Like populism, the MAHA movement spoke to widely shared frustrations with a medical establishment that didn’t seem to have answers to persistent problems and left people who felt failed by the system feeling unheard and disdained.

But like populism’s critique of insider politics, the outsider critique of the medical establishment has always struggled to offer an alternative vision that’s rigorous rather than credulous. And like MAGA populism, MAHA now finds itself in a complicated marriage with a Republican Party that still retains its pre-Trump orientation toward business interests, drug companies and Big Food.

R.F.K. Jr. entered office promising to address two great challenges in American public health, the spread of obesity and the resilience of chronic illness, and in an ideal world an outsider’s critique would have a lot to offer on both fronts.

The roots of the American weight problem are endlessly debated, with car culture and suburbia offered as non-dietary explanations for why we’re fatter than the Europeans. The anti-corporate critique of how we grow and make and sell our food nonetheless has a certain plausibility, and the MAHA impulse to push Americans away from chemicals and processed foods seems like an experiment worth trying.

Meanwhile, chronic illness, and especially the lengthening list of ailments that lack a clear causal explanation, is a zone where the medical establishment has largely failed, and a new approach with new eyes, new studies and new data would be entirely welcome.

But the MAHA approach so far is both self-undermining and politically constrained. It self-undermines by matching the medical dogmas it disdains with dogmas of its own, particularly a zeal for the “natural” that underplays pharmaceutical solutions and imagines that public health is just a matter of stripping away late-modern toxins and restoring ruddy pre-1960s vigor.

Certainly modernity has its toxic side and nature has a lot of wisdom. But the natural world also has a lot of ways of killing us and torturing us, which human ingenuity enables us to overcome. And the pre-1960s landscape yielded better health for some people and premature death for many, many others.

So you need to strike a balance, where you tout organic produce and whole grains and exercise regimes to fight obesity … but also embrace the revolutionary potential of the new wave of weight-loss drugs. Or where you look for the roots of chronic illnesses in chemicals and pollutants …. but also remain open to the possibility that a lot of chronically sick people are dealing with infections that might be cured with the right mix of prescription drugs. (I always tell people that in my experience fighting a chronic tick-borne illness, some of the weird alternative therapies I tried were very helpful, but the high doses of antibiotics were essential.)

And that balance is completely absent from MAHA when it comes to the question of vaccines. There are plenty of legitimate questions about the effectiveness of mRNA vaccines and the true rate of vaccine injuries and the right schedule for childhood vaccinations. But the holistic critique never manages to just stay with those specific issues, while conceding the general truth that vaccines are mostly good. Instead the impulse is always to make vaccines a grand taproot of modern health problems, whether it’s through implausible claims about the scale of mRNA vaccine side effects or the indefatigible-yet-unsuccessful efforts to establish a vaccine-autism connection. And the refusal to be disabused by data suggests a deep instinct that vaccination in general is just too unnatural to be trusted — a very human impulse, clearly, but not one that can guide public health.

R.F.K. Jr. was an exemplar of this instinct as an activist; as health secretary he’s somewhat trapped by it. His moves on vaccines have been aggressive and unwise, especially the recent decision to cancel all funding for further mRNA vaccine research. Yet they aren’t aggressive enough for his allies and supporters, who already feel aggrieved that he isn’t delivering a fuller vaccine-skeptical crusade.

At the same time, he also looks like a prisoner of coalition politics, because the G.O.P. is still the party of Big Agriculture and industry groups, which seem likely to impose hard limits on any big push to make the American food supply healthier.

An analogy to the Trump administration’s economic policy is useful here. The most ambitious populists sought a radically different approach to right-wing economics, but what they got was Trump’s longstanding tariff fixation stapled onto the traditional G.O.P. array of deficit-financed tax cuts. Confronted with the MAHA challenge, likewise, the old corporate powers will make a few concessions on ingredients and learn to live with anti-vaccine sentiment — but otherwise the status quo may win.

(http://www.autoadmit.com/thread.php?thread_id=5760451&forum_id=2).#49170084)