June 6, 2025:
PROVIDENCE, R.I. (AP) — President Donald Trump’s pick to be U.S. surgeon general has said the nation’s medical and food systems are corrupted by special interests and people out to make a profit at the expense of Americans’ health. Yet as Dr. Casey Means has criticized scientists and regulators for taking money from the food and pharmaceutical industries, she has promoted dozens of products in ways that put money in her own pocket. The Associated Press found Means set up deals with an array of businesses and, in some cases, promoted companies in which she was an investor or adviser without consistently disclosing the connection.
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PROVIDENCE, R.I. (AP) — President Donald Trump’s pick to be the next U.S. surgeon general has repeatedly said the nation’s medical, health and food systems are corrupted by special interests and people out to make a profit at the expense of Americans’ health.
Yet as Dr. Casey Means has criticized scientists, medical schools and regulators for taking money from the food and pharmaceutical industries, she has promoted dozens of health and wellness products — including specialty basil seed supplements, a blood testing service and a prepared meal delivery service — in ways that put money in her own pocket.
A review by The Associated Press found Means, who has carved out a niche in the wellness industry, set up deals with an array of businesses.
In her newsletter, on her social media accounts, on her website, in her book and during podcast appearances, the entrepreneur and influencer has at times failed to disclose that she could profit or benefit in other ways from sales of products she recommends. In some cases, she promoted companies in which she was an investor or adviser without consistently disclosing the connection, the AP found.
Means, 37, has said she recommends products that she has personally vetted and uses herself. She is far from the only online creator who doesn’t always follow federal transparency rules that require influencers to disclose when they have a “material connection” to a product they promote.
Still, legal and ethics experts said those business entanglements raise concerns about conflicting interests for an aspiring surgeon general, a role responsible for giving Americans the best scientific information on how to improve their health.
“I fear that she will be cultivating her next employers and her next sponsors or business partners while in office,” said Jeff Hauser, executive director of the Revolving Door Project, a progressive ethics watchdog monitoring executive branch appointees.
The nomination, which comes amid a whirlwind of Trump administration actions to dismantle the government’s public integrity guardrails, also has raised questions about whether Levels, a company Means co-founded that sells subscriptions for devices that continuously monitor users’ glucose levels, could benefit from this administration’s health guidance and policy.
Though scientists debate whether continuous glucose monitors are beneficial for people without diabetes, U.S. Health Secretary Robert F. Kennedy Jr. has promoted their use as a precursor to making certain weight-loss drugs available to patients.
The aspiring presidential appointee has built her own brand in part by criticizing doctors, scientists and government officials for being “bought off” or “corrupt” because of ties to industry.
Means’ use of affiliate marketing and other methods of making money from her recommendations for supplements, medical tests and other health and dietary products raise questions about the extent to which she is influenced by a different set of special interests: those of the wellness industry.
A compelling origin story
Means earned her medical degree from Stanford University, but she dropped out of her residency program in Oregon in 2018, and her license to practice is inactive. She has grown her public profile in part with a compelling origin story that seeks to explain why she left her residency and conventional medicine.
“During my training as a surgeon, I saw how broken and exploitative the healthcare system is and left to focus on how to keep people out of the operating room,” she wrote on her website.
Means turned to alternative approaches to address what she has described as widespread metabolic dysfunction driven largely by poor nutrition and an overabundance of ultra-processed foods. She co-founded Levels, a nutrition, sleep and exercise-tracking app that can also give users insights from blood tests and continuous glucose monitors. The company charges $199 per year for an app subscription and an additional $184 per month for glucose monitors.
Means has argued that the medical system is incentivized not to look at the root causes of illness but instead to maintain profits by keeping patients sick and coming back for more prescription drugs and procedures.
“At the highest level of our medical institutions, there are conflicts of interest and corruption that are actually making the science that we’re getting not as accurate and not as clean as we’d want it,” she said on Megyn Kelly’s podcast last year.
But even as Means decries the influence of money on science and medicine, she has made her own deals with business interests.
