Alcohol vs. Weed: Which One’s Destroying Your Productivity? | Peter Attia - PT 1

Summary

Impact Theory Podcast Summary

Episode: Alcohol vs. Weed: Which One’s Destroying Your Productivity? | Peter Attia - PT 1
Host: Tom Bilyeu
Guest: Dr. Peter Attia
Date: October 8, 2024

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Episode Overview

This episode features Tom Bilyeu in conversation with Dr. Peter Attia, focused on the hard truths of modern health, with a particular lens on the factors driving rising deaths of despair (suicide, overdose) in men, the impacts of modern lifestyle choices (especially around diet, exercise, sedentary living, alcohol, and weed), and how to cultivate resilience and meaning in the face of overwhelming modern abundance and challenge. The dialogue uncovers nuanced takes on drug use, motivation, and how to coach the next generation in a world full of dopamine-driven distractions.

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Key Discussion Points & Insights

1. Declining Life Expectancy & Deaths of Despair

• Current Trend
  • Despite advances in medicine, US life expectancy has plateaued—and even slightly declined—in the last 5-10 years, driven predominantly by rising deaths among men ages 20-60.
  • The leading causes: “deaths of despair”—suicides and drug overdoses, particularly from opioids.
• Connected Themes
  • Isolation & Loss of Purpose: Modern men feel disconnected and lack a sense of purpose, fueling compensatory numbing through drugs and risky behaviors.

Quote:

"Men who are aged 30 to 60 are dying at too high a rate, and it is now dragging down average life expectancy...the most common cause of death that's increasing...are 'deaths of despair.' So that's suicides and overdoses."
— Dr. Peter Attia [02:19]

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2. Modernity’s Double-Edged Sword

• Historical Perspective:
  • Modern medicine has removed many historical barriers to longevity (death from childbirth, infection, trauma), but has introduced new maladaptations: chronic stress, sedentary lifestyle, and pervasive abundance.
• The Stress Paradox:
  • Moderate stress is motivating; chronic, unrelenting stress becomes toxic and ruins productivity and health.
• Lack of Default Purpose:
  • Modern people have to “manufacture” meaning and movement, as primal survival pressures are gone.

Quote:

"Modernity enables a lot of [stress] because basically it changes what we have to optimize for...5,000 years ago, we were really only optimizing for a few things...There really wasn't a lot of self actualization going on."
— Dr. Peter Attia [10:23]

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3. Diet, Exercise, and Lifestyle Realities

• No Default Setting for Health:
  • Modern processed food, a sedentary lifestyle, and decaying social fabrics remove the natural guardrails humans evolved with.
• Sedentariness as a Modern Plague:
  • Humans are structurally unprepared for inactivity; even sitting postures today are far less active than ancestral lifestyles.
• Feedback Loops:
  • Exercise is a "gateway win" for improvement—offers quick physical and psychological reinforcement.

Quote:

"I tend to always gravitate towards exercise because...when they get into a routine of exercise, [people] really start to experience physical benefits and psychological benefits."
— Dr. Peter Attia [30:38]

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4. Dopamine, Technology, and Overstimulation

• Unnatural Dopamine Manipulation:
  • Modern pleasures like video games, pornography, processed foods, and social media hijack evolutionary reward systems—creating withdrawal and dependence similar (but not identical) to physical substances.
• Dopamine Fasts:
  • Recovery from these dependencies may require “dopamine fasts,” with withdrawal symptoms, as described by Dr. Anna Lembke.

Quote:

"Dopamine responses to things that are unnatural tend to produce too much of a counter effect...[leaving] more discomfort than the comfort you gained through the stimulus."
— Dr. Peter Attia [37:13]

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5. Parenting in the Age of Abundance

• Tug of War Analogy:
  • Parental control should be gradually loosened over childhood—kids should make mistakes under supervision, so they don't "go flying" when finally independent.
• Open Discussion vs. Total Abstinence:
  • For both alcohol and weed, open conversations about risks and motivations are more helpful than blanket bans.

Quote:

"Parenting is like playing a game of tug of war that you have to lose after 18 years."
— Peter Attia quoting Rick Elias [46:07]

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6. Alcohol vs. Weed: Health, Behavior & Social Trends

A. Alcohol

• Risks & Ritual:
  • Alcohol is a toxin, but for many people, its draw lies in taste or ritual, not the inebriation itself.

B. Weed (THC)

• Greater Concern for Youth:

  • Especially worrying for developing brains; possible links to anxiety, lack of motivation, and for some, an unpredictable psychological response—sometimes even paranoia or panic.

