I was about 12 years old and I was again standing in the middle of the grocery store, clutching a crumpled twenty-dollar bill. If we were lucky, that’s the amount of money my dad would drop off each day to feed us. It was all we had to cover the food my family would eat that day and maybe even the next one. Twenty dollars for three people. My mom, my brother and I would walk the aisles counting every item, doing math on scraps of paper, putting things back on the shelf when the numbers went above twenty.
Fresh berries? Too expensive. A pack of chicken breasts? Usually out of reach. I quickly learned that certain foods like vegetables, fruit and meat were items for other people. What we could afford was pasta, canned chickpeas, jarred sauce, a loaf of bread, a head of iceberg lettuce and maybe some cucumbers if they were on sale. I became a childhood master at helping to stretch our dollars and meals.
My mom doesn’t drive and we didn’t have a car, so we walked everywhere. So yes we walked a lot, but not because we were making a “healthy lifestyle choice”. Instead, we had no other option to survive.
There was no gym, no running shoes that fit right, no new exercise clothes, no meal plans full of fresh or organic produce. Just long walks to the store and long walks home with plastic bags cutting into our arms. Sometimes they would break open on the side of the road and we would scramble to save our food.
It was hard. I was always bone deep exhausted, my joints ached, I experienced recurring stomach problems and I had frequent headaches. I was eventually diagnosed with an autoimmune disease at 16 (not surprising given my family's genetic history). By medical charts, and by Secretary Kennedy’s standards, I also would have been classified as obese.
I want to pause here, because I know that word is loaded. I am not making a blanket statement that every person labeled obese is automatically unhealthy. What I am saying is that in my particular case, my combination of health challenges reflected a body struggling .
Now, looking back, it’s clear to me that these health issues were tied to many complicated things — like genetics and the living conditions wrapped around my life. It was not just because of my weight. It was also related to the food I had access to, the chronic stress we lived under, the lack of healthcare and likely other factors (health is more complicated than MAHA wants you to think).
It’s this personal experience that made me deeply sad and angry when the Trump Administration released the Make America Healthy Again (MAHA) report in May.
If you just skim it, you’ll notice it names many of the same challenges I lived through as a child. Poor diet, lack of consistent exercise and chronic stress. It also points to environmental chemicals, use of too many medications and corporate influence as culprits.
But here’s my problem with it. The report frames health as though it can be fixed by adjusting diets, limiting screens, cutting out certain food additives or simply reducing prescriptions. IT’S NOT THAT SIMPLE. It largely ignores the conditions that make those things inescapable for so many families.
In other words: MAHA names some symptoms that may or may not be significant, but sidesteps the systemic changes needed to actually fix the issues they say they care about.
The Bigger Picture: Food Insecurity in America
My childhood wasn’t specific to me, sure some aspects of my life were pretty hard and quite unusual, but not my food worries. Millions of families today live the same reality I did. They worry every single day about what food they’ll be able to eat.
According to the USDA, more than 47 million Americans, 14 million of whom are children, lived in food-insecure households in 2023. Food insecurity means they lack consistent access to enough food to live an active, healthy life. In practice, this often looks like what my family experienced, people fill grocery carts with calorie-dense but nutrient-poor foods because that’s what they can afford.
Not everyone faces the burden of food insecurity in the same way. Often, households with children, single-parent families and communities of color face greater burdens. This then also impacts their health outcomes. Children who experience food insecurity are more likely to develop chronic conditions like asthma, anemia, and developmental delays. Adults in food-insecure households face higher risk of diabetes, hypertension and heart disease.
On top of that, where you happen to live matters. The USDA estimates that more than 18 million Americans live in food deserts. These are areas where affordable fresh food is scarce or inaccessible. In rural towns, like the one where I grew up, a family might have one small grocery store with limited produce and higher prices, or maybe none at all. For families like mine who didn’t have a car, even getting to that store can be a barrier.
And the costs keep rising. Since 2020, the price of groceries jumped by more than 28.3%. Families who were already counting their pennies are now facing a reality where those pennies don’t buy them as much food. That means even more reliance on pasta, processed bread and shelf-stable foods. This isn’t because people don’t know vegetables are good for them. Even I, at 12, knew that they were what I was supposed to be eating more of! Instead, it’s because they are making the tough decisions between more vegetables and kids going to bed hungry OR less veggies and full.
