Everyone’s talking about the new food pyramid like it’s diet advice. I’m here to tell you it’s regulatory policy in disguise. In this episode I break down why this change matters beyond grocery aisles: school meal rules, food labeling, federal purchasing, and how the government quietly reshapes what counts as “healthy.” If you think this is just about fats and grains, think again. This affects prices, marketing claims, and what ends up on kids’ plates. I’m a food and drug lawyer focused on how policy becomes enforcement, and I’ll tell you what you need to know in straight language.

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Episode Description

In this episode, Darshan Kulkarni sits down with former FDA Commissioner Robert Califf for a wide-ranging conversation on FDA authority, politics, guidance, and public trust. From the loss of Chevron deference to the role of FDA as a referee, Dr. Califf explains how regulation really works and why wealth inequality has become the most serious health issue in the United States.

Episode Summary

What does it really take to run the FDA, and how political should the agency be? Former FDA Commissioner Robert Califf reflects on his path to the role, the skills a commissioner actually needs, and why FDA must act as an impartial referee rather than a political actor. The conversation explores guidance versus regulation, the loss of Chevron deference, industry expertise, the revolving door debate, and how social determinants of health shape outcomes far more than medicine alone. A candid, opinionated look at regulation from someone who has seen every side of it.

Key Topics Discussed

• How Dr. Califf became FDA Commissioner twice
• Why FDA should act as a referee, not a combatant
• Guidance documents and how they really function
• Politics, policy, and product level decision making
• Preparing for the loss of Chevron deference
• Wealth inequality as the biggest health problem in the U.S.
• Social determinants of health and FDA’s role
• Generic drugs, tobacco, and public health impact
• Digital health hype versus real-world impact
• The FDA–industry revolving door debate

Why This Episode Matters

As courts, politicians, and industry challenge agency authority, understanding how FDA decision making actually works matters more than ever. This episode explains what regulation can and cannot do, where political pressure becomes dangerous, and why ignoring inequality undermines health outcomes no matter how advanced the science becomes.

Guest

Robert Califf
Former Commissioner, U.S. Food and Drug Administration
Instructor in Medicine, Duke University

Dr. Califf has served twice as FDA Commissioner and brings decades of experience across clinical medicine, academia, industry, and government.

Host

Darshan Kulkarni
Founder, The Kulkarni Law Firm
Host, DarshanTalks

Call to Action

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GLP-1 weight loss programs are everywhere right now, especially in the med spa space. For M&A lawyers and deal teams, that popularity comes with serious regulatory risk.

In this episode, Darshan breaks down why GLP-1 compliance has quietly become a dealbreaker in healthcare acquisitions. What used to be framed as an FDA issue is now actively being enforced by state attorneys general using consumer protection and deceptive trade practice laws.

You’ll hear how the end of the FDA shortage changed what compounding pharmacies are legally allowed to do, why “research grade” GLP-1 products are not a workaround, and how recent enforcement actions in Alabama and Connecticut are reshaping diligence expectations.

This episode walks through the red flags buyers must catch before signing, including opaque supply chains, misleading marketing claims, research washing, and misaligned informed consent. It also explains why missing these issues can lead to asset freezes, injunctions, multi-state investigations, and massive post-closing remediation costs.

If you advise on med spa transactions, private equity healthcare deals, or GLP-1-driven growth strategies, this conversation is essential listening.

For deeper diligence support on GLP-1 programs and healthcare transactions, reach out to the Kulkarni Law Firm.

Subscribe for more conversations at the intersection of M&A, FDA regulation, state enforcement, and healthcare compliance.

Support the show

www.kulkarnilawfirm.com