The Peter Attia Drive

Improve your decision-making, frameworks for learning, backcasting, and more | Annie Duke (#60 rebroadcast)

The Peter Attia Drive

View the Show Notes Page for This Episode Become a Member to Receive Exclusive Content Sign Up to Receive Peter’s Weekly Newsletter In this episode, former World Series of Poker champion and author Annie Duke explains how poker is a pertinent model system for decision-making in the real world, a system which blends imperfect information with some unknown percentage of both luck and skill. Annie breaks down the decision-making matrix, revealing how we often focus too narrowly on just one of the four quadrants, missing out on valuable learning opportunities in the remaining 75% of situations. She delves into how our tendency to evaluate only negative outcomes leads to a culture of risk aversion. This mindset, she argues, stifles the kind of bold decision-making necessary for progress and innovation across various fields, from poker and sports to business and medicine. Annie also introduces a robust framework for learning and the levels of thought required to excel in any domain. Finally, she discusses a strategy called “backcasting”, a concept that resonated deeply with Peter in terms of how he thinks about extending healthspan. We discuss: Annie’s background, favorite sports teams, and Peter’s affinity for Bill Belichick [1:30]; Chess vs. poker: Which is a better metaphor for decision-making in life (and medicine)? [6:45]; Thinking probabilistically: Why we aren’t wired that way, and how you can improve it for better decision-making [12:30]; Variable reinforcement: The psychological draw of poker that keeps people playing [19:15]; The role of luck and skill in poker (and other sports), and the difference between looking at the short run vs. long run [32:15]; A brief explanation of Texas hold ‘em [41:00]; The added complexity of reading the behavior of others players in poker [47:30]; Why Annie likes to “quit fast,” and why poker is still popular despite the power of loss aversion [52:45]; Limit vs. no-limit poker, and how the game has changed with growing popularity [55:15]; The advent of analytics to poker, and why Annie would get crushed against today’s professionals [1:04:45]; The decision matrix, and the “resulting” heuristic: The simplifier we use to judge the quality of decisions —The Pete Carroll Superbowl play call example [1:10:30]; The personal and societal consequences of avoiding bad outcomes [1:21:45]; Poker as a model system for life [1:31:30]; How many leaders are making (and encouraging) status-quo decisions, and how Bill Belichick’s decision-making changed after winning two Super Bowls [1:35:15]; What did we learn about decision-making from the Y2K nothingburger? And how about the D-Day invasion? [1:39:30]; The first step to becoming a good decision maker [1:43:00]; The difference between elite poker players and the ones who make much slower progress [1:49:45]; Framework for learning a skill, the four levels of thought, and why we hate digging into our victories to see what happened [1:52:15]; The capacity for self-deception, and when it is MOST important to apply four-level thinking [2:00:30]; Soft landings: The challenge of high-level thinking where there is subtle feedback and wider skill gaps [2:11:00]; The benefits of “backcasting” (and doing pre-mortems) [2:13:30]; Parting advice from Annie for those feeling overwhelmed (and two book recommendations) [2:21:30]; and More. Connect With Peter on Twitter, Instagram, Facebook and YouTube

#315 ‒ Life after near-death: a new perspective on living, dying, and the afterlife | Sebastian Junger

The Peter Attia Drive

View the Show Notes Page for This Episode Become a Member to Receive Exclusive Content Sign Up to Receive Peter’s Weekly Newsletter Sebastian Junger is an award-winning journalist, bestselling author, and previous guest on The Drive. In this episode, Sebastian returns to discuss his latest book, In My Time of Dying: How I Came Face to Face with the Idea of an Afterlife. This episode delves into Sebastian's profound near-death experience and how it became the catalyst for his exploration of mortality, the afterlife, and the mysteries of the universe. They discuss the secular meaning of what it means to be sacred, the intersection of physics and philosophy, and how our beliefs shape our approach to life and death. He also shares how this experience has profoundly changed him, giving him a renewed perspective on life—one filled with awe, gratitude, deeper emotional awareness, and a more engaged approach to living. We discuss: How Sebastian’s near-death experience shaped his thinking about mortality and gave him a reverence for life [3:00]; The aneurysm that led to Sebastian’s near-death experience [6:30]; Emergency room response, his subsequent reflections on the event, and the critical decisions made by the medical team [16:30]; Sebastian’s reaction to first learning he nearly died, and the extraordinary skill of the medical team that save his life [26:00]; Sebastian’s near-death experience [37:00]; The psychological impact of surviving against overwhelming odds [48:00]; Ignored warning signs: abdominal pain and a foreshadowing dream before the aneurysm rupture [54:30]; Sebastian's recovery, his exploration of near-death experiences, and the psychological turmoil he faced as he questioned the reality of his survival [58:15]; A transformative encounter with a nurse who encouraged Sebastian to view his near-death experience as sacred [1:03:30]; How Sebastian has changed: a journey toward emotional awareness and fully engaging with life [1:08:45]; The possibility of an afterlife, and how quantum mechanics challenges our understanding of existence [1:15:15]; Quantum paradoxes leading to philosophical questions about the nature of reality, existence after death, and whether complete knowledge could be destructive [1:26:00]; The sweet spot of uncertainty: exploring belief in God, post-death existence, and meaning in life [1:37:00]; The transformative power of experiencing life with awe and gratitude [1:53:00]; and More. Connect With Peter on Twitter, Instagram, Facebook and YouTube

#314 ‒ Rethinking nutrition science: the evolving landscape of obesity treatment, GLP-1 agonists, protein, and the need for higher research standards | David Allison, Ph.D.