During the same Megyn Kelly podcast, Means mentioned a frozen prepared food brand, Daily Harvest. She promoted that brand in a book she published last year. What she didn’t mention in either instance: Means had a business relationship with Daily Harvest.
Growing an audience, and selling products
Influencer marketing has expanded beyond the beauty, fashion and travel sectors to “encompass more and more of our lives,” said Emily Hund, author of “The Influencer Industry: The Quest for Authenticity on Social Media.”
With more than 825,000 followers on Instagram and a newsletter that she has said reached 200,000 subscribers, Means has a direct line into the social media feeds and inboxes of an audience interested in health, nutrition and wellness.
Affiliate marketing, brand partnerships and similar business arrangements are growing more popular as social media becomes increasingly lucrative for influencers, especially among younger generations. Companies might provide a payment, free or discounted products or other benefits to the influencer in exchange for a post or a mention. But most consumers still don’t realize that a personality recommending a product might make money if people click through and buy, said University of Minnesota professor Christopher Terry.
“A lot of people watch those influencers, and they take what those influencers say as gospel,” said Terry, who teaches media advertising and internet law. Even his own students don’t understand that influencers might stand to benefit from sales of the products they endorse, he added.
Many companies, including Amazon, have affiliate marketing programs in which people with substantial social media followings can sign up to receive a percentage of sales or some other benefit when someone clicks through and buys a product using a special individualized link or code shared by the influencer.
Means has used such links to promote various products sold on Amazon. Among them are books, including the one she co-wrote, “Good Energy”; a walking pad; soap; body oil; hair products; cardamom-flavored dental floss; organic jojoba oil; a razor set; reusable kitchen products; sunglasses; a sleep mask; a silk pillowcase; fitness and sleep trackers; protein powder and supplements.
She also has shared links to products sold by other companies that included “affiliate” or “partner” coding, indicating she has a business relationship with the companies. The products include an AI-powered sleep system and Daily Harvest, for which she curated a “metabolic health collection.”
On a “My Faves” page that was taken down from her website shortly after Trump picked her, Means wrote that some links “are affiliate links and I make a small percentage if you buy something after clicking them.”
It’s not clear how much money Means has earned from her affiliate marketing, partnerships and other agreements. Daily Harvest did not return messages seeking comment, and Means said she could not comment on the record during the confirmation process.
Disclosing conflicts
Means has raised concerns that scientists, regulators and doctors are swayed by the influence of industry, oftentimes pointing to public disclosures of their connections. In January, she told the Kristin Cavallari podcast “Let’s Be Honest” that “relationships are influential.”
“There’s huge money, huge money going to fund scientists from industry,” Means said. “We know that when industry funds papers, it does skew outcomes.”
In November, on a podcast run by a beauty products brand, Primally Pure, she said it was “insanity” to have people connected to the processed food industry involved in writing food guidelines, adding, “We need unbiased people writing our guidelines that aren’t getting their mortgage paid by a food company.”
On the same podcast, she acknowledged supplement companies sponsor her newsletter, adding, “I do understand how it’s messy.”
Influencers who endorse or promote products in exchange for payment or something else of value are required by the Federal Trade Commission to make a clear and conspicuous disclosure of any business, family or personal relationship. While Means did provide disclosures about newsletter sponsors, the AP found in other cases Means did not always tell her audience when she had a connection to the companies she promoted. For example, a “Clean Personal & Home Care Product Recommendations” guide she links to from her website contains two dozen affiliate or partner links and no disclosure that she could profit from any sales.
Means has said she invested in Function Health, which provides subscription-based lab testing for $500 annually. Of the more than a dozen online posts the AP found in which Means mentioned Function Health, more than half did not disclose she had any affiliation with the company.
Means also listed the supplement company Zen Basil as a company for which she was an “Investor and/or Advisor.” The AP found posts on Instagram, X and on Facebook where Means promoted its products without disclosing the relationship.
Though the “About” page on her website discloses an affiliation with both companies, that’s not enough, experts said. She is required to disclose any material connection she has to a company anytime she promotes it.
