This is a difficult book to review.

Firstly, I didn’t understand all of it. I think I got the vibe of all the medical and scientific language that pops up in certain chapters. But I was out of my depth in some of the technical details. I don’t think that mattered too much.

Secondly, from what I’ve read elsewhere, this seems like a somewhat polarising book. There are those who love his approach, and others who condemn its lack of scientific evidence or its lack of humility. I think both those critiques are a little misguided on what Attia’s purpose is for writing this book.

It’s easy to read the title (not that I’m accusing negative reviews of stopping there!) and think this is another arrogant scientist attempting to play god and live forever. That’s not what he is trying to do. I think he mentions it throughout the book in little snippets, but for me it took until the very last chapter – a tangential chapter compared to the rest of the book that focussed on emotional health – before I thought I understood how it all fit together.

Outlive is built on a simple premise: current medicine (what he, somewhat pretentiously, calls medicine 2.0) is focussed on helping sick people get healthy. Medicine 3.0 (his catch-all for his thinking) is focussed on helping healthy people stay healthy. Pre-emptive medicine, if you will.

Where it all unlocked for me in the final chapter of the book was his summary of purpose. The aim is not simply to live longer. The aim is to live well for as long as possible. There is no point in living a long life if you are miserable. So firstly, learn to live well in the present. And then learn how to extend that for as long as you can.

Over the course of the book, Attia addresses the four big killers: heart disease, dementia, cancer and diabetes. And, of course, he calls these the ‘four horsemen’. (At times, his overly dramatic language gets a little tiresome). He then outlines how exercise, nutrition, sleep and emotional health each contribute toward lowering the risk of each of these conditions. Overall, it’s a fascinating read, and I felt I had much to learn.

Who wrote it

Peter Attia is a doctor and popular podcaster on medicine and health.

Why I read it

I enjoy reading the occasional popular science and/or self-help book. This one had been in my periphery for a while, and I found it on Spotify when looking for something to listen to in this genre.

What I liked

It was certainly interesting. He provides detailed accounts of how the big four killers physiologically work in the body. It was fascinating, and almost worth reading just for those.

I found it to be reasonably consistent throughout the book in drawing my curiosity to continue reading. I really appreciated his attempts to not avoid the technical details, but also try and distil it down for the less educated reader (which I believe was the reason Bill Gifford was brought onboard to assist with the writing). I walk away with a fair degree of clarity from what I did understand.

It was really the final chapter that I think reframed my whole sense of the book. Perhaps it was simply because the subject of emotional health is of particular interest to me. I don’t know if it would have the same effect for all readers. It felt like it added a dimension of humility to the whole process. He shared some of his personal life story in that chapter, and that certainly had a more personal resonance with me than the rest of the book. Understanding something of his journey gave me a much better appreciation for what he attempts to do with this book. Strangely, I don’t think it would have had the same power had the final chapter been moved to earlier in the book.

What I didn’t

I frequently found myself out of my depth in the technical discussions in this book. I could make sense of the broad arguments. But, at times, it felt too dense in the details to be accessible to the average reader.

A common critique of the book is it’s lack of scientific evidence to back up his argument. I think this is perhaps a little overstated by critics. However, there certainly is a fair degree of speculation at points. It’s interesting, but it’s far from conclusive. I think some of the worst examples are towards the beginning of the book. This is unfortunate, as it tends to be where he receives a lot more criticism, and perhaps prevents people from getting to the end. His stories about his own journeys in medicine, and how he reached the point of writing this book, are a little over-dramatic at times, and sometimes even sounds incorrect or incoherent. Not enough to undermine the book as a whole. But he does himself no favours in building up the ‘drama’ over the first few chapters.

Although the book maintained my curiosity, it still felt like a little bit of a slog at times through the middle. Thankfully, they never seemed to last too long.

Major Takeaway

Succumbing to ill-health in our later years of life need not be the foregone conclusion that we think it is. It is entirely possible to remain quite active and healthy in old age through careful planning and pre-emptive action (and a little luck!). There’s some useful stuff in the book on habits of health, but perhaps my personal biggest one was on the importance of strength training. Strong muscles and balance are highly significant for good health later in life. This is probably the point that will stick with me and (hopefully!) shape some long-term habits.

Who should read it

I read Matthew Walker’s Why We Sleep last year, and that was a brilliant and life-altering book for me. Outlive is certainly not in the same category. But in its own way, it has sat with me the past few weeks, and gently nudged me in a direction towards greater health. For that alone, it was worth reading. If you’re looking for an interesting read on the subject of health, Outlive ticks many boxes. I think it steps outside the boundaries of science a little too frequently to make it a must-read. And I’m certainly not knowledgeable enough to determine the accuracy of all his claims. But I do think there is something worthwhile here, particularly for those not well versed in the subject of health, but with a curious interest.