Editor's note: This story has been updated to reflect subsequent reporting that found several fabricated academic studies listed among the MAHA Report's citations. It has also been updated since publication with a statement from pharmaceutical industry group PhRMA.
The White House has released its long-awaited “MAHA Report” outlining the government’s target areas for addressing childhood chronic disease: diet, environmental chemical exposure, physical activity/stress and “overmedicalization.”
The 72-page report, prepared by the Make America Healthy Again (MAHA) Commission—which is chaired by Department of Health and Human Services (HHS) Secretary Robert F. Kennedy Jr.—was ordered by President Donald Trump in February.
It serves as an initial assessment for the commission, which now has 82 days to develop a strategy document for realigning federal practices to address the four highlighted factors.
“After a century of costly and ineffective approaches, the federal government will lead a coordinated transformation of our food, health and scientific systems,” the commission wrote of its work in the report. “This strategic realignment will ensure that all Americans—today and in the future—live longer, healthier lives, supported by systems that prioritize prevention, wellbeing and resilience.”
The report’s takeaways largely align with RFK Jr.’s advocacy priorities prior to entering the administration, some of which he and other government heads have already instructed their departments to act on. Those conclusions have been contested by some healthcare and industry organizations, while reporting in the days following the report's release have flagged multiple citations of studies that either do not exist or mischaracterize the published research.
In a White House event held hours after the report's release, Trump described the findings around increased incidence of health conditions like obesity (affecting more than one child in five who is over 6 years of age) and autism spectrum disorder (1 in 31 children by age 8) as "alarming."
"Unlike other administrations, we will not be silenced or intimidated by the corporate lobbyists or special interests," Trump said of the findings and recommendations. "I want this group to do what they have to do. ... In some cases it won't be nice, it won't be pretty, but we have to do it."
Vaccine schedule scrutinized, pharma's 'corporate capture' denounced
Likely of immediate interest to the healthcare industry is the section on “The Overmedicalization of Our Kids.” It outlines increased utilization of prescription treatments with “proven harms,” such as psychiatric drugs that could have short-term adverse effects like seizures or antibiotics that could bring allergic reactions and contribute to antibiotic resistance development.
It also describes unnecessary treatments or those without benefit over placebo as a net harm, which the report said is the case when treatments are given for a misdiagnosis of conditions like attention-deficit/hyperactivity disorder or depression that “are diagnosed disproportionately in children relatively young for their school grade.”
Other treatments are highlighted due to “an important likelihood of undetected but potentially major long-term repercussions.” Among these are SSRIs used to treat depression and anxiety, stimulants for ADHD, GLP-1 drugs and “child chemical and surgical mutilation” (the terms used by the administration for some components of gender-affirming care).
But likely among the most controversial of the overmedicalization considerations come within roughly three pages exploring “Growth of the Childhood Vaccine Schedule.”
Echoing arguments from vaccine skeptics, including groups with which RFK Jr. has ties, the report says “there has been limited scientific inquiry into the links between vaccines and chronic disease, the impacts of vaccine injury and conflicts of interest in the development of the vaccine schedule.”
It calls for “more rigorous clinical trial designs” for childhood vaccines, says that vaccine manufactures as well as the HHS have conflicting interests when reporting injuries linked to vaccines and criticizes existing vaccine safety reporting systems as failing to capture a complete picture of potential harms.
Just this week, the Food and Drug Administration (FDA) laid out stricter COVID vaccine regulatory policy with a higher bar for approvals and recommendations among those under 65 with no risk factors for severe outcomes.
Additionally, the report describes the combination of states’ vaccine requirements for public schooling, public health initiatives to combat vaccine hesitancy and the policies of medical boards and professional organizations as a damper on childhood vaccine schedule scrutiny.
“This silences critical discussion, discourages reporting to safety systems and hampers vaccine research, and undermines the open dialogue essential to protecting and improving children's health,” the report said on the topic of “Scientific and Medical Freedom.”
The commission placed much of the blame for its overmedicalization claims on the pharmaceutical industry and “‘corporate capture,’ in which industry interests dominate and distort scientific literature, legislative actions, academic institutions, regulatory agencies, medical journals, physician organizations, clinical guidelines and the media.
To support the claim, the commission pointed to the billions spent on federal lobbying in recent decades, ties between professional association membership and pharmaceutical companies producing products for their specialties and industry contributions to government charity foundations. Direct-to-consumer advertising of pharmaceutical products, for which drug companies spent over $5 billion in 2023, is unique to the U.S. and can potentially increase inappropriate prescriptions, according to the report.
The commission also discounted the role of peer-reviewed journals as sources of scientific evidence. Drugmakers have a large role in funding clinical trials and could selectively provide data for researcher and reviewer analysis, the commission wrote, and editorials written for these journal can be biased.
Further, “peer review, the gatekeeping attribute that defines medical journals, is ineffective and biased; reviewers at top journals are untrained, ineffective when tested, and many have financial ties to drug companies,” according to the report.
PhRMA, an industry group representing pharmaceutical manufacturers, released a statement commending the administration's interest in children's chronic disease but stressing that "medicines are part of the solution, not the cause of chronic disease."
The statement also warned of "several untrue or misleading claims" included in the report. The industry group described its collaborations with academia and government researchers on medical research as a "unique open and transparent innovation ecosystem" that should be preserved to ensure America's global biopharmaceutical leadership. On overmedicalization, PhRMA said that any care decisions "should always be made with the guidance of doctors and parents' involvement."
