Casey Means: A MAHA leader, and the next surgeon general?

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0:29The Surgeon General is one of the nation's most recognizable and trusted medical positions. Now, a new type of leader has been tapped for the role, Casey Means. American health is just getting destroyed. It's getting destroyed. Means is a health products entrepreneur and popular online personality. She's also been very critical of the medical establishment. Like, here she is on the Megyn Kelly show last year. When our cells make good energy, i.e. have good metabolic health, so many of the conditions that are plaguing us can improve. And so that needs to be the central focus of our American health care system.

1:09And right now it is the intentional blind spot of the American health care system. Means promotes this idea that some diseases can be prevented and even reversed by, quote, good energy. To her, that means improving metabolic health with a healthy lifestyle. Tomorrow, lawmakers will vet Means as the next Surgeon General of the United States. She's set to testify before Congress for her confirmation hearing. And she'll be attending virtually because she's pregnant and due at any moment. Well, Casey Means really epitomizes the Make America Healthy Again movement. She helped shape it. She's Maha's doctor.

1:51Lauren Weber is a health and science accountability reporter for The Post. She spent months reporting on means with our colleague Rachel Rubine.

2:03Many medical experts that we spoke to said they're highly concerned that the quote-unquote America's top doctor could be someone that they say veers outside of established science and overpromises on what that science can deliver. And they're worried that she'll use her platform, which is essentially a megaphone about America's health, to do the same.

2:29From the newsroom of The Washington Post, this is Post Reports. I'm Elahe Izadi. It's Wednesday, October 29th. Today, we follow the rise of Casey Means. We talk about her background and how her collision course with the medical establishment could shake up American medicine.

2:55Lauren, hi. Thanks so much for joining us today. Thanks for having me. So, first of all, we're talking about this position, the U.S. Surgeon General, that I think a lot of us have heard before, might be vaguely familiar with, but maybe don't fully understand what the U.S. Surgeon General's role is and why it matters. So, what exactly is the U.S. Surgeon General? So Surgeon General is typically actually one of the nation's most recognizable and trusted medical posts. And traditionally, they've used their bully pulpit of sorts to help fight important public health threats to shine a light on them, like HIV, smoking, obesity, addiction.

3:36And the Surgeon General also oversees more than 6 ,000 uniform public health personnel that often are deployed to fight public health threats or work on America's public health crises. And they're also charged with issuing seminal reports with the latest medical research. In the history of the world, no non-essential habit ever got so entrenched so fast. 70 million Americans smoke. Today they got a message from the United States Surgeon General. So like in 1964, the Surgeon General report on smoking causing lung cancer and heart disease was a huge, huge deal. — Cigarette smoking is a health hazard of sufficient importance to the United States to warrant remedial action.

4:20— And we saw the most recent Surgeon General, Vivek Murthy, propose warning labels for social media and also sound the alarms on America's growing epidemic of loneliness. — Loneliness is more than just a bad feeling. It has real consequences for our mental and physical health. It increases our risk of depression, anxiety and suicide. But social disconnection also raises the risk of heart disease and dementia and premature death. So while they can't directly change actual policy, they can set the health agenda for the country. And that can make a real difference.

5:00So President Donald Trump has nominated Casey Means to be the next U.S. Surgeon General. why does this pick stand out to you? You know, Casey Means is really a fascinating example of the moment that we're in. She's someone who's amassed a popular online following. She's also someone who's controversial. You know, many experts have picked apart some of her statements saying they're not based in science. You know, she's an unusual pick for a fair amount of reasons. But for one, she doesn't come from the traditional medical establishment that we've seen surgeon generals come from in the past. She really made a name for herself on podcasts.

5:44She's a bestselling author. She also has promoted supplements and diagnostic texts and even teased elixirs in the wellness and alternative medicine space. She's also a leading critic of the medical establishment. Even on her own website, she says, quote, means is considered controversial because her work challenges the economic and cultural foundations of U.S. health care, agriculture, and food systems. Additionally, she's frequently suggested that Americans should question the advice they get from medical authorities. Here she is on the Tucker Carlson show last year. The system is rigged against the American patient to create diseases and then profit off of them.

