FDA Commissioner Marty Makary Resigns: What His Departure Means for Public Health
Dr. Marty Makary, the FDA Commissioner appointed in 2025, has announced his resignation after just 13 months in office, marking the end of a turbulent tenure characterized by political clashes, ambitious reforms, and high-profile controversies. His departure—amid reports of White House pressure—leaves behind a mixed legacy of accelerated drug approvals, dietary policy shifts, and tensions with both the Trump administration and public health advocates.
Why Did Marty Makary Resign?
Makary’s resignation follows months of escalating conflict with the White House, particularly over flavored vape approvals, dietary guidelines, and vaccine policies. While President Trump publicly praised Makary’s work, anonymous sources suggested his leadership was no longer tenable. His resignation was confirmed on May 12, 2026, with Kyle Diamantas, JD, the deputy commissioner for food, set to assume acting leadership pending confirmation.
“The FDA is one of the greatest brands in the world. My grandfather trusted it. It’s hard to get things done in government. We live in a highly partisan time where there’s a toxic polarization.”
Makary’s Most Impactful Reforms
Despite the turmoil, Makary’s tenure saw sweeping changes aimed at modernizing the FDA. Below are the most significant initiatives:
- Accelerated Drug Approvals:
Makary prioritized faster approvals for life-threatening conditions, including a gene therapy for genetic hearing loss and a lung cancer treatment approved in 44 days. The FDA now processes high-priority therapies at record speeds, mirroring the urgency seen during the HIV/AIDS crisis.
- Dietary Policy Overhauls:
Makary challenged decades of nutritional dogma, advocating for:
- Ending the “war on natural fats,” promoting whole milk and natural foods over processed alternatives.
- A reassessment of artificial food dyes and preservatives, including BHT and ADA.
- New guidelines on ultra-processed foods, framing them as disruptors of metabolic feedback loops linked to obesity.
- Vaccine and Peptide Policies:
Makary’s stance on vaccines and peptides reflected a data-driven approach:
Commissioner Marty Makary Resigns - He emphasized the need for rigorous studies on vaccine safety, particularly for novel or repurposed products.
- On peptides, he called for placebo-controlled trials to evaluate their safety and efficacy, acknowledging both their potential and the lack of robust evidence.
- Hormone Replacement Therapy (HRT):
Makary highlighted the understudied benefits of HRT for menopausal women, noting anecdotal reports of improved quality of life and marital stability. He pushed for reduced stigma around testosterone replacement therapy (TRT) for men, framing it as a public health opportunity rather than a controlled substance.
Controversies That Defined His Tenure
Makary’s leadership was not without controversy. Three key flashpoints shaped his legacy:
1. Flavored Vapes and Youth Access
Makary resisted approving menthol and fruit-flavored vapes, citing concerns about underage use. However, the Trump administration reportedly overruled his objections, leading to public friction. The FDA ultimately authorized some flavored products, but the debate over youth vaping remains unresolved.
2. Vaccine Policies and Transparency
Makary’s approach to vaccines was cautious and data-driven, clashing with both vaccine skeptics and mandates. The FDA blocked the publication of internal studies on COVID-19 and shingles vaccines, citing methodological concerns—sparking criticism from both sides of the debate.
3. Alignment with the MAHA Movement
Makary’s partnership with the Make America Healthy Again (MAHA) movement, led by HHS Secretary Robert F. Kennedy Jr., accelerated reforms on ultra-processed foods, artificial dyes, and school meal programs. However, critics argued his alignment with MAHA’s skepticism of conventional nutrition science risked undermining evidence-based policy.
Makary’s Legacy: What Stays and What Changes?
While Makary’s resignation closes one chapter, his reforms may endure. Key questions moving forward:
- Will accelerated drug approvals continue?
The FDA’s National Priority Voucher Program and streamlined reviews for rare diseases are likely to persist, given bipartisan support for faster cures.
- How will dietary policies evolve?
Makary’s push against ultra-processed foods and artificial additives gained traction with consumers. The FDA’s reassessment of BHT and ADA signals a shift toward stricter scrutiny—though industry lobbying may unhurried progress.
- What’s next for vaccines and peptides?
Makary’s call for better vaccine studies and peptide research may gain momentum, especially if future leadership prioritizes transparency.
- Who will replace Makary?
Kyle Diamantas, the acting commissioner, is expected to take over. His background in food regulation suggests continuity on dietary policies but may signal a return to more traditional FDA approaches on drugs and vaccines.
FAQ: What You Need to Know About the FDA’s Future
Q: Why did Marty Makary resign?
A: Makary’s resignation stemmed from political pressure, particularly over flavored vape approvals and vaccine policies. Reports indicated the White House was dissatisfied with his leadership, despite his reforms.
Q: Will the FDA slow down drug approvals now?
A: Unlikely. The accelerated approval process for life-threatening conditions is widely supported and will probably continue under Diamantas.
Q: Are ultra-processed foods now banned?
A: No. The FDA is reassessing their safety but has not banned them. Expect stricter labeling and potential restrictions on additives like artificial dyes.
Q: What happens to vaccine policies?
A: The FDA will likely maintain its cautious stance, focusing on rigorous studies rather than mandates. Future policies may depend on political shifts.
Q: Can I still get HRT or TRT?
A: Yes. Makary’s reforms reduced stigma around HRT and TRT, and these treatments remain accessible by prescription.
Looking Ahead: The FDA’s Crossroads
Makary’s resignation marks the end of an era at the FDA—one defined by bold reforms, political battles, and a push to modernize America’s food and drug policies. While his legacy is mixed, his tenure accelerated critical debates on nutrition, drug approvals, and public health transparency.
The next commissioner will face immense challenges: balancing innovation with safety, navigating partisan divides, and addressing the public’s growing skepticism of both government and Big Pharma. One thing is clear—under Makary, the FDA was never the same. And under Diamantas, it may continue to evolve in unexpected ways.
Dr. Natalie Singh is a board-certified internal medicine physician and health policy expert. Her work focuses on translating complex medical and regulatory issues into actionable insights for the public.