The industry groups also described vaccines as the second greatest public health advancement behind clean water. They are "held to extremely high safety standards" that involve large-scale randomized, controlled studies "with an appropriate comparator" such as placebo or an existing vaccine.
"It's essential for public health and U.S. pandemic preparedness that we maintain a policy environment that supports continued advances in vaccines," PhRMA said in its statement.
Tina Tan, M.D., president of the Infectious Disease Society of America, similarly pushed back on the report's questioning of vaccine safety and referenced the ongoing measles outbreak as "a painful reminder of how dangerous inaccurate information can be to the health of everyone, especially infants and children."
During the afternoon event, Trump and RFK Jr. described the report and the commission's cross-department work as unique from prior public health efforts for its willingness to oppose industry influence on the subject of health.
"We will not allow our public health system to be captured by the very industries it's supposed to oversee," Trump said during the event.
Later, when discussing his recent most favored nation executive order, the president described drugmakers as "the most powerful lobby in the world. ... I'm not saying bad, good, I'm not saying anything. But they have tremendous power over the Senate, over the House, over the governors, everybody."
RFK Jr. added that it should be "common sense" to more heavily scrutinize industry-backed study results than independent research.
Ultra-processed foods, pesticides, Wi-Fi—but not smoking
Sections on the other three factors identified by the commission also have components in line with RFK Jr.’s advocacy and recent actions.
Fluoride, for instance, is recommended in the report for additional research as a potentially detrimental chemical exposure in reference to a 2025 peer-reviewed meta-analysis of studies conducted in other countries linking excess fluoride consumption to reduced IQ, though other recent international analysis finding no ties related to community water fluoridation were not referenced. The Environmental Protection Agency is currently conducting its own review to inform potential revisions to the federal drinking water standard, and the FDA has begun removing prescription fluoride supplements from the market.
Other environmental exposures of potential interest outlined in the report include microplastics; chemicals used in manufacturing such as bisphenols and phthalates; electromagnetic radiation from cell phones, Wi-Fi routers, cell towers and wearables; and pesticides used to protect crops. The latter earned a quick retort from farming groups, with the National Corn Growers Association describing the scrutiny of pesticides as “fear-based rather than science-based,” even as administration officials sought to shift blame from the agricultural industry in press events held immediately before and after the report’s release.
On nutrition, the report often points to the dietary shift toward ultra-processed foods and risks from certain food additives like food colorings or artificial sweeteners. The commission said current government dietary guidelines fail to address these while also blaming government programs such as the Supplemental Nutrition Assistance Program (SNAP) for “compounding the issue” by allowing purchases of non-nutritious foods.
State-level SNAP food restriction waivers, which are now being approved by the U.S. Department of Agriculture, starting with Nebraska, were a frequent talking point during the afternoon White House event.
The portion of the report focused on children’s declining physical activity and “mental health crisis” points to factors such as insufficient sleep, screen time, loneliness and social media.
Separate from the upcoming federal strategy document, the commission concluded the report with several recommendations to promote “gold-standard scientific research.” These included the implementation of new post-marketing surveillance systems, new drug safety studies for pediatric drugs, funding for long-term nutrition trials and large-scale lifestyle interventions, among others.
The MAHA Report's takeaways are primed to serve as the backbone of upcoming health policy, amplifying concerns that the findings aren't built on a solid foundation.
A report from NOTUS published a week after the MAHA Report highlighted seven citations that do not appear to exist, according to the listed authors and the studies' listed journals. Among these were studies purporting to describe anxiety and substance use, overprescription among children with asthma and direct-to-consumer drug advertising. NOTUS also flagged other described "dozens" of papers with citation errors and others in which study authors said their work was misinterpreted.
Further, the report has noteworthy omissions on children’s health previously flagged by health researchers, including those from government agencies such as the Centers for Disease Control and Prevention.
Maternal health and preterm birth, for instance, have often been cited as worse in the U.S. compared to other nations and can have lifelong influences on children’s development.
Gun violence, the leading cause of death for children and teens from 2020 to 2022, was not mentioned.
The recreational use of addictive substances such as nicotine, alcohol and opioids were also excluded—noteworthy amid the HHS’ recent cuts to smoking cessation programs and education.
Another contrast with recent action is the topic of lead exposure. The report notes lead ingestion among infants as a long-known risk and references data showing a 90% reduction since the 1970s but does not list lead exposure among key action items. Recent cuts among HHS teams and the Childhood Lead Poisoning Prevention Program, meanwhile, have made it difficult for the government to act on new lead exposure crises, an issue RFK Jr. appeared to be unaware of during a recent hearing.
Several statistics cited in the report around increased utilization of different types of prescription drug treatments are not paired with information on diagnostic rates or changes in diagnosing practices. When increased diagnoses are referenced alongside higher treatment rates, they are often presented in the context of false diagnoses and unneeded medications. This is the case for ADHD and other mental health conditions such as depression and anxiety, for which researchers have noted rising awareness and recent stressors like the COVID-19 pandemic have played a role.
The Alliance of Community Health Plans (AHCP), which represents nonprofit insurers, said it welcomed the report and “its urgent focus on reversing the rising tide of chronic disease among America’s children.”
“ACHP’s member plans support Secretary Robert F. Kennedy Jr.’s priorities for a more transparent, efficient and high-quality health sector, and we stand ready to partner with the MAHA Commission to advance evidence-based and community-driven solutions,” the group said.