not measured only in pounds lost, but in metabolic correction and risk reduction across organ systems.

Cardiovascular disease, fatty liver disease, type 2 diabetes, and certain cancers are all influenced by metabolic health. When we treat obesity effectively, we are intervening far beyond the scale. We now have so many tools at our disposal for the appropriate management of obesity. When they’re used by experienced practitioners, we are altering risk trajectories decades into the future.

If obesity is truly a chronic disease, then our treatment goals must extend beyond short-term weight reduction and into long-term disease prevention.

At the same time obesity care is evolving, we are seeing concerning trends in digestive health – including rising colorectal cancer deaths in younger adults. It is one of the clearest examples of how metabolic dysfunction translates into measurable cancer risk, and it’s one of the few cancers for which we have both modifiable risk factors and effective screening tools.

Obesity and metabolic disease are directly tied to colorectal health, and risks for colorectal cancer increase with an excessive amount of body fat. Excess adipose tissue is not metabolically neutral. It actively promotes inflammatory and hormonal signaling that influences tumor development and other disease pathways.

Chronic inflammation, insulin resistance, and metabolic dysfunction all contribute to increased cancer risk. When we improve insulin sensitivity, reduce systemic inflammation, and stabilize weight, we are modifying the biological environment that contributes to long-term disease development.

Effective obesity care considers both the immediate goal of weight reduction and the long-term goal of preventing systemic disease. The WHO’s endorsement of GLP-1 medications and its clear designation of obesity as a global health crisis propel us away from the episodic, short-term mentality that has historically defined weight loss care. Promoting earlier weight loss interventions and metabolic improvements can reduce mortality rates.

Preventive care should be part of the discussion in weight management patients as a logical extension of obesity care. More and more, we are connecting the dots between metabolic health and lifelong outcomes.

This is what integrated service lines are built for. When we collaborate, patients benefit from comprehensive, evidence-based care instead of siloed treatment.

Bariatric Surgery-Still the Most Effective Way To Lose Excessive Weight

Our approach to weight loss i s guided by getting healthier. That does not always translate to a so-called “ideal body weight.” Probably every time you have tried a diet, exercise regimen, or medication in the past, you have thought, ” I need to lose X pounds by X date.”

In our program, we encourage you not to think that way. If you drop down to a BMI of 30, for example, after treatment, but you are healthier than when you started, who cares what the scales say? While we are excited about the addition of these new weight loss medications to our treatment options, the most effective means for losing weight with morbid obesity (BMI > 35) is still bariatric surgery. Ultimately, if we can help you drop down to a BMI in the high 20s or lower 30s, we consider that SUCCESS. The GLP-1 medications are good choices for patients with lower levels of morbid obesity typically with BMIs less than 35.

We also like to use them in patients who have undergone bariatric surgery but have regained some weight. Ultimately, though, these medications usually do not provide the amount of weight loss necessary to achieve a healthier life if your BMI is greater than 35.

The surgical options we at SAMPA provide are sleeve gastrectomy, Roux-en-Y gastric bypass (GBP), and duodenal switch with biliopancreatic diversion (DS BPD). Similar to GLP-1 medications not being the answer for everyone, each operation is not the right solution for everyone.

Taken in order as listed above, the amount of expected weight loss increases from sleeve gastrectomy to DS-BPD. If your BMI is, say, 35-45, a sleeve might be the right operation for you, but the DS-BPD might be overkill. Alternatively, if your BMI is 55-60 or even higher, the GBP or DS-BPD would be better for the desired weight loss over a sleeve.

In such a situation, a patient will lose weight with a sleeve but will likely end up with a BMI still over 40. The GBP in general is appropriate over a wider range of patients with BMIs from 35-60 and i s considered to be the best option for most of our patients when it comes down to weight loss. Individually, there may be reasons why one operation may be better suited for a particular patient regardless of BMI, and that is where the experts at SAMPA can help guide you through the decision-making process.

Wherever you are on your weight loss journey, our specialists are here to guide you through a coordinated, integrative plan. If you’d like to explore what that could look like for you, the team at SAMPA is here to have that conversation.

