MAHA vs. ANTI-MAHA

by Jeff Krasno

I’ve just returned from the Eudemonia Summit in West Palm Beach, Florida, where I had the dubious pleasure of moderating a panel that was unofficially billed as “MAHA vs. Anti-MAHA.” 

On the stage with me were two brave souls I consider friends: Dr. Will Cole and Dr. Jessica Knurick. Both have appeared on my podcast, Commune, where I explore the ideas and practices that help us live happy, purposeful lives.

Jessica has become a very prominent, articulate critic of the MAHA movement, particularly on Instagram and TikTok. She’s well credentialed, with a PhD in nutrition, and has spent many years working in public health. Will hails from Pittsburgh, where he runs a functional medicine telehealth clinic. He’s written a number of bestselling books, and while he’s very much an independent thinker, he’s become closely associated with the MAHA movement and many of its prominent figures.

So that was the setup: two smart, thoughtful people who profoundly disagree on some very consequential issues in public health, sitting on stage together with me in the middle.

My goals for this session were two-fold.

The first was to model what a sane, constructive, respectful hard conversation looks like.

This is, as most Tangle readers know, anomalous in our current media environment. What passes for “discourse” on social media is mostly people screaming over each other from their respective echo chambers. Content is engineered — and algorithmically rewarded — to tickle our negativity bias: to keep us scared, outraged, anchored in our preconceptions and addicted to a firehose of sensationalism. Outrage works famously for engagement, by providing perverse incentives for content creators — especially in the health space where, ironically, we talk about amygdala hijack and the importance of emotional regulation. We’ve built a virtual machine that rewards hyperbole and punishes nuance.

But it’s really hard to spew vitriol up close.

When you put people together in actual, four-dimensional spacetime — sharing oxygen and making eye contact — tempers are, well, tempered. There’s more room for curiosity, less appetite for humiliation. And that’s the space I wanted to create: not a food fight, but an honest, “spicy but substantive” conversation (about food).

This work is not new to me. Last year, I hosted a Palestinian–Israeli summit at Commune Topanga. At Eudemonia 2024, I facilitated a conversation between a Trump supporter and a Harris supporter. While no ballots were reconsidered, it, somewhat astoundingly, ended with a hug.

As a means of facilitating these conversations, I lean into the tools of nonviolent communication:

• listening to understand, not to reload
• seeking connection, not immediate solution
• looking for islands of common ground instead of obsessing over the fault lines
• steelmanning: a technique in which you reiterate the best parts of an opposing argument

So that was goal one: model the kind of conversation I hope people can replicate around their own contentious dinner tables.

The second goal was to untangle the public health debate around the MAHA movement. Because whatever you think about Bobby Kennedy and HHS, the Health secretary has undeniably helped drag the conversation about the epidemic of chronic disease into the foreground of American life. And that’s undeniably a good thing.

We do have chronic disease crisis in this country: heart disease, diabetes, cancer, dementia, autoimmune conditions. On that the data are pretty clear and there’s broad agreement across the spectrum — from MAHA folks to their fiercest critics.

Fractures start to form around identifying the causes of this crisis — and therefore the solutions.

Many in the MAHA world locate the problem almost exclusively in captured agencies: the CDC, the FDA, the NIH. And to be clear, I think there is significant regulatory capture within the industry. Pharma has oversized influence, guidelines are often distorted by industry interests — that’s all real.

But there’s a much bigger frame: the social determinants of health.

Your health is not just the result of your individual choices or your last lab panel. It’s profoundly shaped by whether you have access to:

• clean air and water
• safe housing
• good food within a reasonable distance
• health insurance
• parks and public space
• decent schools and hospitals
• a livable wage
• some basic degree of safety

If you compare a map of chronic disease “hot spots” in the U.S. with a map of communities that lack these things — food swamps, hospital deserts, neighborhoods saturated with pollution — they overlap almost completely. Communities where these maps overlap are often marginalized communities, both rural and urban. They are not sick because they all simultaneously made maladaptive choices in a vacuum, they’re sick because the conditions of their lives make health uncommonly hard and disease extremely easy.

So, one tension in this debate is whether the problem is mostly concentrated within HHS and its agencies, or is it the entire social, economic, and environmental context that shapes health? Of course, it’s both. But how you weight those pieces greatly impacts policy.

The other big knot we tried to pull on is the strange marriage between the MAHA movement and the Trump administration.

After dropping out of the presidential race, Bobby Kennedy actively and vociferously campaigned for Trump. There’s no question that the MAHA movement helped deliver a pretty broad constituency that was crucial to getting him elected. A brood of suburban moms, flocks of people disillusioned with pharma and public health, young and old people struggling with chronic disease — all found voice in that movement.

