Americans are known around the world for two things: being the fattest country on Earth, and being the most medicated by a wide margin. Our adult obesity rate is 42.9%. Japan’s is under 5%. Most American adults take at least one prescription drug every day, and more than one in five takes five or more. That’s a nation on maintenance.
You’ve felt it. You try to eat right and it never feels like enough. You read labels and half the ingredients require a chemistry degree. Your kids come home from school with lunch barely touched, and you wonder if what the cafeteria served qualifies as food. Then you, or your parents, or your spouse end up on another prescription. And then they need another prescription to help manage the side effects of the first prescription. It’s like the little old lady who swallowed a fly. It feels like nothing you do on your side of the fence is winning.
That isn’t in your head. The cards are stacked and they’re stacked by design.
The Food and Drug Administration is one federal agency with two jobs. Job one: decide what’s safe to eat. Job two: decide what’s safe to take as medicine, after eating what job one approved gave you diabetes, obesity, cancer, and a chronic inflammatory condition.
Anyone looking at this setup for the first time would call it a conflict of interest so obvious it should be criminal. The American public is the testing base for poor-quality food on one side of the agency and massive prescription drug demand on the other. Both sides of the agency win. We lose.
Both political parties have their reasons to leave the FDA alone. Both parties should be furious instead. Here’s why this is broken, why it isn’t a left-versus-right issue, and what I think we should do about it.
What the FDA actually does, and how it’s funded
The FDA is one agency with roughly a $7.2 billion annual budget. The way that budget breaks down is where the problem starts.
About half, roughly $3.5 billion, comes from what the agency calls “user fees.” Those aren’t taxpayer dollars. Those are fees paid directly to the FDA by the pharmaceutical industry to review the pharmaceutical industry’s own drugs.
That arrangement started in 1992 with the Prescription Drug User Fee Act (PDUFA). Every reauthorization since has expanded it. As of 2026, roughly two-thirds of the FDA’s drug review activity is funded by the companies whose drugs are being reviewed.
Sound like a conflict of interest? We’re just getting started.
Imagine a judge whose salary comes from the defendants they rule on. Now imagine every case that judge hears is life-or-death for a company that just wrote them a check. That’s the FDA’s drug side, delivered plainly.
Now the food side. Food manufacturers don’t pay user fees to the FDA. Never have. Food industry trade groups have blocked every serious attempt to require them, going back decades. So the food side of the FDA runs on whatever taxpayer money is left over after the drug side is fed by industry.
Sit with that for a second. The FDA takes billions from pharma to review pharma’s products, and pennies from taxpayers to review food. That isn’t conspiracy theory. That’s the FDA’s own budget document.
The GRAS loophole: the food side barely regulates
There’s a legal category called Generally Recognized as Safe, or GRAS. Under GRAS rules, a food manufacturer can add a chemical to your food WITHOUT any FDA review, as long as the manufacturer, or a consultant the manufacturer paid, decides the chemical is generally recognized as safe.
Between 2000 and 2021, nearly 99% of new chemicals introduced into the US food supply came through GRAS notices, not through FDA review. That isn’t an oversight. That’s the design.
You’re essentially trusting the food industry to police itself on additives, colors, preservatives, and processing agents. And the food industry is paid by results, which are measured in sales, not in how healthy their customers are.
So the only time we find out an added chemical is dangerous is after enough people have been hospitalized, seriously sickened, or killed by it to force the issue.
What ends up on your plate
Here’s a partial list of things sitting in the American food supply right now that are banned or heavily restricted in Europe:
- Titanium dioxide (whitener used in candy, dressings, and dairy). The European Food Safety Authority banned it in 2022 after determining it could damage DNA.
- Potassium bromate (used to make bread dough more elastic). Classified as a possible human carcinogen. Banned in the EU, UK, Canada, Brazil, and much of the world. Still legal in US bread.
- BHA and BHT (preservatives with potential endocrine-disrupting effects). Restricted across many EU food categories.
- Brominated vegetable oil (a flame-retardant additive that used to sit in some citrus sodas). Banned across most of the world for decades. The FDA finally caught up in 2024, with the US ban taking effect in 2025.
- Red Dye No. 3. Banned in European food for years. The FDA finally banned it in January 2025, after decades of thyroid tumor evidence in animal studies.
The FDA’s official position on many of these is that the science doesn’t yet warrant a ban. Europe’s position is that if the science can’t yet prove safety, it doesn’t go in food until it can. That’s the difference between “innocent until proven dangerous” and “not allowed until proven safe.” Guess which framework the US uses.
What ends up in your medicine cabinet
Ultra-processed food consumption increases the risk of developing diabetes by 37%, hypertension by 32%, and obesity by 32%, according to peer-reviewed research. In the US, ultra-processed foods make up more than half of the average adult’s daily calories.
You know what treats diabetes? Drugs. Ozempic. Mounjaro. Wegovy. Metformin. All approved by the FDA. All reviewed with drug-side money.
You know what treats hypertension? Drugs. Statins. ACE inhibitors. Beta blockers. All approved by the FDA.
You know what treats obesity? Drugs. Increasingly, weight-loss medications marketed for chronic long-term use. All approved by the FDA.
I’m not saying these drugs shouldn’t exist. Many save lives, and for a lot of families, one of them is the difference between a normal life and a serious emergency. What I’m saying is this: the FDA lets your food make you sick, then collects billions from the drug companies that sell you the pills to treat it.
If it wasn’t all of our lives on the line, I’d have to say that’s one hell of a business model.
