Trump's surgeon general pick criticizes others' conflicts but profits
from wellness product sales
[June 06, 2025]
By MICHELLE R. SMITH and ALI SWENSON
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.
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Dr. Casey Means, a wellness influencer, left, and journalist Megyn
Kelly, attend a confirmation hearing for Robert F. Kennedy Jr. for
the Secretary of Health and Human Services post, at the Capitol in
Washington, Jan. 29, 2025. (AP Photo/Ben Curtis, File)
 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?”
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Swenson reported from New York.
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