Podcast Summary: "The Truth with Lisa Booth: How Marty Makary is Revolutionizing Public Health"

Podcast Information:

• Title: The Clay Travis and Buck Sexton Show
• Host/Author: iHeartPodcasts
• Episode: The Truth with Lisa Boothe: How Marty Makary is Revolutionizing Public Health
• Release Date: July 10, 2025

Introduction

In this episode of The Truth with Lisa Booth, host Lisa Booth engages in a comprehensive discussion with FDA Commissioner Marty Makary. The conversation delves into Makary’s journey through the confirmation process, the transformative changes he is implementing at the FDA, and broader public health initiatives aimed at making America healthier.

Confirmation Process and Initial Impressions [04:07 – 06:22]

Lisa Booth begins by congratulating Marty Makary on his appointment, highlighting his intelligence and common sense. Makary reflects on his transition from a high-stress career in trauma and cancer surgery to the politically charged environment of government service.

Marty Makary [05:02]:
"I've been doing trauma surgery in the past and cancer surgery and complex medical stuff. So the stress didn't bother me at all. It was actually less stressful than a complicated operation I was doing at Johns Hopkins..."

Makary discusses the challenges of entering a political arena where a significant portion of the populace may wish for his failure, contrasting it with the supportive environment of clinical practice.

FDA Workforce and Organizational Changes [05:57 – 09:09]

Booth raises concerns about workforce reductions within the FDA, linking it to broader national trends. Makary provides context, explaining that the FDA had already reduced its workforce by 15% to return to 2019 levels prior to his tenure.

Marty Makary [06:22]:
"The FDA reduced its workforce by about 15%. The goal was to get back to 2019 levels, and that happened just before I got into office."

He emphasizes that despite workforce cuts, the FDA’s size has more than doubled since 2007, growing from 9,000 to nearly 20,000 employees. Makary details efforts to eliminate redundant structures and improve operational efficiency, including addressing misconduct such as unauthorized gene editing of cancer cells in China.

Marty Makary [08:00]:
"We discovered a lot of insane things that we discovered... making the FDA more streamlined, better cut the red tape and talk about food, not just drugs."

Transparency in Drug Approvals [09:09 – 11:37]

The conversation shifts to the FDA’s commitment to transparency in drug approvals. Makary outlines steps taken to ensure the scientific independence of the FDA’s review process by removing pharmaceutical representatives from advisory committees.

Marty Makary [09:50]:
"This agency belongs to the American people. Some people perceive that it's captured. And I'm happy to report that we have done everything possible to ensure that the review at the FDA is scientifically independent."

He announces upcoming policy changes to make FDA decision letters public, aiming to reduce the influence of pharmaceutical lobbyists and enhance accountability.

Marty Makary [10:05]:
"When companies get a decision, a rejection from the FDA, they will spin the decision to their shareholders. Well, now these will be public and it'll also help inventors and other drug developers to understand what the FDA wants."

COVID-19 Vaccine Policies [11:37 – 14:48]

Booth inquires about the FDA’s stance on COVID-19 vaccines, particularly regarding myocarditis warnings and age-specific vaccination policies. Makary explains the FDA’s approach to maintaining rigorous scientific standards for COVID-19 boosters.

Marty Makary [12:14]:
"We're going to use the same scientific standard we use for other drugs for the COVID booster shot in healthy Americans. We're not going to just rubber stamp blindly COVID boosters every year without clinical data that's updated."

He addresses the recent warnings about myocarditis in young men, acknowledging that earlier delayed responses necessitated recent actions to ensure vaccine safety.

Marty Makary [13:57]:
"We issued a warning about myocarditis with the COVID shot that was long overdue."

Regulation of Synthetic Dyes in Food [19:52 – 23:43]

Makary discusses the FDA’s initiatives to eliminate petroleum-based synthetic dyes from the American food supply, aligning with the "Make America Healthy Again" movement. He underscores the link between synthetic dyes and behavioral issues in children, citing studies from reputable journals like The Lancet.

Marty Makary [20:50]:
"There are randomized controlled trials, for example, one in the Lancet, showing that petroleum-based food dyes were associated with attention deficit disorder."