The fix: split the FDA into two competing agencies
Split it. Two independent, competing agencies. Call them whatever you want. Food Safety Administration and Drug Safety Administration. Give each of them:
Different funding models. Food regulation gets funded through general taxation. Any fee-based option is limited to inspection and facility registration, never approval decisions. Drug regulation keeps the user-fee model, but the fee revenue gets capped at a percentage of the drug agency’s total budget so industry money never dominates.
Different missions. Food agency mission: prevent chronic disease driven by the food supply, and keep questionable ingredients OUT of the market until they’re proven safe. Drug agency mission: ensure drugs are safe and effective for their approved use. These are fundamentally different jobs and should not report to the same commissioner.
A structural adversarial relationship. When the drug agency approves a new drug to treat something the food agency should have prevented, that becomes a red flag on the food agency’s record, publicly. Reward the food agency for the outcomes people don’t need drugs for. Reward the drug agency for approval speed AND long-term safety data.
Right now, both sides win when Americans get sick and stay sick. That’s the design defect. Split the agency, split the incentives, and the two halves start pulling in opposite directions. That’s the whole point.
Why this isn’t a partisan proposal
Both sides of the aisle have their version of this critique. It’s worth unpacking each, because both point at the same structural flaw, and neither party has actually fixed it.
The right calls it regulatory capture and industry sweetheart deals. Regulatory capture is when the agency that’s supposed to watchdog an industry ends up working for that industry instead. The clearest recent example is Boeing and the FAA. Boeing’s own engineers were allowed to self-certify the safety software on the 737 MAX, because the FAA didn’t have the budget or the expertise to check the work themselves. Two crashes. 346 dead. That’s what regulatory capture looks like when it’s finished cooking.
The FDA is running the same play on the drug side, just quieter. When two-thirds of drug review activity is paid for by the drug companies whose drugs are being reviewed, the reviewers are working next to the check-writer. Sweetheart deals follow naturally: faster approvals for well-connected companies, softer enforcement on the biggest players, quiet exemptions on inconvenient rules. This isn’t a conspiracy. It’s what any organization looks like when its paycheck depends on keeping specific people happy.
Republican administrations have tried to address this with deregulation, executive orders limiting the revolving door, and pressure to justify existing rules. None of that touches the funding structure. So the capture persists no matter which party controls the White House.
The left calls it corporate influence and public health failures. Corporate influence is the political-money version of the same story. Pharma spends more on federal lobbying than any other US industry, funds patient advocacy groups that push for faster drug approvals, and pours resources into campaigns on both sides of the aisle. That influence buys quiet on the food side (blocking food-industry user fees for thirty years, protecting the GRAS loophole) and buys momentum on the drug side (protecting PDUFA reauthorizations, expanding the user-fee model). Public health failures are what the country pays for it: chronic disease rates that lead the developed world, drug approvals that get pulled years later after the body count adds up, and a food supply that produces exactly the illnesses the drug pipeline treats. Democratic administrations have tried to address this with bigger enforcement teams, tougher marketing rules, and more transparency in the approval process. None of that touches the funding structure either. So the incentive to keep the drug pipeline moving keeps winning.
Here’s the conspiracy theory
To a normal person looking at this from the outside, the fix is obvious. Split the agency. Kill the funding conflict. Stop letting the same building make you sick and then charge you to get better. It doesn’t take a policy expert to see it. Any twelve-year-old could draw the org chart.
So why hasn’t it happened?
The uncomfortable answer is that everyone with the power to fix it is doing fine under the current setup. FDA commissioners leave for board seats at the same drug companies they used to regulate. Members of Congress get campaign checks from pharma and speaking fees from food-industry associations. Former staffers become lobbyists. The industry writes the rules, funds the agency, and hires the referees the moment those referees take the whistle out of their mouth. Nobody at the top is actually trying to lose that gravy train.
Pick your flavor of explanation: deviousness (they know exactly what they’re doing and don’t care), acceptance (they’ve decided this is just how Washington works), or incompetence (they don’t grasp the incentive problem well enough to see the obvious fix). Whichever one you pick, the result is identical. The bodies keep stacking up on the food side. The prescription counts keep climbing on the drug side. And the fix keeps not happening.
That’s the conspiracy theory. And it’s not much of a theory when the campaign donations and the post-agency board seats are all public record you can look up yourself.
Both sides describe it. Nobody fixes it.
The fix of separating the FDA into two agencies hasn’t been proposed on either side because it doesn’t fit inside either party’s usual toolkit. It’s not deregulation and it’s not more enforcement. It’s a structural rebuild that changes who writes the check.
Personally, I don’t care who signs the bill. Democrat, Republican, bipartisan coalition, all fine by me. What I care about is that we stop pretending it’s normal to have one federal agency profit from the disease it enables.
Americans, of every political stripe, deserve better than that.
What you can do while we wait
You can’t split the FDA yourself. But you can:
- Read food labels. Pay attention to which ingredients your family is actually eating.
- Write your representatives. This is one of the rare issues where a well-written letter to your congressperson might actually land.
- If a family member is on multiple daily medications for chronic conditions and you’re wondering whether all of that is really necessary, work with your doctor to look at the food side too. Doctors are starting to talk about this openly. Nutritionists have been talking about it for years.
The system is finally catching up to what our grandmothers already knew: food is either medicine, or the reason you need medicine.
If you want help sorting through your family’s healthcare situation, including how coverage handles preventive care, nutrition counseling, and prescription drugs, book a healthcare review with us. We’ll walk through what’s covered and what your options actually look like, in plain English.
Sources: FDA budget documents and PDUFA reauthorization data; BMJ umbrella review on ultra-processed foods (2024); NRDC and JAMA analyses of GRAS notifications; European Food Safety Authority rulings on titanium dioxide (2021), Red Dye No. 3, and potassium bromate; CDC NHANES adult obesity and prescription drug use data; OECD international comparison data.