6:24This is happening across almost every level of our major industries, from processed food to tech to pharma. And so really what Americans need to understand is that these trends can stop immediately. So, yeah, I want to get more into her backstory and how she got to this point. But first, Lauren, what was the administration's reason for choosing Casey Means as the Surgeon General? Well, Means was pretty instrumental in shaping and creating. Robert F. Kennedy Jr., the Secretary for Health and Human Services Maha Initiative, the Make America Healthy Again initiative, which has really been galvanized by women who support his goals and have become known as Maha Moms.

7:06And on Fox News in May, RFK Jr. actually noted that Means was pregnant and says that she, quote, has a touchstone with every mother in this country. I don't think there's going to be a more effective Surgeon General in our history because of the capacity and the talents and the experience that she has. So, Lauren, you and your colleagues dug into Casey Means' writings and also her social media presence. How does she come across to the world? You know, she comes across in a way that I think a lot of people relate to. She's, like many of us, an elder millennial. She writes in emojis often in her newsletter.

7:44You know, she titled her Instagram account Dr. Casey's Kitchen. She's been on all these podcasts. She's very persuasive on them. But when she first started out, she did a lot of recipes. You know, it was a lot of how I can show you how to eat healthier, you know, how you can optimize your health. So, Lauren, I know that you and our colleagues dove pretty deep into learning more about Casey Means, her backstory, and just trying to get a sense of what kind of Surgeon General she would be. How did you all go about this? Like, what did your reporting look like? who was really important to us to get the full scope of what she stands for.

8:19So we read her book. We went through all our newsletters. We reviewed her podcasts. We reviewed her online writings. We spoke to over 35 of her friends, colleagues, medical experts, and other folks to really get a sense of who she is as a person and how she got here. So what did you learn? How did KC Means get here? Where does that story begin? Well, I mean, at the end of the day, Casey Means has racked up quite a lot of accolades for being only 38 years old. You know, she went to Stanford. She graduated with many academic honors. She did research at the NIH and NYU and went on to Stanford Medical School.

9:02You know, these are all very prestigious. And then she went on to have a residency in one of the top fields for head and neck surgery at Oregon Health and Science University. I mean, that's a top residency. That's really hard to get into. I mean, she's a very accomplished person to be able to do that. And I think it's important to note, too, I mean, she came from a background based in the D.C. area. I mean, her dad served in a Republican administration. Callie, her brother, and her grew up going to elite private high schools. They were raised Catholic with a strong spiritual grounding, you know, with a basis for independent thinking, Callie says.

9:39And, you know, nutrition was always important to Casey Means. You know, she tells the story about how she weighed over 200 pounds as an adolescent and then did her own research so that she could lose the excess weight. And that was an interest she carried through to her Stanford years and onward. And then what happened? Because she did depart that sort of typical path of medicine. So nutrition obviously was very important to her and clearly threaded throughout her interests over this time. So she's on the cusp of finishing her very prestigious residency, and she walks away from it in September of 2018.

10:18Like she's left residency. Yes. The biography on her website says that, quote, ultimately she felt so disillusioned with the practice and incentives of surgical care that she chose to resign and work on reform from outside the system. And just tell us, what exactly is medical residency? So medical residency is the training you go through as a doctor after you've already gotten your MD to specialize. A lot of people train to be, you know, internal medicine, which is, you know, the regular doctors we go to to check on stuff. Or, you know, in Means' case, she was learning how to be a head and neck surgeon, which is a top medical specialty.

10:56Additionally, in her book, she describes how the stress of residency affected her own health. writing she suffered from chronic neck pain, depression, severe gastrointestinal problems. And, you know, I also spoke with some residents that she worked with who expressed some concern that someone would drop out of residency and then become Surgeon General. But they also described her as passionate, kind, and a great communicator. So as I'm understanding it, is she a practicing doctor or no? So as of last year, she can't practice medicine, according to the Oregon State Medical Board. She currently has a medical license in Oregon that she voluntarily placed in an active status.

