Chasing Life

Episode: Beyond the Headlines of MAHA With the FDA
Host: Dr. Sanjay Gupta
Guest: Dr. Marty Makary, current FDA Commissioner
Original Release Date: October 3, 2025

Episode Overview

This episode centers on Dr. Sanjay Gupta’s deep-dive interview with Dr. Marty Makary, a surgical oncologist who recently became the Commissioner of the FDA. Together, they explore how the FDA is adapting—and what may change—amid growing pressure from science, politics, and public health crises. The conversation covers food safety, drug approval reform, high-profile autism/Tylenol debates, vaccine safety, abortion drug regulation, and the broader intersection of public trust and health policy.

Key Discussion Points & Insights

1. Modernizing the FDA (03:11–05:00)

• Makary's Listening Tour: Dr. Makary describes touring to meet drug developers for input on improving the FDA.
  • Quote: “There’s no shortage of things that are broken to fix at the FDA. I want to modernize the agency.” (03:21)
• Streamlining Drug Approval: Challenges FDA's historically slow drug approval (10–12 years):
  • Proposes continuous clinical trials using real-time data, reducing bureaucratic idle time.
  • “You wouldn’t apply for college after each year. …We can get decisions out in our new program in weeks, which is unprecedented at the FDA.” (04:01–04:50)
• Maintaining Safety Standards: Stresses need for speed without compromising safety.

2. Individual vs. Public Health & FDA's Food Safety Push (05:00–08:56)

• Balancing Individual and Public Health: Makary recounts moving from clinical practice to public health, emphasizing root causes not typically addressed in medicine.
• Food Chemicals & Child Health:
  • Efforts to remove petroleum-based food dyes linked to ADHD in children.
  • Major manufacturers are eliminating controversial ingredients (e.g., high fructose corn syrup, BHT, titanium dioxide).
  • Quote: “Our obesity problem in children, which is rampant, it’s not a willpower problem, it’s not their fault. This is something we are doing to kids.” (05:48)
• Regulatory Philosophy: Advocates for gradual, evidence-based ingredient swaps versus abrupt bans, balancing health and consumer choice.

3. The "Nanny State" Debate (08:01–08:56)

• Discussion of prior public health interventions (e.g., NYC soda regulation).
• Makary stresses a “balance,” arguing that evidence should guide policy, not ideology:
  • “We shouldn’t be messing with the minds just to sell more products to children.” (08:10)
  • Highlights bipartisan public support for healthier standards (“MAHA agenda”).

4. Makary’s Transition to Leadership (08:59–10:39)

• Leaving Surgery: Discusses leaving the OR for the FDA, calling the agency role “so much bigger than anything I’ve done.”
• Resources and Reform: Expresses confidence in his team and vision, despite massive challenges and government budget pressures.

5. Accelerating Drug Review Without Sacrificing Safety (10:39–11:02)

• Makary clarifies that faster drug review and safety can coexist.
  • Proposes conducting parts of the review process during clinical trial “idle time.”
  • “We can do much faster reviews without cutting corners on safety.” (09:46)

6. Autism, Tylenol, Vaccines: Nuanced Evidence & Communication (12:19–22:21)

Autism Research and Causation Theories (12:39–14:54)

• Population Surge: Autism has surged to affect “1 in 12 boys in California.”
• Mechanisms Under Study:
  • Immune dysfunction (autoimmune blockage of folate receptor)
  • Mitochondrial dysfunction, microbiome, even circadian rhythms.
• Potential Therapy: Leucovorin (a reduced B vitamin) may help a subset of autistic children.
  • NIH funding $50 million in further studies.

Tylenol (Acetaminophen) and Autism (12:19–21:32)

• Public Comment: Recent statements by the President about Tylenol and autism have fueled confusion.
• Makary: FDA sent a measured letter summarizing the data:
  • Some studies show an association; others don’t.
  • Advised minimizing acetaminophen use for trivial fevers, but acknowledged a strong safety track record overall.
  • Quote: “We’re simply including this information for you to think about minimizing the use of acetaminophen for routine low grade fevers.” (20:40)
• Sanjay Gupta Clarifies Presidential Statement: The President said “don’t take Tylenol” at least 10 times, but did allow exceptions—advising consultation with physicians.

Vaccines and Autism: Honest Communication (15:49–17:09)

• Makary: “I don’t think so,” regarding vaccines causing autism, but stresses no medical product is “1000% safe."
  • Warns against public health absolutism, which can erode trust:
    • “I think the absolutism around some of this stuff creates mistrust.” (16:04)
  • Says physician guidance should be measured and evidence-based, even when political leaders send mixed signals.

7. Abortion Drug (Mifepristone) Oversight & Data Transparency (22:21–26:22)

• Ongoing Review: FDA is reviewing mifepristone after pressure from lawmakers and concerns about complication data.
  • Makary emphasizes all drugs should remain under “eyes on” evaluation with anonymized patient big data, not just high-profile drugs.
• Criticism of Politicized Reports: Sanjay Gupta notes a key anti-mifepristone study cited by politicians is not peer-reviewed and not from medical experts.
• Commitment to Ongoing Safety: “No drug is a thousand percent safe. So we’re going to continue to look.” (24:58)

8. Restoring Trust, Civil Discourse & Holistic Health (26:22–28:59)

• Personal Motivation: Makary credits his physician father for shaping his public health values—emphasizing service, humility, and a holistic approach.
  • Quote: “We want to talk about root causes and the environment and food as medicine and the microbiome, gut health, and the soul.” (26:53)
• Depoliticizing Health: Both agree that health is now unavoidably political, and Makary expresses hope for a time of more humility and less absolutism.
  • “The science is a process of asking questions and a healthy discourse among experts.” (28:29)
  • Advocates for civil disagreement as essential to winning back public trust.

Notable Quotes & Memorable Moments

• “There’s so much idle time…You wouldn’t apply for college after each year. So we can run more continuous trials using modern technology.”
  — Dr. Marty Makary (04:01)
• “Our obesity problem in children… it’s not a willpower problem, it’s not their fault. This is something we are doing to kids.”
  — Dr. Marty Makary (05:48)
• “We shouldn’t be messing with the minds just to sell more products to children.”
  — Dr. Marty Makary (08:10)
• “I think the absolutism around some of this stuff creates mistrust.”
  — Dr. Marty Makary (16:04)
• “The science is a process of asking questions and a healthy discourse among experts.”
  — Dr. Marty Makary (28:29)
• “We want to talk about root causes…food as medicine and the microbiome, gut health, and the soul. And these are topics that traditional medicine has pushed to the side.”
  — Dr. Marty Makary (26:53)

Timestamps for Key Segments

• 03:11 – FDA modernization & drug approval reform
• 05:00 – FDA food regulation, child health, & food dyes
• 08:01 – The "nanny state" debate & bipartisan support for food policy
• 12:19 – Autism surge, possible causes, and therapies
• 15:49 – Vaccines, autism, and measured regulatory communication
• 20:38 – FDA’s letter on Tylenol and autism evidence
• 22:21 – Political pressure and scientific rigor on abortion drug oversight
• 26:34 – Dr. Makary’s personal motivations, restoring humility, and hope for depoliticized health

Conclusion

This episode provides a nuanced look behind the headlines involving the FDA at a time of heightened political controversy and scientific uncertainty. Dr. Makary outlines a vision for modernization, transparency, and trust-building—both for the FDA and public health at large. The conversation emphasizes humility, continuous questioning, and evidence-driven policy, urging a move away from absolutism and political polarization in health communication.

For the full, uncut interview, watch the episode on the Chasing Life YouTube channel.