Inside the Health Views of Casey Means, Trump's Surgeon General Nominee

Time​ Magazine

08-05-2025

Not long before the 2024 election, Dr. Casey Means wrote a letter to her Good Energy newsletter subscribers with a health-related wishlist for the next Administration.
In it were priorities that echo those of Robert F. Kennedy Jr., Secretary of Health and Human Services: investigating toxins in the food supply, incentivizing healthy food purchases with food stamps, replacing factory farming with regenerative farming.
'More than anything, I would like to see our future White House rally Americans to be healthy and fit,' wrote Means, a physician who President Trump nominated on May 7 for U.S. Surgeon General. Trump discarded his first pick, Dr. Janette Neshiewat, a day before she was scheduled to appear before a Senate committee.
Means, who co-wrote the 2024 book Good Energy: The Surprising Connection Between Metabolism and Limitless Health with her brother Calley Means, holds many beliefs on health that mirror Kennedy's. She writes frequently about how drugs are overprescribed and that many modern ailments are caused by preventable lifestyle conditions. She believes that children should be served more nutritious food in school lunches, and she voices skepticism about seed oils. And she believes there are far too many chemicals in the U.S. food supply.
Those similarities are partly why she was nominated, President Trump said in a May 8 news conference. 'Bobby really thought she was great, I don't know her,' Trump said, after a reporter asked about the choice. Means' pinned post on X is a celebration of Kennedy's swearing-in ceremony at the White House, which she called a 'BEAUTIFUL AND MOMENTOUS DAY FOR AMERICA.'
Means and her brother Calley, a startup founder, are central figures in the Make America Healthy Again movement, and in the months leading up to the election, they appeared together on Joe Rogan's and Tucker Carlson's podcasts. Their father, Grady Means, worked in the administration of President Gerald Ford as an assistant to Vice President Nelson Rockefeller, a political centrist.
In their 2024 book, the siblings make several points that would likely be embraced by Democrats. One is that nutrition and exercise play a huge role in our overall health (one of Michelle Obama's signature public health campaigns, Let's Move!, tried to reduce childhood obesity through exercise), and that the pharmaceutical and food industries have too much influence over everyday Americans.
But some of Casey Means' ideas are more controversial. In her interview with Tucker Carlson, she said that birth control pills are overprescribed and that they signal a 'disrespect of life.' She said Ozempic has 'a stranglehold on the U.S. population' and convinces people that there is a magic pill that can save them from chronic health issues. And she questioned why babies in America were getting hepatitis B vaccines after birth, a practice that the U.S. Centers for Disease Control and Prevention (CDC) recommends.
She also calls into question the safety of childhood vaccines, writing in her newsletter, 'There is growing evidence that the total burden of the current extreme and growing vaccine schedule is causing health declines in vulnerable children."
Though many doctors do not align with Means' positions on medical issues, some say that the pick will help advance Americans' health.
'I'm glad to see a nominee for surgeon general who is focused on food and diet-related exercise,' says Dr. Dariush Mozaffarian, director of the Food is Medicine Institute at Tufts University. 'This is the top issue facing Americans' health.' Means criticized Mozaffarian in a past newsletter for leading a 2021 study that assessed the healthfulness of certain foods, denouncing it for being funded by companies that make ultra-processed foods. (He declined to comment on the criticism.)
Means' perspective about the importance of health and exercise fits into the field of functional medicine, which focuses on identifying and treating the root cause of diseases rather than just treating symptoms. It disrupts traditional medicine's focus on prescription drugs—which is a good thing, says Dr. David Perlmutter, a neurologist and advocate for low-carb diets and functional medicine.
'What Casey brings to the spotlight is this perspective that we should really be focusing on health and keeping people healthy,' says Perlmutter, who has known Means for eight years. 'Our health care system now has very little to do with health. It has to do with treating disease.'
Perlmutter appeared on a podcast episode for Levels, the tech company Means co-founded in 2019 that helps users track their real-time metabolic measures through the use of continuous glucose monitoring. (She is the company's chief medical officer; it is unclear whether she would step down from that role as surgeon general.) Means has also appeared on Perlmutter's podcast. In 2021, the two co-authored an op-ed in MedPage Today, a website for health professionals, criticizing the Biden Administration and federal guidelines for not recommending, in their view, a low-enough maximum threshold for daily added sugar.
Means went to college and medical school at Stanford University. She began a medical residency in the department of otolaryngology-head & neck surgery at Oregon Health and Science University, but dropped out in her fifth year after realizing, she wrote in her book, that she wasn't learning the root causes of why people were getting sick.
She was an editor for the International Journal for Disease Reversal and Prevention, a peer-reviewed publication that documents the science of nutrition and lifestyle, from 2019 to 2022. In that role, Means mainly edited poems, essays, and art work, according to Kim Allan Williams, the journal's editor in chief. 'I can't answer much except outside of her eye for art and literature. She was great at that!' he wrote in an email inquiring about her tenure there.
Means has also dabbled in poetry in her newsletter. A poem she wrote in April (with the help of AI, she notes) called 'The Devil's Wellness Plan' begins: 'If I were the devil, I'd ditch the disguise—/No pitchfork, no flames, just marketing lies.'
The poem touches on vaccinations, marketing, and medications, including stanzas that echo several talking points espoused by the MAHA and MAGA movements:
'I'd give boys man-boobs through toxic food,/And call masculine strength aggressive and lewd./I'd whisper, 'You're too much, too loud,'/And shame men's fire as something rude.
I'd flood your screens with porn on demand,/Till touch means pixels, not holding a hand./I'd teach women that cooking is something to dread,/That birth needs control and a hospital bed.'