The FDA has approved several natural alternatives and is pushing companies like Kraft, Heinz, and General Mills to adopt these safer dyes. Makary is optimistic about ongoing negotiations with companies such as Mars to phase out harmful synthetic dyes.

Marty Makary [22:30]:
"We're going to announce another natural dye next week... we have been getting these natural dyes out on the market expeditiously."

Rewriting Dietary Guidelines and Addressing Chronic Diseases [23:43 – 25:40]

Booth asks about the Trump administration’s efforts to rewrite the U.S. dietary guidelines. Makary highlights the past failures of the food pyramid and the current initiative to promote whole foods and reduce ultra-processed food consumption, which now constitutes 70% of children’s diets.

Marty Makary [23:52]:
"We are rewriting the food guidelines, the dietary guidelines. That has been probably one of the greatest sources of health misinformation in the United States in our history."

He announces the upcoming release of updated guidelines, which also grant states the authority to exclude ultra-processed foods and sugary drinks from programs like SNAP and school lunches. Makary emphasizes a shift from treating diseases to addressing their root causes through improved nutrition and reduced environmental exposures.

Reducing Animal Testing and Modernizing FDA Practices [25:40 – 28:05]

Booth brings up Makary’s pledge to reduce animal testing within the FDA. Makary advocates for modern alternatives such as computational modeling and "organ on a chip" technologies, which can predict human toxicity more accurately and ethically than traditional animal tests.

Marty Makary [25:55]:
"We can modernize the agency and use computational modeling now. AI technology that looks at a molecule and can predict its toxicity in humans better than an animal test."

He outlines the FDA’s roadmap to eliminate unnecessary animal testing and streamline the drug approval process, aiming to reduce decision times from nearly a year to just one or two months.

Addressing Misconceptions and Enhancing Public Health Research [27:37 – 29:47]

Booth mentions criticisms regarding potential cuts in health research under the Trump administration. Makary refutes these claims, asserting that no NIH funding has been reduced. He criticizes the previous focus on health equity research that lacked substantial impact and emphasizes the current administration's commitment to studying chronic disease root causes.

Marty Makary [28:05]:
"Not one NIH dollar has been cut. There's not a single dollar to the NIH budget that has been cut."

He praises NIH Director J. Bhattacharya for steering the agency towards more impactful research, particularly in addressing chronic diseases rather than solely relying on high-tech medical interventions.

Conclusion and Final Remarks [29:47 – 30:07]

Lisa Booth expresses her gratitude towards Marty Makary for his contributions and leadership at the FDA. Makary reciprocates the appreciation, emphasizing the importance of having dedicated individuals in government roles to advance public health.

Marty Makary [30:01]:
"Well, thanks so much, Lisa. Great to talk to you again. Great to connect and thanks for having me."

Key Takeaways

• Leadership Transition: Marty Makary brings a clinical and common-sense approach to the FDA, focusing on operational efficiency and scientific independence.

• Transparency and Accountability: The FDA under Makary is committed to making decision processes more transparent, reducing pharmaceutical influence, and publicizing drug approval decisions.

• Public Health Initiatives: Significant efforts are underway to eliminate synthetic dyes from the food supply, rewrite dietary guidelines, and address the root causes of chronic diseases through improved nutrition.

• Modernizing Practices: The FDA is embracing modern technologies to replace animal testing, streamline drug approval processes, and enhance overall regulatory efficiency.

• Research Focus: Contrary to criticisms, the administration supports robust health research, particularly targeting chronic diseases, without cutting NIH funding.

Notable Quotes

• Marty Makary on Transitioning to Government:

  "I'm walking into this sort of crazy world of politics. I'm going to miss being a doctor." ([05:02])

• On Scientific Independence:

  "This agency belongs to the American people... we have done everything possible to ensure that the review at the FDA is scientifically independent." ([09:50])

• Regarding Synthetic Dyes:

  "Why do we take risks when we have an epidemic of child behavioral problems and attention deficit disorder?" ([20:50])

• On Reducing Animal Testing:

  "We can modernize the agency and use computational modeling now... we have a pilot program to reduce the decision Time of the FDA from nearly a year to just one or two months." ([25:55], [26:14])

This episode provides an insightful look into the ongoing reforms at the FDA under Marty Makary’s leadership, highlighting his commitment to transparency, modernization, and addressing fundamental public health challenges.