Representatives for Function Health did not return messages seeking comment through their website and executives’ LinkedIn profiles. Zen Basil’s founder, Shakira Niazi, did not answer questions about Means’ business relationship with the company or her disclosures of it. She said the two had known each other for about four years and called Means’ advice “transformational,” saying her teachings reversed Niazi’s prediabetes and other ailments.
“I am proud to sponsor her newsletter through my company,” Niazi said in an email.
While the disclosure requirements are rarely enforced by the FTC, Means should have been informing her readers of any connections regardless of whether she was violating any laws, said Olivier Sylvain, a Fordham Law School professor who was previously a senior adviser to the FTC chair.
“What you want in a surgeon general, presumably, is someone who you trust to talk about tobacco, about social media, about caffeinated alcoholic beverages, things that present problems in public health,” Sylvain said, adding, “Should there be any doubt about claims you make about products?”
Potential conflicts pose new ethical questions
Means isn’t the first surgeon general nominee whose financial entanglements have raised eyebrows.
Jerome Adams, who served as surgeon general from 2017 to 2021, filed federal disclosure forms that showed he invested in several health technology, insurance and pharmaceutical companies before taking the job — among them Pfizer, Mylan and UnitedHealth Group. He also invested in the food and drink giant Nestle.
He divested those stocks when he was confirmed for the role and pledged that he and his immediate family would not acquire financial interest in certain industries regulated by the Food and Drug Administration.
Vivek Murthy, who served as surgeon general twice, under Presidents Barack Obama and Joe Biden, made more than $2 million in COVID-19-related speaking and consulting fees from Carnival, Netflix, Estee Lauder and Airbnb between holding those positions. He pledged to recuse himself from matters involving those parties for a period of time.
Means has not yet gone through a Senate confirmation hearing and has not yet announced the ethical commitments she will make for the role.
Hund said that as influencer marketing becomes more common, it is raising more ethical questions, such as what past influencers who enter government should do to avoid the appearance of a conflict.
Other administration officials, including Homeland Security Secretary Kristi Noem and Centers for Medicare and Medicaid Services Administrator Dr. Mehmet Oz, have also promoted companies on social media without disclosing their financial ties.
“This is like a learning moment in the evolution of our democracy,” Hund said. “Is this a runaway train that we just have to get on and ride, or is this something that we want to go differently?”
May 8, 2025:
WASHINGTON (AP) — President Donald Trump is tapping Dr. Casey Means, a wellness influencer with close ties to Health and Human Services Secretary Robert F. Kennedy Jr., as his nominee for surgeon general after withdrawing his initial pick for the influential health post. Trump said in a social media post Wednesday (May 7, 2025) that Means has “impeccable ‘MAHA’ credentials” – referring to the “Make America Healthy Again” slogan – and that she will work to eradicate chronic disease and improve the health and well-being of Americans. Trump withdrew former Fox News medical contributor Janette Nesheiwat from consideration for the job, marking at least the second health-related pick from Trump to be pulled from Senate consideration.
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WASHINGTON (AP) — President Donald Trump is tapping Dr. Casey Means, a physician-turned-wellness influencer with close ties to Health and Human Services Secretary Robert F. Kennedy Jr., as his nominee for surgeon general after withdrawing his initial pick for the influential health post.
Trump said in a social media post Wednesday (May 7, 2025) that Means has “impeccable ‘MAHA’ credentials” – referring to the “ Make America Healthy Again ” slogan – and that she will work to eradicate chronic disease and improve the health and well-being of Americans.
“Her academic achievements, together with her life’s work, are absolutely outstanding,” Trump said. “Dr. Casey Means has the potential to be one of the finest Surgeon Generals in United States History.”
In doing so, Trump withdrew former Fox News medical contributor Janette Nesheiwat from consideration for the job, marking at least the second health-related pick from Trump to be pulled from Senate consideration. Nesheiwat had been scheduled to appear before the Senate Health, Education, Labor and Pensions Committee Thursday for her confirmation hearing.
Means and her brother, former lobbyist Calley Means, served as key advisers to Kennedy’s longshot 2024 presidential bid and helped broker his endorsement of Trump last summer. The pair made appearances with some of Trump’s biggest supporters, winning praise from conservative pundit Tucker Carlson and podcaster Joe Rogan. Calley Means is currently a White House adviser who appears frequently on television to promote restrictions on SNAP benefits, removing fluoride from drinking water and other MAHA agenda items.
