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Casey Means, the wellness guru who is now Donald Trump’s pick for surgeon general, has said a lot of weird stuff over the years. She maintains that whether you drink raw milk is a decision that should be made based on vibes: “I want to be free to form a relationship with a local farmer, understand his integrity, look him in the eyes, pet his cow, and then decide if I feel safe to drink the milk from his farm.” She thinks that everyone should wear a glucose monitor, a tool that is very useful for diabetics but doesn’t really do anything for the rest of us. She will, incidentally, as the co-founder of the wellness company Levels—the main job she has held— sell you said glucose monitor as well as a subscription to an app needed to use it. This is an expensive service that, again, most people do not need, and yet which she describes as being about “empowerment.” Though she initially trained to be a surgeon, she didn’t finish her residency, and according to reporting from Mother Jones, her Oregon medical license is inactive. Nonetheless—or perhaps, relatedly—her New York Times bestselling book Good Energy, which she co-wrote with her brother, a health and wellness entrepreneur, promises to help readers “prevent and reverse” conditions from dementia to erectile dysfunction with the help of quizzes and recipes.
But the Casey Means fact that most sticks in my mind—and I think the one most telling of where I fear she wants to shepherd Americans, health-wise—was on The Liz Moody Podcast in 2022. The episode was all about metabolic health, which, according to Means, explains how illness can be prevented from the jump so that we don’t need pesky things like surgery or medication. It boils down to the idea that how you eat affects how your body works, which is both correct and can be quickly taken to an almost-religious extreme. Means, in fact, characterizes herself as a “metabolic health evangelist.” In a review of some of the concepts in her book, McGill’s Office for Science and Society called Means’ thinking “not pure fiction” but noted that she, as wellness folks are wont to do, takes preliminary findings in science and contorts them into easy take-home messages for her audience (and customers). On the podcast episode, Means explained to listeners that they might consider swapping ultra-processed foods like chips for crackers made entirely from seeds and nuts, as she does. We eat about “2–3 pounds of food a day,” she told the host. “I want to maximize the limited number of calories and quantity of food I have today to serve my real long-term goals, which is long-term contentment and health.” The specific brand of noncracker crackers that she recommends frequently are made of flax seeds, and are called, unfortunately, Flackers.
I tried the Flackers after listening to Means talk about them. What can I say, I lived in Park Slope at the time. They look like a bunch of flax seeds glued together and taste like dense particleboard squares dipped in apple cider vinegar. Crumbled onto a salad, they are actually not bad. I’d eat them again, I think, if they were there. They do not, and I cannot stress this enough, come close to being an adequate substitute for chips. I cannot imagine seeing them on a cheese board at a public event, let alone topping one with a dollop of brie.
To hear Means tell it, though, the alternative is the devil. Regular crackers, she has explained, “often have one or more of the Unholy Trinity in them (aka, refined grains, refined sugars, refined seed oils).” In a ranking of crackers that Means created, Flackers earn an A+, while a brand of almond flour crackers gets a C- for the sin of having 18 grams of carbs in a serving, or about 15 percent of the minimum carbs you need per day. I probably don’t even have to tell you how Ritz crackers fared in her analysis. In her pantry, of which she has provided a tour on YouTube, she has a “Flackers section.” She advocates adding them as a topping to bowls from the meal service Daily Harvest, which she has a discount code for. Her enthusiasm for Flackers is so great that she has clarified that she is not sponsored by Flackers, though the whole thing would be more understandable if she were.
If a celebrity talked about a food like this, we might see it as a sign that they had some kind of issue, like a psychological need to exclude from their diet many very common ingredients. (The Means siblings both cite their mother’s death from Stage 4 pancreatic cancer in 2021 as a core motivation for what they do.) Casey Means has so far showcased a brand of health leadership that is focused on individuals making not just better, but actively neurotic, choices. That tone may not be totally out of step for a government position that involves things like calling for warning labels on alcohol were it not combined with an alarming willingness to depart from expert consensus in favor of being the person with all the answers. To pick a Flackers-related example, it is bonkers that someone who loudly advocates avoiding seed oils, which are, nutrition researchers agree, simply not bad for you, may be in charge of “communicating the best available scientific information to the public.”
Well, it would be bonkers if it wasn’t perfectly in line with Trump’s other appointees. She’s Dr. Oz if he were a member of a Brooklyn food co-op. As with Robert F. Kennedy Jr., her critiques of our food systems and treatment of the environment can, if you just catch them on TV for a second, make sense. But what that translates to in practice seems to be that you personally need to figure out how to solve that for yourself, including by looking farmers in the eyes and being responsible for your child’s vaccine schedule rather than trusting the recommendations of many, many, many, many doctors, researchers, and scientists. And eating goddamn Flackers.
If the route to a disease-free body is within your own grasp, then what role is there for public health, or even medicine, to play? As recently as a few years ago, engaging with the kinds of wellness advice Means dispensed could be a lark—maybe I really am a few dietary changes away from a new me. There is something alluring about it even now. We all know that our doctors don’t know everything. The trouble is that Means thinks she knows more. The guidance she is offering is at best very obvious (cut down on sugar) and often quite weird (sorry, but: Flackers!). If she’s confirmed, just imagine the kinds of surgeon general advisories we’re going to be in for. In the meantime, you can subscribe to her newsletter for “unfiltered takes.”
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