11:38She holds no other licenses, according to the Federation of State Medical Boards. So just going back then to Casey Means' path to this moment, after she left residency, what did she then do? So she ended up launching a functional medicine and wellness consulting practice called Means Health out in Oregon. And what is functional medicine? So supporters of functional medicine say it's a way of tackling the chronic disease epidemic by focusing on a more holistic lifestyle intervention approach to the root causes of disease. The field is not recognized as a specialty certified by the American Board of Medical Specialties.

12:17And some medical critics contend it can result in over-testing and fringe treatments. But I also would imagine it's rising perhaps in popularity because the medical establishment that exists right now, also there are a lot of people who feel ill served by it. Oh, I mean, that's this is where the Maha movement has gotten so much political power. Americans in general are not happy with their health care system. They don't feel like it looks out for them. It's too expensive. They don't feel like the treatments are serving them. And so this idea that a more holistic look at you as a whole person that takes time to look at you certainly has gained a lot of legs.

12:57So then for Casey Means, she has this practice within this space. What does she start doing with it? She also begins circulating this concept called Labra Kadabra, which she describes on her website as it would have used, quote, existing lab information from routine blood work as an educational biofeedback tool to empower patients to understand their health. OK, so like unpack that for me, please. Does it mean like I go in and do a bunch of labs and then I can make decisions about how I eat or when I sleep and that sort of thing? That's exactly right. It's a very popular idea in the functional medicine space.

13:35And, you know, it certainly does have a lot more personalized medicine to it, but the critics of it say that it can be expensive and may not reveal all that it's cracked up to. And then what else has she been up to? Well, she went on to become co-founder and chief medical officer of the company Levels, which charges somewhere in the hundreds of dollars for a subscription to continuous glucose monitors in an app. And continuous glucose monitors, what they do is they measure your levels of glucose, which diabetics use to maintain their health. But Levels wants folks that are not diabetic to use these devices.

14:12And the American Association of Clinical Endocrinology does not recommend them for these folks. The group's president said in an email to me that there just isn't strong scientific evidence to use them for this purpose. The numbers that these devices produce only tell part of the story for your overall health. Levels did not respond to our request for comment, but on its website, the company says it's currently reviewing its effectiveness in non-diabetic patients through a research study. And Means herself has written, I believe continuous glucose monitoring is the most powerful technology for generating the data and awareness to rectify our bad energy crisis in the Western world.

14:55And then in 2024, Casey went on to publish what has largely been described as a sort of manifesto of the Make America Healthy Again movement, which we all know as Maha. She wrote it with Callie, her brother, and it's this bestselling book called Good Energy, the surprising connection between metabolism and limitless health.

15:18After the break, we'll dig into what Casey Means had to say in her Maha Manifesto. We'll be right back.

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17:07So, Lauren, I want to learn more about Casey Means' worldview on health. And as you mentioned, she wrote this book with her brother that's thought of as a manifesto to the Maha movement. So what did you and our colleagues learn about her thinking on health from reading this book? She really calls out a lot of big food companies for ultra-processed foods. But she also speaks very definitively about concepts that medical experts told me and my colleague Rachel is just going too far. Let's go through some of those examples then. One of the most striking phrases was that she wrote in her book that, quote, the ability to prevent and reverse, end quote, a variety of ailments, including infertility and Alzheimer's, is, quote, is under your control and simpler than you think.

17:54and she dedicates the book to her mom who died of pancreatic cancer, calling it a, quote, preventable metabolic condition. So the medical experts we spoke to say there's significant evidence that diet and exercise can lower the risk of some chronic conditions and slow the progression of other diseases, but they caution that she goes too far when she says it can reverse many of them. What does she say about this lack of trust in the current medical establishment? Because that does, as we say, seem to be part of her appeal and that she is speaking to something that is real and there are legitimate concerns about it.

18:38I mean, look, chapter three of her book is titled Trust Yourself, Not Your Doctor. You know, she speaks very clearly about needing to find your own individualized approach to medicine. And, you know, the doctors are not all knowing. It's a very interesting point coming from someone who would then be America's top doctor. You know, Lauren, this notion of if you only change what you eat or take these supplements or do X, Y, and Z, then you won't have chronic illness or you can reverse your illness. That is a very compelling argument. And as you've said, there is evidence that shows that making these lifestyle changes does reduce risk.