Casey Means has no government experience and dropped out of her surgical residency program, saying she became disillusioned with traditional medicine. She founded a health tech company, Levels, that helps users track blood sugar and other metrics. She also makes money from dietary supplements, creams, teas and other products sponsored on her social media accounts.
In interviews and articles, Means and her brother describe a dizzying web of influences to blame for the nation’s health problems, including corrupt food conglomerates that have hooked Americans on unhealthy diets, leaving them reliant on daily medications from the pharmaceutical industry to manage obesity, diabetes and other chronic conditions.
Few health experts would dispute that the American diet — full of processed foods — is a contributor to obesity and related problems. But Means goes further, linking changes in diet and lifestyle to a raft of conditions including infertility, Alzheimer’s, depression and erectile dysfunction.
“Almost every chronic health symptom that Western medicine addresses is the result of our cells being beleaguered by how we’ve come to live,” Means said in a 2024 book co-written with her brother.
Food experts say it’s overly simplistic to declare that all processed foods are harmful, since the designation covers an estimated 60% of U.S. foods, including products as diverse as granola, peanut butter and potato chips.
“They are not all created equal,” said Gabby Headrick, a nutrition researcher at George Washington University’s school of public health. “It is much more complicated than just pointing the finger at ultra-processed foods as the driver of chronic disease in the United States.”
Means has mostly steered clear of Kennedy’s controversial and debunked views on vaccines. But on her website, she has called for more investigation into their safety and recommends making it easier for patients to sue drugmakers in the event of vaccine injuries. Since the late 1980s, federal law has shielded those companies from legal liability to encourage development of vaccines without the threat of costly personal injury lawsuits.
She trained as a surgeon at Stanford University but has built an online following by criticizing the medical establishment and promoting natural foods and lifestyle changes to reverse obesity, diabetes and other chronic diseases.
If confirmed as surgeon general, Means would be tasked with helping promote Kennedy’s sprawling MAHA agenda, which calls for removing thousands of additives and chemicals from U.S. foods, rooting out conflicts of interest at federal agencies and incentivizing healthier foods in school lunches and other nutrition programs.
Nesheiwat, Trump’s first pick, is a medical director for an urgent care company in New York and has appeared regularly on Fox News to offer medical expertise and insights. She is a vocal supporter of Trump and shares photos of them together on social media. Nesheiwat is also the sister-in-law of former national security adviser Mike Waltz, who has been nominated to be Trump’s ambassador to the United Nations.
But she had recently come under criticism from Laura Loomer, a far-right ally of Trump who was instrumental in ousting several members of the president’s National Security Council. Loomer posted on X earlier this week that “we can’t have a pro-COVID vaccine nepo appointee who is currently embroiled in a medical malpractice case and who didn’t go to medical school in the US” as the surgeon general.
Independent freelance journalist Anthony Clark reported last month that Nesheiwat earned her medical degree from the American University of the Caribbean School of Medicine in St. Maarten, despite saying that she has a degree from the University of Arkansas School of Medicine. The White House pulled Nesheiwat’s nomination because of doubts about her confirmation prospects, according to a person familiar with the matter who spoke on condition of anonymity to discuss the administration’s reasoning.
“I am looking forward to continuing to support President Trump and working closely with Secretary Kennedy in a senior policy role to Make America Healthy Again! My focus continues to be on improving the health and well-being of all Americans, and that mission hasn’t changed,” Nesheiwat wrote on social media Wednesday.
The surgeon general, considered the nation’s doctor, oversees 6,000 U.S. Public Health Service Corps members and can issue advisories that warn of public health threats.
In March, the White House pulled from consideration the nomination of former Florida GOP Rep. Dave Weldon to lead the Centers for Disease Control and Prevention. His skepticism on vaccines had raised concerns from key Republican senators, and he withdrew after being told by the White House that he did not have enough support to be confirmed.
The withdrawal was first reported by Bloomberg News.
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