Reference:

1. World Health Organization News. (2025, December 1). WHO issues a global guideline on the use of GLP-1 medicines in treating obesity. Who.int; World Health Organization (WHO). https://www.who.int/news/item/01-12-2025-who-issues-global-guideline-on-the-use-of-glp-1-medicines-in-treating-obesity.

Does Bariatric Surgery Address Male Sexual Function?

The multitude of erectile dysfunction (ED) advertisements are seemingly everywhere on TV, radio, and social media. Online pharmacies and ED medication purveyors are selling billions of dollars worth of generic and compounded pills annually. But this begs the question: Are there alternatives, or should men resign themselves to relying on pharmaceutical or surgical assistance to maintain a sex life into middle age and beyond?

While many men have legitimate medical needs for these medications, it is essential to understand why the dysfunction is occurring. For those struggling with obesity, the excess weight itself could be the culprit.

Addressing the root cause is far more beneficial for long-term health than simply treating the symptom. And waiting too long to address the underlying causes often plays a significant role in the permanent worsening of sexual function.

Psychological vs. Mechanical Function

When discussing sexual health, we must distinguish between two distinct components: the physical ability to perform (erectile function) and the desire to do so (libido). Excess weight, and especially obesity, can have devastating consequences on both.

Many individuals carrying significant excess weight struggle with self-image issues, anxiety, and depression. In a society that is often critical of body size, these feelings can bleed into the bedroom, making intimate relations fraught with insecurity. If the mind is anxious or depressed, the libido shuts down regardless of physical ability.

Low libido can also be a direct result of the hormonal environment created by obesity. Adipose tissue (body fat) is not just an inactive storage depot. It actively communicates with the body and converts testosterone into estrogen. Men with severe obesity often suffer from hypogonadism (low testosterone), which kills sexual drive and energy levels.

The mechanical aspect of physical manifestations of ED is typically related to vascular restriction, also known as atherosclerosis.

If your doctor has spoken to you about how carrying excess weight increases the risk of coronary artery disease or heart attack, you are essentially discussing the same issue. Regardless of weight, arteries tend to harden and accumulate plaque as we age. However, the constant presence of excess fat and cholesterol in the bloodstream (hyperlipidemia) accelerates this plaque buildup, leading to premature narrowing of the arteries.

It is vital to remember that the arteries supplying the penis are significantly narrower than the coronary arteries of the heart or the peripheral arteries in the legs. As such, erectile dysfunction is often the very first manifestation of cardiovascular disease. It is the body’s warning light that blood flow is being restricted – the proverbial “canary in the coal mine.”

How Bariatric Surgery Fits Into the Care Continuum

Every human body is different, and it is hard to predict precisely when atherosclerosis will begin to affect a patient. However, we know that obesity, poor diet, and a sedentary lifestyle accelerate this process. To that end, we have more weight loss solutions today than ever before.

Patients now have access to effective GLP-1 receptor agonists (GLP-1 RAs), like Wegovy and Zepbound, that reduce inflammation and weight. For those with higher BMIs, bariatric surgery options, including the gastric sleeve, gastric bypass, and duodenal switch, provide a profound metabolic reset.

By rapidly reducing weight and normalizing blood sugar and cholesterol, these interventions can halt the progression of vascular damage and, in many cases, improve blood flow.

Is Bariatric Surgery a “Dramatic” Option for ED?

Given the low cost and ease of acquiring ED meds, many patients might feel that bariatric surgery is too extreme an option to consider for what seems like an easily treatable problem.

However, it is essential to realize that ED medications like sildenafil (Viagra) and tadalafil (Cialis) typically do not work forever. These drugs work by temporarily dilating blood vessels. If the underlying vascular disease continues to progress because the obesity is not treated, the arteries eventually become too clogged for the pills to work.

At that stage, men are forced to move up the “treatment ladder,” which includes:
Injections: Injecting medication directly into the side of the penis before intercourse.
Vacuum Devices: Mechanical pumps that draw blood into the area.
Penile Implants: A major surgical procedure where inflatable cylinders are placed inside the body.

Viewed in this light, bariatric surgery seems much less “extreme.” It treats the root causes, obesity and metabolic disease, rather than just the symptoms. Bariatric surgery not only improves or eliminates the diseases associated with obesity, but also offers a benefit no penile implant can ever provide: massive weight loss, improved confidence, higher testosterone levels, and a longer, healthier life.

