If you’ve ever swallowed an aspirin, put milk in your coffee, fed your pet, or filled a prescription, then you’ve relied on the lifesaving oversight of the U.S. Food and Drug Administration. Long viewed as the world’s gold standard in regulating food and medicine, the FDA is a behemoth that oversees products comprising roughly one quarter of the U.S. economy.
Even on the best of days, the FDA commissioner — a Senate-confirmed position — must wander a pitiless wilderness of excruciating judgement calls, whether the record-speed approval of Covid-19 vaccines or the minefield of mail-order birth control pills, all while fending off powerful companies expecting VIP treatment.
Doing the job well, or even at all, is not a friend-building exercise.
After days of being dangled like a cat toy between warring parties in the White House and the Department of Health and Human Services, which oversees FDA, news broke on Tuesday that President Donald Trump’s embattled FDA commissioner, Dr. Marty Makary, a Johns Hopkins surgeon, was resigning.
Attention immediately turned to the question of which towering medical figure might step into the job. Soon after Trump posted Makary’s resignation text to Truth Social, Kyle Diamantas, 38, an obscure Florida lawyer who first landed at the FDA in 2025 as director of the human foods program, following his previous role as Don Jr.’s hunting buddy, was named acting FDA commissioner.
In March 2021, Don Jr. and Diamantas posed holding dead Osceola wild turkeys, as I had first reported. Mike Tussey, the founder of the hunting outfit Osceola Outdoors, described the scene on X as: “Don Jr. With his good friend Kyle Diamantas! Kyle’s first Osceola!” A picture of Trump Jr., Diamantas, and Tussey, with a single turkey, is featured on Osceola Outdoors’s website.
How you get from hunting turkeys with the president’s son, to overseeing 1,000 employees in the FDA’s human foods program, to serving as acting FDA commissioner is a story whose outlines have become familiar throughout Trump’s second administration, where being buddies with the right people is a qualification in and of itself.
It is perhaps testament to the current state of the FDA that Diamantas was the only deputy commissioner who could credibly assume the role, says Susan Mayne, professor adjunct at Yale School of Public Health, who served as the FDA’s director of food safety and applied nutrition from 2015 to 2023. “Mr. Diamantas is not an MD. It’s an unusual choice. But given the circumstances, it’s the logical choice.”
After DOGE staff cuts devastated the agency, and ongoing turmoil has led scientists to leave in droves, the FDA organizational chart has been denuded of leadership. And in an FDA wracked by diva-style personnel eruptions, Diamantas had a “more balanced style of leadership,” says Mayne.
In what should have been a sober regulatory environment, under Makary’s stewardship, chaos was often the headline. There was the director of the Center for Drug Evaluation and Research, George Tidmarsh, who was forced to resign, after allegedly using his regulatory role inside the agency to pursue a vendetta against a former business partner.
And there was Vinay Prasad, who served as director of the FDA’s Center for Biologics Evaluation and Research, who roiled the pharmaceutical industry — and his own staff — with an abrasive leadership style and peremptory rejection of certain drug applications.
Amid innumerable battles, it was ultimately a fight over fruit-flavored vapes that ended Makary’s tenure, after Trump had a “fateful lunch” with tobacco industry executives seeking approval for their products, an FDA official says.
The White House was exerting pressure on the FDA to approve the products and Makary was resistant, given that such products would clearly appeal to kids. “It was the end of the rope for him,” says a Makary associate. “He didn’t want to sign off on candy flavors.”
But ultimately he did sign off, albeit too late to save his position. Trump thanked him on Tuesday in a social media post, writing, “He was a hard worker, who was respected by all, and will go on to have an outstanding career in Medicine.”
Diamantas has the job on a temporary basis for now, and anyone tapped to fill it permanently would need to sit for Senate confirmation hearings. One name that has emerged as a possible candidate is Admiral Brett Giroir, a pediatrician who served as the assistant secretary for health at HHS during the first Trump administration, and oversaw diagnostic testing during the Covid pandemic. Giroir, reached by Rolling Stone on Tuesday, declined to comment.
It’s unclear if or when Trump will nominate someone, though, and there’s no telling how long Diamantas could wind up overseeing the FDA on an acting basis.