• Mode & Dose Matters:

  • Edibles, potent extracts, and unclear dosing are especially risky. The cannabis products available now are much stronger than in the past.

• Possible Gateway?

  • Direct causal link between weed and harder drug use is debated—but cannot be entirely ruled out, especially in certain predisposed populations.

• Adult Use vs. Adolescents:

  • While adults using small, controlled doses may be less at risk, chronic and heavy youth use is particularly concerning.

Quotes:

"I think we need to be pretty concerned with the ubiquitous adoption of THC...I would just be very cautious using that in kind of a developing brain, both boys and girls."
— Dr. Peter Attia [53:02; 56:15]

"You don't...always get the same response [with weed]...That's not necessarily desirable, especially if any of those responses are unfavorable."
— Dr. Peter Attia [62:32]

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Notable Moments & Memorable Quotes

• On the Modern Human Lottery

"There have already been 100 billion people on this planet who have lived and died before us...We really have hit the lottery to be here where we are right now."
— Dr. Peter Attia [18:56]

• On Parenting Strategies

"How do you lose [the game of tug of war with your kid]? You can't let go of the rope all at once...You have to slowly, slowly, slowly lose such that by the time they head off to college...they won the game, but they won it slow."
— Dr. Peter Attia [46:10]

• On Sedentary Living

"This chair is designed to make us as relaxed as possible, as comfortable as possible...I sit on a chair with the back, but I also make sure I'm going to exercise every single day so that I can sort of offset the damage that comes from turning into a piece of wagyu beef."
— Dr. Peter Attia [36:43]

• On Feedback from Modern Technology

"It's called negativity bias and we're hardwired to it. It's evolutionarily very adaptive because...in our tribe, you had to be way more attuned to when you were upsetting people than when you were pleasing people."
— Dr. Peter Attia [23:14]

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Timestamps of Key Segments

| Segment | Content | Timestamp | |---------|---------|-----------| | 1 | Declining life expectancy & male deaths of despair | 02:19–06:47 | | 2 | Modern medicine vs. ancestral living thought experiment | 06:47–11:39 | | 3 | Role of exercise, meaning, and adaptation | 11:39–14:33 | | 4 | Sedentary behaviors & evolutionary mismatch | 14:33–17:48 | | 5 | Dopamine manipulation in modern life | 36:43–42:35 | | 6 | Parenting in an age of drugs & abundance | 44:32–50:44 | | 7 | Alcohol vs weed: developmental risks and nuances | 52:47–59:39 | | 8 | Unpredictable effects and gateway risks of weed | 59:39–64:07 |

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Summary for the Uninitiated

This episode provides a deep-dive into the intersection of modern health, psychology, and society. Dr. Attia and Tom Bilyeu challenge listeners to look beyond easy narratives, weighing the benefits and new dangers of the world we've built—especially as they pertain to rising deaths of despair in men, the challenges of maintaining health in a sedentary, dopamine-saturated world, and the nuanced risks of alcohol and weed, especially for the young. Underlying it all is a call to cultivate meaningful exercise, strong familial and social bonds, and intentionality in daily habits—a toolkit for resilience amid the comforts and perils of modern abundance.

Transcript

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[Tom Bilyeu]

I'm Tom Bilyeu and this is Impact Theory. This is not your average conversation about health. What we're about to get into could save your life. I'm not at all exaggerating about that. If you don't take what we're discussing seriously, you're playing with fire when it comes to your own future. The hard truth is if you don't get a handle on your health right now, the consequences can be life altering. Look, if you're not already thinking about how a sedentary lifestyle is wrecking your body or questioning whether modern medicine is really as safe as you assume, you need to start paying attention to the latest information coming out. The decisions you're making today about your diet, your fitness, your overall health, they're shaping whether or not you're going to be around in 10, 20, 30 years from now. And there's no one better to help you get real about this than Dr. Peter Attia. Peter is one of the few people that I trust absolutely when it comes to the information that he puts out there because he is relentless about getting to the truth through experimentation. He's got the science, the data and the real world experience to back it all up. This episode is going to help a lot of people. I know because we covered so many important topics from things like the truth about weight management, drugs like semaglutide, to why your VO2 max is the number one thing that predicts your longevity. You are not going to want to miss this episode, guys. This is an opportunity to act. Do not tune out. And without further ado, I bring you Dr. Peter Attia. Let me ask, what is it about modern life that is suddenly shortening life expectancy?

