Means, a health entrepreneur who advocates for changing food choices and farm practices,  and her brother Calley Means have been fixtures of Health and Human Services (HHS) Secretary Robert F. Kennedy Jr.’s Make America Healthy Again (MAHA) movement since last fall. As surgeon general, she’d join her brother at HHS, where he is a special advisor to Kennedy.

Unlike past surgeons general, Means has limited experience practicing medicine. She got her medical degree from Stanford University in 2014 and then dropped out of a residency program before finishing. She co-founded Levels, a health start-up that sells bracelets that continuously monitor blood sugar in service of healthier choices, in 2019. For comparison, the last surgeon general, Vivek Murthy, had cared for thousands of patients and trained medical students for nearly a decade at Brigham and Women’s Medical Center and Harvard Medical School prior to taking the surgeon general position.

Instead, Means says she was struck by the lack of attention to root causes of disease in modern medicine and set out on her own path to address those. “For most of us (literally 93 percent of adults!), our metabolism is not doing well because of our toxic, ultraprocessed food system and modern industrial environment,” she wrote in a recent newsletter. “This is the root cause of nearly every chronic health issue we’re facing today, and we need to get it back on track.”