The Bottom Line

Is bariatric surgery right for you? Perhaps. Ultimately, having a BMI over 30 (or 27, if you are of Asian descent) is a great starting point for a conversation with your primary care physician and bariatric surgeon.

Yes, bariatric surgery is a significant commitment that requires lifelong focus and dedication to one’s health. But given its metabolic, psychological, and hormonal benefits, it is a powerful tool for reclaiming your vitality.

Addressing weight-related issues, whether through exercise, medication, or surgery, gives patients the best chance to restore lost function or prevent erectile dysfunction from becoming permanent.

Make your health a priority and get in touch with the team at SAMPA. We know weight loss is a tough conversation, and that sexual dysfunction makes that conversation even more difficult. Believe us when we say, we’ve heard it all, and that you are in great hands.

Why We Fail in Our New Year’s Resolutions and What to Do Instead

We are several months into the new year, and this is the time when we all take a look at our New Year’s resolutions to see if we are following them. It’s when we start looking at how much progress we’ve made.

For many, this is around the time when resolutions start to wither, and the great motivation from the beginning of the year turns into frustration and despair.

It’s important to know that you’re not alone in this. Bariatric surgery and the subsequent lifestyle changes aren’t easy. But you can do this!

New Year’s resolutions can go two ways. They can be very motivating and exciting when done right, or anxiety-inducing and downright depressing when approached incorrectly. Ultimately, while we all have the best of intentions, sometimes we don’t hit our goals. Why is that? And what can we do?

Pacing and Expectations

First, it’s all about how quickly we want to reach our goals. No matter what you are looking to achieve, slow and steady is key. Often, in a fit of motivation, we set unnecessarily lofty goals for ourselves, forgetting that getting healthier is a process and doesn’t happen overnight.

Think about how long your health may have been in decline, and give yourself at least half that time to return to normal. For some of us, it requires even more. Most importantly, set interim goals, so you have small celebrations along the way to the ultimate big win.

Preparation and Buy-In

Lack of preparation can take down even the best of intentions. Any improvement you want to make in your lifestyle requires the buy-in of those around you. In the case of losing weight, you can’t have everyone around you eating sugary foods and expect you will be able to avoid them indefinitely. The same goes for alcohol. Going to the gym is another biggie—if you don’t have somebody to go with, being alone there may be dispiriting and unenjoyable.

It’s Not Temporary

A New Year’s resolution is often seen as temporary, which can be problematic when it comes to long-term lifestyle change. Let’s say you hit all your goals and met or exceeded the expectations you set for your resolution. What do you do then? Do you go back to your old habits? Of course not. You have to stick to your new lifestyle changes well into the future. As such, a New Year’s resolution is simply a catalyst or a starting point toward a lifelong commitment to improve your health.

It’s Never Too Late

Lastly, but certainly not least, if you have not achieved what you wanted by now, it’s not too late to get back on track. No matter what your goals are, they are still achievable, and you shouldn’t give up on them just because you didn’t hit them on the timeline you expected. Remember to pick yourself back up and try again. Slow, incremental changes are not always linear, and you may encounter setbacks before moving forward.

Are Your Goals Reasonable for Your Age and Activity Level?

This is an important consideration because you necessarily lose some ability as you age. If you are a sprightly young 25-year-old, you have quite a bit more opportunity to push yourself physically than even the most active and wise 65-year-old. It’s just how our bodies are made and a consequence of aging. Ensure your goals are realistic for where you are in life right now.

Get Professional Help

If you don’t have anyone to work out or diet with, or if you find yourself struggling to stay on track, consider getting professional help, whether psychological or physical. Doing so makes you accountable and gives you a professional in your corner, allowing you to push yourself without as much worry about injury or doing the wrong thing. Further, they can help you change up your workouts or diets to make them more enjoyable and, consequently, sustainable.

The Bottom Line

If your New Year’s resolution hasn’t panned out the way you expected and you’ve gotten frustrated, we encourage you to take a step back. Lean on our team at SAMPA to help understand where you may have gone wrong, regroup, and try again. This time, enlist the help of your medical professionals to get on the right track and stay there.

We look forward to seeing the results of your health renewal and hope you’ll share them with us soon.