# Outlive: The Science and Art of Longevity

Outlive: The Science and Art of Longevity is a non-fiction health and wellness book authored by Peter Attia, a physician specializing in longevity, and co-written with journalist Bill Gifford. Published in March 2023, Outlive was listed on The New York Times Best Seller list in 2023 and 2024. The book is divided into three parts with 17 chapters in total, exploring various aspects of longevity.

## Synopsis

Outlive presents a guide to preventing age-related diseases and promoting longevity through lifestyle changes, emphasizing the importance of managing physical and emotional health. He sees longevity as encompassing two aspects: the length of life and the quality of life. Healthspan, a major theme in the book, refers to "the portion of life free from disability or disease." Attia identifies the "Four Horsemen" of aging as the primary causes of declining healthspan—heart disease, cancer, neurodegenerative disease, and type 2 diabetes. Attia advocates for early screening, personalized health management, and lifestyle adjustments such as improved sleep, regular exercise, a balanced diet, and emotional well-being. He integrates scientific research with practical, specific steps to optimize well-being and healthspan.

## Key themes
### Preventative healthcare

Attia promotes a proactive approach to healthcare, focusing on prevention rather than reactionary treatment. This includes early screening and personalized health strategies.

### Diet and nutrition

He argues that many people are consuming too many calories without considering the nutritional quality of their meals, which contributes to poor health outcomes and shortened healthspan.

### Exercise

He emphasizes the importance of intense exercise for maintaining health and longevity. He also stresses the significance of knowing and improving one's VO2 max, an indicator of cardiovascular fitness, to optimize healthspan.

### Modern healthcare critique

He is critical of healthcare in the United States's reactive approach to patient care, which often focuses on treating symptoms (Medicine 2.0). He would rather address the root causes of chronic illnesses (Medicine 3.0).

## Reception and reviews

Outlive has been extensively reviewed from many different perspectives. Bobby Stroup praises the book for its accessible insights into improving healthspan and mitigating diseases like Type 2 diabetes and neurodegenerative conditions. Stroup notes its limitations for those with unique health needs or older individuals. He praises the book for its storytelling and practical approach to personal health. Matthew Rees' review in the Wall Street Journal highlights the books focus on the need for proactive, prevention-focused healthcare practices to improve longevity through early screening, personalized nutrition, exercise, and emotional well-being. Another reviewer praised the book's approach to proactive healthcare. The Economist and Apple Books, among others, ranked it as one of the best books of 2023.
Some have criticized his advice and perspectives. One review by a trauma surgeon critiques his interpretation of the Hippocratic oath, where he dismisses it as an excuse for inaction. The reviewer argues that his reliance on an Emergency Room anecdote overlooks the principle that "do no harm" doesn't mean "do nothing". Additionally, the reviewer argues that his recommendations for medications and screenings lack strong evidence, posing risks that outweigh potential benefits.