Colorectal cancer is now the leading cancer killer in adults under 50, and patients in their 20s are presenting with metastatic disease that has nothing to do with family history. Most physicians are still telling young patients with rectal bleeding that it's probably just hemorrhoids and that's costing lives.In this episode, Dr. Gabrielle Lyon sits down with Dr. Michelle Pearlman, a board-certified gastroenterologist and founder of a Miami-based gastro-metabolic clinic, to discuss:The specific warning signs every adult under 50 should never ignore, regardless of age including rectal bleeding, unintentional weight loss, and persistent abdominal painWhy GLP-1 medications like Ozempic and Zepbound are being miscategorized as weight loss drugs when they're actually metabolic reprogrammers with applications in fatty liver, sleep apnea, and inflammationThe protein, fiber, and resistance training protocol Dr. Pearlman uses to protect muscle mass in patients on GLP-1 therapyHow hormone replacement therapy combined with GLP-1s is changing body composition outcomes for perimenopausal women and why current guidelines are still 20 years behind the dataDr. Pearlman's personal osteoporosis diagnosis at 39, despite being a lifelong bodybuilder, and what it revealed about the diagnostic gaps in standard medicineThis conversation gives you the framework to recognize the warning signs most physicians are still missing, and the foundational habits; nutrition, resistance training, and hormone optimization that protect your gut, bones, and muscle through midlife and beyond.Thank you to our sponsors: Cozy Earth - Go to https://bit.ly/4teXQhz for up to 20% off!Timeline - Get 20% off your Mitopure order at https://bit.ly/4eLBWhBLucy - Get 20% off your next order with code DRLYON at https://bit.ly/42HiUlc, or find yours in store at https://bit.ly/3RfGnYaAmp - Visit https://bit.ly/3RcmqBz to get your AI-powered at-home gym for smarter, personalized training.Explore More from Dr. Gabrielle LyonPremium Podcast Subscription: Ad-free episodes, key takeaway summaries, exclusive Q&A, and behind-the-scenes content https://foreverstrong.supercast.comWeekly newsletter: Recipes, podcast updates, and practical weekly insights https://drgabriellelyon.com/sign-up/Apply to become a patient: Personalized care with Dr. Lyon’s clinical team https://drgabriellelyon.com/new-patient-inquiry/Find Dr. Michelle Pearlman at:Instagram: https://www.instagram.com/michellepearlmanmd/Website: https://www.primeinstitute.us/Connect with Dr. Gabrielle LyonInstagram: https://www.instagram.com/drgabriellelyon/TikTok: https://www.tiktok.com/@drgabriellelyonX (Twitter): https://x.com/drgabriellelyonFacebook: https://www.facebook.com/doctorgabriellelyonChapters00:00 - Introduction: Colorectal cancer under 5001:15 - The gastro-metabolic approach explained03:30 - Why nutrition isn't taught in GI fellowship05:45 - When the colonoscopy is normal but patients suffer07:00 - Weight, reflux, and visceral fat09:15 - PPIs, bone density, and long-term risk11:30 - Three things to never do for gut health14:00 - Ultra-processed food and early-onset cancer16:45 - Rectal bleeding, warning signs, and age19:00 - Screening guidelines and the obesity gap22:30 - GLP-1 medications: history and mechanism27:15 - Hunger, cravings, and food noise30:00 - The stigma around metabolic medications33:45 - Side effects: nausea, reflux, constipation38:30 - Compounded formulations and pharmacy safety42:00 - Hair loss, protein, and supplementation45:15 - Pill versus injection delivery systems49:30 - Fiber, the microbiome, and short-chain fatty acids54:00 - GLP-1s plus hormone replacement therapy58:45 - Testosterone, Kyzatrex, and women's bone health1:03:00 - Pearlman's osteoporosis diagnosis at 391:09:30 - The diagnostic gap in standard medicine1:14:00 - Building Bite MD and the future of nutrition techDisclaimers: This episode includes paid sponsorships.The Dr. Gabrielle Lyon Podcast and YouTube are for general information purposes only and do not constitute the practice of medicine, nursing, or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this podcast, YouTube, or materials linked from this podcast or YouTube is at the user's own risk. The content of this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard or delay in obtaining medical advice for any medical condition they may have and should seek the assistance of their health care professional for any such conditions.