Who is Casey Means? Trump's new surgeon general nominee sparks drama
After Trump's named his new surgeon general pick, Laura Loomer said 'MAHA is literally being taken over by Marxists and Grifters.' What to know about the nominee, a glucose monitoring company founder.
President Donald Trump on May 7 announced a new pick for U.S. surgeon general, naming Dr. Casey Means, an ally of Robert F. Kennedy Jr. with a prominent online following who is an advocate for metabolic health and preventing chronic disease.
It was a decision that quickly sparked drama among some Trump supporters, skepticism from some people who practice traditional medicine and hurrahs from many of Means' online followers.
"Casey has impeccable 'MAHA' credentials," Trump wrote in a May 8 Truth Social post referencing the acronym for Health and Human Services Secretary Kennedy's 'Make America Healthy Again' campaign. "Her academic achievements, together with her life’s work, are absolutely outstanding."
Trump said on the day of the nomination that he didn't know Means personally and chose her at Kennedy's recommendation.
"Because Bobby thought she was fantastic," he said, calling her a "brilliant woman."
Trump tapped Means after withdrawing his first pick for the role, Dr. Janette Nesheiwat.
According to a source familiar with the president's decision, Nesheiwat's previous positions supporting masking, social distancing and COVID-19 vaccines did not mesh well with the MAHA vision. In his social media post, the president said Nesheiwat would work with Kennedy "in another capacity."
Here's what we know about Trump's new U.S. surgeon general and the controversy around the appointment.
Who is Casey Means?
Means, 37, is a Stanford-educated physician and a New York Times bestselling author with a large online following. She had 765,000 Instagram followers on May 8.
Means graduated from Stanford Medical School and pursued a surgical residency as an otolaryngologist, often called an ENT doctor, specializing in conditions related to the ears, nose, throat, head and neck at Oregon Health & Science University.
She dropped out of the residency program. Her medical license expired in 2019.
She later founded Levels, a glucose-monitoring tech company that aims to help people see how food impacts their health through "AI-powered food logging" and "habit tracking."
"I love using Levels as my personal food journal (even when I'm not using a glucose monitor) so I can make sure I'm staying accountable to my goals," Means wrote on the company's website. "It makes knowing if you're hitting your goals for protein and fiber (and other macros you want to track) completely effortless."
Means has also raised some skepticism about vaccines, The New York Times reported.
She is the sister of Calley Means, an entrepreneur who is a close adviser to Kennedy. She and her brother have been outspoken about Kennedy's focus on conquering chronic diseases and have championed his "Make America Healthy Again" platform. Her brother's mission is to steer more health care dollars to incentivize habits like healthy eating, exercise, sleep and stress management, according to his business' website.
"Right now, we have a sick-care system where 95% of healthcare dollars are spent to manage disease after people get sick," he says on the website. "It is a big problem when the largest (and fastest growing) industry in the country is incentivized for us to be sick."
In a recent interview with Politico, her brother said Kennedy had taken on a department that had "utterly failed." He defended recent mass workforce reductions at the Department of Health and Human Services and the $1.8 billion in funding cuts from the National Institutes of Health's budget.
The 'real reasons' people get sick
The siblings coauthored a 2024 book entitled “Good Energy: The Surprising Connection Between Metabolism and Limitless Health," which explores the rise of chronic disease.
Casey Means, Trump's surgeon general nominee, said in an Instagram post in August that she wrote the book because "the metabolic health crisis is the biggest threat we face."
"The biggest lie in healthcare is that type 2 diabetes, cancer, heart disease, dementia, Alzheimer's, depression, arthritis, infertility and more are totally different diseases requiring separate doctors and pills," she wrote in the post. "The siloing of chronic disease has been the costliest mistake in the history of modern medicine."
Casey Means and her brother gained attention after an appearance on Tucker Carlson's podcast in August and have since appeared on several other popular conservative podcasts, including Joe Rogan's.
On Rogan's podcast, Means said she wanted Americans to be able to speak about how to get on top of metabolic health "without the fear of being called a totally, alt-right crazy person for even talking about the things."
"Parents don't want their kids getting sick. We don't want to be sick. We don't want to see our parents dying of Alzheimer's and cancer and all of these diseases," she said. "There is this pervasive thread that Americans are lazy and they don't want to be healthy."
She said she was "indoctrinated with that message" as a medical student and a surgical resident and said it is "not true."
"People want to be healthy. There's a huge system rigged against them," she said. "People don't want to be feeding their kids this dead trash food that comes in a package, but it is what is cheaper because of current policy at the top with the farm bills."
Some of the solutions Means supports include "restoring sustainable agriculture practices that contribute to biodiverse soil and nutrient-rich food, and moving away from industrial agriculture that uses toxic synthetic pesticides," according to her business website. Shifting to these practices is among her top suggestions for improving Americans' health.
The Means siblings' mother died of Stage 4 pancreatic cancer weeks after receiving the diagnosis. She saw five specialists who prescribed five separate medications, Casey Means wrote on X.
The illness could've been prevented, she said, and her encounters with the health care system made her question whether it was working.
"It wasn't supposed to be this way. I became a doctor so this wouldn't happen," she wrote on X. "But 9 years into training, I had a realization: I didn't know why patients get sick. I only learned how to cut into them or prescribe them a drug."
She said she left traditional medicine "to discover the real reasons why people get sick."
She says chronic illnesses are rooted in poor metabolic health.
"The truth is depression, anxiety, acne, infertility, insomnia, heart disease, erectile dysfunction, type 2 diabetes, Alzheimer’s dementia, cancer, and most other conditions that torture and shorten our lives are actually rooted in the same thing," she wrote. "And the ability to prevent and reverse these conditions – and feel incredible today – is under your control and simpler than you think."
Second nominee sparks backlash among some Trump supporters
Nesheiwat, the president's first choice for surgeon general, had faced sharp criticism from conservative podcast host Laura Loomer.
Now, Means, too, has caught the ire of the MAGA activist and Trump ally.
"MAHA is literally being taken over by Marxists and Grifters," Loomer wrote on X early May 8, amid a series of posts, many of which called Means out by name. "The entire MAHA movement is being taken over by Marxist Trump haters. It’s a full-fledged vetting crisis.
Nicole Shanahan, Kennedy's 2024 running mate when he ran as an Independent in the presidential race, expressed her disappointment with the nomination in a post, splitting with Trump and Kennedy.
"Doesn't make any sense," Shanahan wrote on May 7. "I was promised that if I supported RFK Jr. in his Senate confirmation that neither of these siblings would be working under HHS or in an appointment (and that people much more qualified would be)."
"I don't know if RFK very clearly lied to me, or what is going on," she continued, adding, "With regards to the siblings, there is something very artificial and aggressive about them."
Contact Kayla Jimenez at kjimenez@usatoday.com. Follow her on X at @kaylajjimenez.