[Dr. Peter Attia]

Well, I mean, I think it's an interesting question, right, because most of what's in modern life has actually increased life expectancy. But I think what you're referring to is over the past five, 10 years in the modern world, in the developed world, we've seen kind of a slight plateau, and not just a plateau, but actually a downtick for the past five or six years. Even outside of COVID So if you take Covid out of it, is it true that we are living shorter? The answer is yes, but it's a bit of a statistical issue. Here's what it is. Men who are aged 30 to 60 are dying at too high a rate, and it is now dragging down average life expectancy. So just as 300 years ago, average life expectancy was really short. A big part of the drag was that too many women and babies were dying during childbirth. And when that happens, you just drag down the whole population average. So what's happening today is too many men, call it age 20 to 60, are dying, and the most common cause of death that's increasing, that are what we call deaths of despair. So that's suicides and overdoses, and that is having a significant enough drag now, on average life expectancy of people in the United States. Unfortunately, I can't speak to this in other countries. I'm not as familiar with the data in Europe or Australia, but I can tell you that in the United States, that's what's happening.

[Tom Bilyeu]

Okay. Yikes. That actually, oddly enough, I try to predict the answers before I ask the questions. That isn't the answer I was expecting. So suicide and overdose. Okay, so take some swags here. As somebody who's thought a lot about mental health, it was in your book, what is going on? Where are we disconnecting in the way, especially men are living their life in modernity, which has brought us so many amazing things. But to your point, something has tipped. If you had to aggregate some of the biggest factors, what are they?

[Dr. Peter Attia]

So at the risk of just disclosing that, this is not an area where I consider myself an expert. So now I'm speaking hopefully less as an expert and more just as a kind of consumer of information and someone who listens to experts. I think what I would say is there's been a little bit of isolation of men. There's been a little bit of a sense that maybe men are becoming less connected to their sense of purpose. And as such, this is producing behaviors in men that are ultimately harmful. So one of the things that would result from everything I just said is basically a need to sort of mask pain. And in many ways, if you think about the rise in the use of. Of opioids as an example, which is the biggest driver of what I just said, A second ago. So opioid use is the biggest driver of what we call accidental poisoning or accidental overdose. And that's been by far the largest group of deaths that have risen in the entire category of accidental deaths. So it's not that more people are dying in car accidents. Right. It's deliberate self harm suicide and then unintended self harm, which is overdose, Although you could argue that that's slow suicide or what someone like Paul Conti has called parasuicide. So what? Yeah, meaning behaviors that are kind of adjacent to suicide. So, you know, you asked the question through the lens of modernity. I think modernity's been with us for a while. I don't know if there's something from a technology perspective that's making that worse. So, for example, we know, I think with, I think a reasonable degree of certainty that social media has some harm on mental health and a lot has been written about its negative effect in particular on adolescent girls, them being more susceptible maybe even than adolescent boys or men and women who are out of adolescence. But there is clearly something else that's going on with men. Probably again, with respect to purpose would be my best guess, that is leading to some sort of pain that's resulting in some sort of compensatory numbing strategy that at least I think plays a partial role in this.

[Tom Bilyeu]

Let me ask a question that'll get at us the same topic, but from an angle that may be deeper into your wheelhouse. So if we were to take modern medicine, and we may need to define what I mean by that, but I'll finish the question first. If we were to take modern medicine back say 5,000 years, and so, hey, if you're out chucking spears and you know, getting the antelope and dragging it back and you get an infection, we can take care of that if we brought that apparatus. But otherwise their lifestyle did not change, do you think we would increase life expectancy beyond what it is for Gen Z right now?

[Dr. Peter Attia]

Yeah. So let me make sure I understand your question. You're saying, Peter, let's take everything that modern medicine has to offer.

[Tom Bilyeu]

Medicine 2.0, specifically.

[Dr. Peter Attia]

Yes, let's take medicine 2.0 back to 3000 BC, make no other change. Which is a complicated thing to imagine because that also means you had to bring electricity back and you have to. There's a lot of things you have to bring back. So it's, it's. But let's just play it as a thought experiment. Somehow you just transport alien doctors and medicine back to 3000 BC. Yeah, it's interesting, right? Because going back to that point in time, our life expectancy was shy of 40. But as I said, there were largely three things that resulted in such a drag on life expectancy. The first is the one I already alluded to. So infant mortality was enormous. I don't remember exactly the numbers of like one out of every X number of babies. And it was a small number, like maybe one out of every four or five babies born, the mother and or baby die.

[Tom Bilyeu]

Jesus.

