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:
- 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.
- 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.
- 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.
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.