Marty Makary, his successors, and the FDA on peptides

Marty Makary, a surgeon and former Johns Hopkins professor, was Commissioner of Food and Drugs from April 2025 to May 2026, the dates FDA itself now gives beside his name. The committee vote on peptides happened after he left. Much of what FDA said about peptides and compounding during his tenure came in agency notices rather than in his own words. This page separates the two.

What Makary said

Undark described his December 2025 answers as "open yet non-committal". We found no interview, hearing testimony or post in which Makary commented on BPC-157 or on the April 2026 Category 2 decision by name.

What FDA did while he was commissioner

• September 2025: the advertising crackdown, with "thousands" of letters and about 100 cease-and-desist letters. Warning letters posted that month included telehealth companies marketing compounded GLP-1s.
• 6 February 2026: the GLP-1 ingredient statement, which also said companies "cannot claim that non-FDA-approved compounded products are generic versions" of approved drugs.
• 1 April 2026: a compliance policy on "essentially copies" of approved GLP-1s, with a four-prescriptions-a-month threshold for 503A pharmacies.
• 15 April 2026: the announcement removing 12 peptides from Category 2 and scheduling committee review.
• 30 April 2026: the Commissioner renewed the PCAC charter for two years, to 25 April 2028.
• 1 May 2026: the proposal to keep semaglutide, tirzepatide and liraglutide off the 503B list.

The GLP-1 steps are covered on the GLP-1 compounding policy page and the dated FDA and compounded GLP-1s page.

His resignation

Makary resigned on 12 May 2026. NBC News reported that the departure followed months of friction with the White House, and that a source close to HHS leadership said he opposed the decision to authorise fruit-flavoured e-cigarettes. Reporting at the time did not link his resignation to peptides or compounding. President Trump named Kyle Diamantas, FDA's deputy commissioner for human foods and a lawyer, as acting commissioner.

Since May 2026

Diamantas led the agency through the July committee meeting and remained acting commissioner in October 2026. NBC News reported he declined the permanent job. On 19 August 2026 Trump said he would nominate Dr. Heidi Overton, a White House Domestic Policy Council official. The Senate Health, Education, Labor and Pensions Committee held her confirmation hearing on 24 September 2026. Coverage of the hearing centred on vaccines and mifepristone; we found no report that peptides were raised, and no committee vote had been reported when this was written.

We found no public statement by Diamantas or Overton on peptides. The agency's position since May has come through documents: the July briefing packages, which recommended against all seven peptides, and warning letters to online sellers of "research use only" products in June and August 2026.

What FDA's documents said about the process

The April 2026 action was framed narrowly. Law firms that read the announcement reported that FDA gave the nominators' withdrawals as the reason for removing the 12 peptides from Category 2, not new safety evidence. The July briefing documents opened with a standard caution: "The FDA does not intend to issue a final determination on the issues at hand until input from the advisory committee process has been considered and all reviews have been finalized." It added that "the final determination may be affected by issues not discussed at the advisory committee meeting." In other words, the agency told the committee, in writing, that its vote was one input among several.

Agency staff versus agency leadership

One feature of 2026 is that FDA's written record and its leadership's public direction were not the same. FDA's reviewers concluded, for each of the seven July peptides, that the balance of evidence "weighs against" listing. FDA's leadership had scheduled the meeting after Secretary Kennedy's public comments and after nominators withdrew from Category 2. Both are part of the record. Neither is the final word; that is a rule FDA has not yet proposed.

Where to look next

The Kennedy page covers the Secretary's statements, the committee page the July meeting, and the timeline the full sequence. For background on what the list is, start with the 503A explainer.

Rules change faster than most people's records. If you are on a prescribed peptide, the dose log keeps each dose with the product, the pharmacy and the concentration, and bloodwork sits on the same timeline, so a change of product or source is easier to plan with your prescriber. The peptide library grades how much research exists behind each compound, and that grading does not move when a committee votes. The app is on iOS and Android.