But here’s where this collides with public health in a very concrete way: Trump and the current Republican Party position themselves as anti-regulation. They want to unleash the free market and view government as the problem: bloated, overreaching, suffocating. The solution is to gut agencies, fire civil servants, and concentrate power in the executive. But you cannot meaningfully address chronic disease, environmental toxins and ultra-processed food without regulation. Period. 

This came up on stage in a very practical way around SNAP — the Supplemental Nutrition Assistance Program, what we used to call food stamps.

For decades, Republicans have tried to cut SNAP, usually under the banner of “fraud.” However, an abundance of research has shown that the program functions quite well, and that it generates positive economic impact by providing food assistance to over 40 million Americans.

But here’s an area where I actually find myself more aligned with Will (and by extension, with some of Bobby’s ideas): While I am against cutting SNAP, I do think we should limit what the program’s funds can be redeemed for.

Right now, you can’t use SNAP for alcohol or tobacco. That makes sense. Those products are unequivocally harmful. But you can use SNAP to buy Coke and ultra-processed foods that are absolutely driving obesity and diabetes. Why are we okay with one and not the other?

This is not about moralizing poor people’s choices, it’s about not giving yet another subsidy to companies that are already massively subsidized.

Here’s how that works:

• We subsidize monocrop agriculture — including corn, soy, and wheat — at scale. We did this for understandable reasons in the Great Depression and WWII, but failed to wean ourselves off these subsidies and in fact distorted the market even further, in the 1970s and beyond. 
• Companies like Coca-Cola use those subsidized inputs (like high fructose corn syrup) to make products below their true cost of production and sell them at high margins.
• Then, when someone on SNAP buys that Coke, taxpayer money is essentially transferred directly to Coca-Cola.
• Ten years later, after a liter of tax-subsidized Coke per day, that same person now has type 2 diabetes and is on insulin, metformin, maybe Ozempic — often paid for by Medicaid (i.e., more taxpayer money).
• At no point does Coca-Cola pick up the bill for the downstream health costs of its product.

That’s what it means to externalize costs. The profits are privatized; the consequences are socialized. 

So, I don’t think the solution is to slash food assistance. Instead, we should restructure it to scale up other programs — like “Double Up Bucks,” which allows people to double their food dollars when they buy fruits and vegetables. And we should stop allowing SNAP to be redeemed for products that directly fuel the chronic disease epidemic.

This circles us back to the broader point: You don’t change that system without regulation. You don’t get endocrine disruptors out of water, or microplastics out of food chains, or junk out of school cafeterias purely through good vibes and consumer choice. You need public policy. You need functioning agencies. You need some version of government that is actually oriented towards public health rather than corporate gain.

Already, the MAHA movement has scored up some wins in this regard:

• Removing the black-box warning on vaginal estrogen, which was based on a flawed interpretation of the WHI study, is a real positive step for women’s health.
• Putting chronic disease front and center is important.
• Questioning chemical additives and food dyes is important.

But those wins can act as a kind of smoke screen if they convince people that we’re “fixing health” while, in the background, the larger machinery of deregulation and environmental degradation accelerates.

That’s the crux of the discomfort for me: This sense that we’re celebrating the removal of Red Dye 40 from Skittles while quietly dismantling the very systems we need to tackle the bigger, structural drivers of disease.

Back on stage, I tried to surface some of that disagreement. It was spicy — but, it was also deeply respectful. Jessica and Will disagreed plenty, but they also found little plots of agreement — such as on the reality of chronic disease, on the harms of ultra-processed foods, and on the need to change the food system. And it ended, literally, with a hug — with a recognition of shared humanity of the fact that we probably have more in common than the algorithm would like us to believe.

Walking away from Eudemonia, I felt a strange mix of dissonance and hope. Dissonance, because we are in a genuinely precarious moment: Public health is politicized, and people are confused and scared and sick. And hope, because when you actually sit people down — in person, in good faith — you realize that nuance is still possible. Disagreement doesn’t have to mean dehumanization. We can hold two truths at once: that agencies need reform and that we need them, that corporations create value and require guardrails, and that personal responsibility matters and so does the environment we live in.

We’re not going to meme our way out of the chronic disease crisis. We’re not going to solve it in 15-second clips. We need longer, messier, more human conversations.

So, I’m grateful to Eudemonia (and my dear old friends Sean Hoess and Karina McKenzie) for giving us the stage, grateful to Will and Jessica for showing up fully, and grateful to you for reading. My hope is that by unpacking some of this here, you feel a little more equipped to navigate your own conversations, maybe with a little less reactivity and a little more curiosity.

Because if there’s one thing I took home from Eudemonia, it’s this: We are profoundly interdependent. Our health, our politics, our ecosystems, our microbiomes — it’s all connected.

And if we’re going to build a healthier world, we’re going to have to do it together.

Jeff Krasno is the co-founder and CEO of Commune, a masterclass platform for wellness. He hosts the Commune podcast and is the author of the book GOOD STRESS: The Health Benefits of Doing Hard Things.