600 Pounds Down Really Wanted The Truth.

So I told them. Starting with how I spent two decades helping build the machine. And why I started telling people how to break out of it.

The free Diet Coke in the West Wing was the highlight of my day.

I am not joking. I would sprint over from my office multiple times before lunch to refill. I was in charge of health policy for the President of the United States, and my sole hydration was a product I’ve since described as fridge cigarettes. (I have since written a whole article about this. It is embarrassing. You should read it.)

That is who the 600 Pound Down podcast invited onto their show.

Coaches Justin and George are leading a weight loss and wellness movement comprised of people doing the hard, unglamorous work of actually changing their lives — not the Instagram version, the real version. Blue collar workers, middle class families, people who’ve been failed by the system and are figuring out what to do about it.

They are not policy wonks. They are not DC insiders. They are exactly the kind of people I spent two decades in Washington wanting to help.

So when they asked me to come on and just... tell the truth? I did.

We covered a lot of ground; here are a few of the highlights:

The medical cartel you’ve never heard of.

The AAMC, the American Association of Medical Colleges, is the trade group for medical schools. Their entire business model depends on scarcity.

Fewer doctors = higher salaries.

They fight like hell against any effort to open new medical schools, diversify curricula, or let anything other than petroleum-based pharmaceutical products count as medicine.

This isn’t conspiracy theory. I was lobbied by these people. I watched them frame issues for my colleagues before anyone else could get in the room. That’s how the game is played.

The Rockefellers figured this out in the 1930s. They needed a profitable use for petroleum byproducts. They commissioned the Flexner Report, which conveniently declared that the only legitimate medicine was the kind that prescribed petroleum-based pharmaceuticals - and formed state licensing boards to shut down every homeopathic, naturopathic, and osteopathic school that disagreed. The word “doctor” comes from the Latin for teacher, by the way. Not “prescriber of symptom-suppressing drugs.” Teacher.

We have been living inside that rebranding project ever since.

The PBMs are the real bond villains.

People assume the pharmaceutical manufacturers are the worst actors in this system. They’re not. They’re sub-demon tier. (A meaningful distinction.)

The real carnage is happening at the level of the middlemen - specifically the three PBMs that control 80% of the market: ExpressScripts, CVS Caremark, and OptumRx. Check your insurance card. If one of those logos is on it, your employer is being systematically robbed, and they probably don’t even know it.

In the Trump administration, a colleague of mine came in from the PBM industry to help us figure out how to lower drug prices. He put together a plan that would have cost the PBMs and pharmaceutical manufacturers real money.

He fell off a balcony in DC.

It was ruled a suicide. He had a family. Small kids. He was not miserable.

I’m not saying I know what happened. I’m saying nobody ever talked about it again.

Your body is not attacking you. It’s trying to save you.

We spent a long time on this one, because Justin and George’s audience lives it. The chronic pain, the infertility, the weight that won’t move no matter what. They are not random “failures.” They are your body doing exactly what it was designed to do when it thinks you’re being chased by a bear.

The problem is that the bear is your Instagram account. Your boss. Your commute. The fluorescent lights you’ve been sitting under for eight hours while eating from a vending machine because there was nothing else and you didn’t have time anyway.

Your body is not safe to reproduce. Your body is not safe to digest or detox. Your body is running every non-essential process on minimal power until the threat passes.

The threat doesn’t pass.

When I was a teenager with debilitating period symptoms, no doctor ever said: get more sleep, eat real food, reduce your stress, get outside. They just handed me birth control, which suppressed my symptoms beautifully while everything causing those symptoms festered for another two decades.

By the time I was ready to have children, the damage was done - well… maybe, but that’s a story for another time.

I am not anti-medicine. I want to be very clear about that. If you have a bullet in your belly, there is nowhere on earth I would rather be than a U.S. operating room. Broken arm? Go.

But chronic disease - the stuff that is killing us at scale, the stuff that half the country is now drowning in - conventional medicine cannot cure that. It can suppress it. Manage the decline. Slow the bleeding. But it cannot teach your body to heal, because it was never trained to do that, and the cartel that controls its curricula has a vested interest in making sure it never is.

Nobody is coming to save you from this. Washington is not coming. Your doctor is not coming.

They are working with the tools they have, inside a system designed to get paid only for those tools, and they mostly believe they’re doing the right thing.

You have to become the authority on your own body - and if you think about it honestly - you already are.

Which is either terrifying or the most liberating thing you’ve heard all week. I’m told it depends on the person.

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If this kind of thing makes you furious (and it should), this is what we’re here for. Every piece I write is an attempt to hand you a weapon: something you can know, something you can do, some corner of this machine you can refuse to fund.