19:21But does this overly imply that it's in an individual's hands, that they can fix these conditions? Because bodies are really complicated. Yeah, because of genetics and a whole variety of other things, infectious disease. I mean, that's exactly the point many public health experts I spoke to flagged as a big concern they have about means as message. You know, I spoke to George C. Benjamin, who's a physician and longtime head of the American Public Health Association. And he said, for most diseases, there are very few absolutes. And the problem with a lot of our wellness advocates is they give people the impression that if you do some very simplistic things, you'll avoid some very bad things.

20:00Tragically, life just isn't that simple. And where is this criticism coming from? Is it partisan? Is it also just, you know, leading medical associations or doctors you spoke to? Like, where is the criticism coming from for her? Some of her fiercest critics have been on the right. I mean, Jerome Adams was actually the Surgeon General during Trump's first administration, and he's come out pretty strongly against Casey Meade. He told us, quote, quote, RFK Jr. and Casey Means have a history of saying things in a direct and potentially misleading, often scientifically wrong way, which you can defend if you're just saying it as Casey Means or as RFK Jr., but are hard to defend if you're saying that as the HHS secretary or as a Surgeon General of the United States.

20:45It's important to note that in a statement, the Department of Health and Human Services called Means a, quote, world-class physician and scientist whose nomination as Surgeon General reflects her deep understanding of modern metabolic health and her fierce commitment to evidence-based care. And what has Casey Means said about vaccines? Because I do think that's one of the biggest things that RFK Jr. has been criticized for, for his position on vaccines and how he's handling vaccines. You know, it's a great question. Do you know that in her book, which came out in the beginning of 2024, she does not mention vaccines one time.

21:19But in the fall of 2024, as the Kennedy orbit starts to consolidate, she starts talking about vaccines on podcasts. She has publicly questioned the culmination of the childhood vaccine schedule and the hepatitis B vaccine, which echoes talking points we've heard out of Kennedy. And she said on Joe Rogan's podcast. It's like with vaccines, like, yeah, I bet that one vaccine probably isn't causing autism. But what about the 20 that they're getting before 18 months? Like, we don't look at it in synergistic, you know, and so that's a big problem. Again, it's worth reiterating that there is no scientific link between vaccines and autism.

22:00Reams, the scientific evidence showed there is no link. And so how has Means responded to criticism about her? Casey Means recently updated the About page on her website, and it has a lot of response to a lot of the criticism, including this quote, legacy media critics often dismiss her credibility because her message exposes institutional failures and calls for disruption. And her career trajectory has included periods without direct one-to-one patient care while pursuing work in preventative health that has reached tens of millions. So Lauren, one thing that has already come up in our conversation is that Casey Means has been involved in companies that sell products or services that are not really in the medical mainstream.

22:45She has this book. She's also pretty influential online. Do we know how much money she has made doing all of this? What do we know about that? So, yes, actually, we went through her financial disclosures and we found that she reported income from last year and into the summer of this year that she was paid more than half a million dollars for partnerships as well as book tour and newsletter sponsorships with companies that those financial forms described as selling, quote, diagnostic testing, herbal remedies, and wellness products, and teas, supplements, and elixirs, just to name a few. So sponsorships and partnerships, what are some examples of that?

23:25So in her newsletter or on social media, she'll talk about some of the supplements she takes. You know, in one example, she wrote in a newsletter, without identifying them as a book launch partner, that she was taking longevity supplements from the brand timeline. Now, she did include a link in the newsletter to a URL that identifies her as a partner for the brand. Those supplements, they cost$125. And at one point, there was a 10 % off coupon code with her name, Casey. Additionally, she does unboxings for other things. Oh, like unboxing videos? Like, yes, unboxing videos for a diagnostic test about, you know, different nutrition things.

24:03But, I mean, at the end of the day, she's been paid a fair amount of money for a lot of these sponsorships. And the concerns from some of the ethics and advertising folks we spoke to said that she blurred sponsorship lines because she, you know, while she says she only promotes products that she researches herself, she sometimes did not disclose that she was receiving sponsorships or partnerships with these folks when talking about taking them. So tell me about that. Has this administration said anything about the ethical obligations there? HHS has told us that she will comply with all ethical requirements.