The Peter Attia Drive

View the Show Notes Page for This Episode Become a Member to Receive Exclusive Content Sign Up to Receive Peter’s Weekly Newsletter David Allison, a leading expert in obesity and nutrition, quantitative genetics, clinical trials, and research methodology, returns to The Drive to explore the evolving landscape of nutrition science and obesity treatment. In this episode, David begins by discussing the intricate relationship between nutrition, obesity, and body composition, emphasizing the multifaceted impacts of food beyond mere calorie intake. David provides a critical analysis of the complexities in nutrition research and their practical implications for tackling obesity. He critiques historical public health policies, addresses the trust issues plaguing nutrition science, and underscores the need for a paradigm shift to more effectively combat obesity. The conversation also delves into the rise of GLP-1 receptor agonists like Ozempic and Mounjaro, exploring their ethical and practical considerations in obesity treatment. The episode concludes with an in-depth look at protein intake recommendations and highlights the significant research gaps that remain in the field. We discuss: The complex relationship between nutrition, body weight, and body composition [2:30]; The slow progress in addressing obesity and public health despite substantial effort and investment [7:30]; The very limited success of public health initiatives in curbing obesity [17:15]; The evolving landscape of obesity research: public health initiatives and the impact of pharmacological success [26:30]; Rethinking obesity solutions: the need for a paradigm shift [32:45]; Understanding environmental triggers and embracing a balanced approach to addressing obesity that includes both pharmacological treatments and realistic lifestyle changes [41:45]; The need for higher standards in obesity research [51:45]; The rapid success of GLP-1 receptor agonists for weight loss: a discussion on the societal impact and controversy of their growing usage [1:02:15]; The ethical and practical considerations of obesity drugs: risks, benefits, and motivations for usage [1:11:30]; The use of GLP-1 agonists by athletes as performance enhancers [1:23:45]; Unanswered questions about protein intake and health [1:30:45]; Future research needed to understand basic questions around protein intake [1:45:00]; David’s weekly newsletter: “Obesity and Energetics Offerings” [1:50:45]; and More. Connect With Peter on Twitter, Instagram, Facebook and YouTube

#313 - AMA #62: Protein’s impact on appetite and weight management, and uric acid's link to disease and how to manage levels

The Peter Attia Drive

View the Show Notes Page for This Episode Become a Member to Receive Exclusive Content Sign Up to Receive Peter’s Weekly Newsletter In this “Ask Me Anything” (AMA) episode, Peter dives into two important health topics: uric acid and protein, examining them from unique perspectives. For uric acid, he explores its metabolic role and connection to various diseases, focusing on the potential causal link with cardiovascular disease. He also discusses factors influencing uric acid levels, such as diet, genetics, and lifestyle, providing practical tips for effective management. Shifting to protein, Peter delves into its role in appetite and weight management, the consequences of insufficient protein, and the “protein leverage hypothesis” linking protein deficiency to obesity. He covers optimal protein intake and its impact on energy expenditure, and he compares the satiety effects of solid versus liquid protein. Finally, Peter shares his strategy for incorporating protein into a comprehensive weight management plan. If you’re not a subscriber and are listening on a podcast player, you’ll only be able to hear a preview of the AMA. If you’re a subscriber, you can now listen to this full episode on your private RSS feed or our website at the AMA #62 show notes page. If you are not a subscriber, you can learn more about the subscriber benefits here. We discuss: Overview of episode topics (and an important discussion on fanny packs) [2:00]; Understanding uric acid: its role in metabolic processes, its association with gout and kidney stones, its impact on blood pressure, and more [6:00]; Non-modifiable factors that influence uric acid levels [11:00]; Modifiable factors that influence uric acid levels [14:15]; Association between high uric acid levels and cardiovascular disease [20:00]; Evidence suggesting a causal link between high uric acid levels and cardiovascular disease [24:00]; Inconclusive evidence about the cardiovascular benefits of lowering uric acid pharmacologically [28:15]; Exploring the potential risks of low uric acid levels in neurodegenerative diseases [37:00]; Managing uric acid levels: dietary interventions and pharmacological approaches [42:00]; The impact of protein on appetite and weight management [44:00]; The consequences of insufficient protein on eating behaviors and satiety [52:15]; The relationship between protein deficiency and obesity: exploring the “protein leverage hypothesis” [57:15]; The impact of protein intake on energy expenditure [1:02:15]; Determining optimal protein intake to avoid deficiency and support health [1:05:45]; The role of different amino acids and protein sources in promoting satiety [1:08:15]; Comparing the satiety effects of solid vs. liquid protein sources [1:10:30]; Peter’s framework for incorporating protein intake into a strategy for controlling body weight [1:12:00]; and More. Connect With Peter on Twitter, Instagram, Facebook and YouTube