When you put these numbers next to the MAHA report, the true issue becomes clear. Yes, ultra-processed foods and chronic stress may be a part of the problem. But many people impacted by these issues are navigating food deserts, low wages, high rent and broken social safety nets. Until we actually face and deal with those realities, no amount of ingredient bans or individual behavior change will Make America Healthy Again.
Is this what the administration is focusing on though? No. Instead of tackling systemic changes needed to improve our health, they’re actually making it worse.
The “One Big Beautiful Bill” that was passed this summer cut the supplemental nutrition assistance program (SNAP), Note, SNAP fraud is rare, regardless of what anyone will tell you (here’s a great post with more).
The congressional budget office has stated that these cuts proposed will worsen food insecurity. An estimated 2.4 million Americans will lose benefits. This will not improve health, instead it will worsen health outcomes. This is just one example of policies being enacted by this administration that will harm, not help, the health of Americans. I’ve talked about another example here.
One common argument I see is that people want help to come from the church or other community organizations instead of the government. My family wasn't on SNAP, for complicated and quite dramatic reasons (stories for the future). So, we didn’t use this system. However, the church we went to also barely did anything to help us. This isn’t all churches, but my experience has taught me we cannot expect that alone to fix the issue. We need systemic changes.
When What If Becomes What Is
These days, my life looks very different. My medical chart no longer classifies me as obese. My autoimmune issues are mostly in remission. I don’t have daily headaches. I have resources my mother didn’t.
When I walk into the grocery store with my own two children, I don’t have to do mental math on scraps of paper. Instead, I am lucky enough to be able to buy lots of fresh fruit without worrying it will mean going without a meal. My fridge holds vegetables, eggs, yogurt and chicken. I can afford to sign my kids up for sports, let them play in safe parks and buy them shoes that fit when they outgrow the old ones.
My kids don’t know what it’s like to stare at the shelves and wonder if dinner will be enough (and my goodness am I so grateful for that). They get to eat fresh picked strawberries in June, Maine blueberries in August and bake apples they themselves have picked in October. They get to move their bodies because there are sidewalks, playgrounds and bikes waiting for them in our garage. They have regular check-ups. They are up to date on their vaccines. They are happy and they are healthy. Their childhood looks like those “what-ifs” I only occasionally dared to dream about growing up.
And that's what every single child deserves. Not just mine. Not just kids in America. Not just kids in families with stable jobs, safe housing or who happen to have insurance cards in their wallets. Every kid should have the chance to grow up with nourishing food, clean water, safe spaces to play and the stability to dream about more than just getting through another week.
I can give my children this life I didn’t have, because when the systems around me failed, amazing people saw my potential and helped me escape. I worked hard, yes. But hard work never would have been enough on its own. Neither would have removing red food dye or seed oils.
I never could have worked hard enough or ate healthy enough to escape the system I was born into. I never would have figured out how to apply to college, survived college, moved to Maine for grad school, discovered a love of hiking and running and gotten a handle on my health if I didn’t have that initial help (a bit more about that here and here).
This is just one of the reasons why I push back on MAHA. Real health is about building a country where healthy choices are actually possible for everyone. My children get to live that reality now. But when will we decide that all of our children deserve the same?
A Question for All of Us
So I’ll leave you with this:
When you hear our leaders talking about health, do they focus on individual choices or ingredients, or instead do they talk about the conditions that shape those choices?
What would it look like if we designed our government and health policy for families that were like mine when I was growing up?
Until we start answering these types of questions, no slogan or ingredient ban will actually MAHA.
For the Instagram version see below:
Xoxo,
Liz
P.S. I am a long time admirer of Sharon McMahon and she posted the below on Instagram a few months ago. I think about it a lot in all aspects of life. And today’s post reminded me of it as well. The problem is big, but we still need to act.
I’m doing a lot of work these days, and I’m committed to keeping my science content freely available to everyone—but if you find value in what I share and have the means, I’d be so grateful if you considered upgrading to a paid subscription. If that’s not possible right now, no worries at all—I’m just glad you’re here. ❤️
This has me bawling 😭 the way you wrote this, I could picture it all and it was so moving. Thank you for sharing. I wish NPR would have you on one of their podcasts to talk about this ❤️
Elizabeth, thank for you telling this very moving story! It hurts to read because it's so true! And so many families are suffering.
Not to mention the families who, in addition the challenges you describe, have a child with a severe developmental disability. Despite words that might sound good at first, nobody is actually doing anything to improve their lives.