[Dr. Peter Attia]

Full stop. Now this is not that hard to believe for anybody who's watched their. You know, if you're listening to this and you're a guy, if you've watched your wife go through childbirth, you can totally appreciate this. Like, my wife would have not survived the birth of our daughter if not for modern medicine. Absolutely. Full stop. So we would have lost both of them for sure. So you have a, you have, you have a huge amount of humility for what medicine has done to make childbirth safe. Secondly, you have infections. So, you know, it was very easy to get an infection. And without any sort of antibiotic, you, you didn't get too many shots on goal there. And then lastly trauma, so, you know, you got a big cut on you, you fell, you broke a leg, you broke a hip. You're done. So those three things alone basically wiped out our species, but not, not to the point where we couldn't proc. Create again. Enough of us were able to still pass on our genes before we died. But life expectancy was probably in the high 30s.

[Tom Bilyeu]

Right.

[Dr. Peter Attia]

There were probably people who lived beyond that if they managed to escape all of those things. But they, you know, we weren't dying of chronic disease. So I guess what your question is getting at is, is there something else in the modern world that is so toxic that despite all of the advantages of modern medicine, it's killing us? And I think the answer has to be yes. Right. So is the amount of stress we're under beneficial? Probably not. It's probably a bit maladaptive for many people, especially people who are, you know, on, on, you know, at the, at the high end of it, right. Stress is kind of like an inverted U shape relationship between performance and stress. So low, low, low levels of stress are not very helpful. They don't actually, we, we don't have the motivation to do anything. So you have to have some stress, some drive. But for, for any of us, at some point that becomes really unproductive and you start to, you know, kind of spiral in, in your response to stress. You you, you can't even multitask anymore. And sometimes that is all self imposed and sometimes that is imposed by the world around you. Right? You have too many things in your life. You know, you, you, you've got a job. You, you, you're working three jobs to try to pay this and you're, you know, you, you have this bill that's due and, and all of those things are very stressful and they're purely external. And then other times you could be in your shoes, right, where you're an entrepreneur, you don't have to wor, you're imposing a ton of stress on yourself because of who you are and your desire to do something that is above and beyond what you're doing today. So I think modernity enables a lot of that because basically it changes what we have to optimize for. So 5,000 years ago, we were really only optimizing for a few things. We had to find shelter, we had to find food, we had to procreate and we had to be safe. Those were about, that was really it. There really wasn't a lot of self actualization going on. At least we don't have really much evidence that it was. That probably started a little bit later on. But 5,000 years ago, it's not really clear that there was much of that going on. Certainly 10,000 years ago I would, I think I'd be comfortable saying there was none of that going on or at least not enough of that, that it mattered. Basically, natural selection was the force that was driving us.

[Tom Bilyeu]

Yeah, that is the lens through which I look at a lot of this is what would have been selected for. So when talking to people in a modern context, so my life is divided into entrepreneurship and mindset. So I get people that come to me with mindset stuff and a lot of times I'm like, this is just a maladaptive response to the modern world. Where the very first time this occurred to me was at Awareness Technologies, the first company that I got involved with. And I remember thinking, dude, some people just need to be chased by a lion. Like the, the way that they are approaching their lives is so bizarre that they're majoring in minor things. And when you don't have to worry about your survival, when you aren't looking left and right and being like, yo, I need you to keep me from getting eaten by something you can afford to isolate, which then has all these knock on effects. But it isn't maybe immediately apparent that this is going to be problematic. You don't have ready Made meaning and purpose. Because when you have a child and you're like, yo, I have to make sure this thing lives and everything is trying to kill it, all of a sudden you're. You're having to manufacture this stuff.

[Dr. Peter Attia]

Yeah.

[Tom Bilyeu]

Now, I am a hyper responder to the modern world. So for me, I'm a city bather, not a forest bather. Like, I love building things. I love being around a lot of people and yet thoroughly enjoy isolation. So it's like I am just built for this moment. However, I have these. What I can feel like are evolutionarily planted algorithms running in my brain that are saying, if you don't do these things, you're going to feel profoundly ill at ease. And so I've had to think a lot about, okay, why would I need meaning and purpose? That's the big one, right? So why would I continue to need meaning and purpose? I have all the money in the world. I never have to work again. Like, I should be on easy street, but. But I was the most paranoid, at my most successful because I realized. So I. My last day of quest was a Monday, and my first day at impact theory was Tuesday because I knew time off is not going to be the thing that I need to lean into. It's going to be meaning and purpose. And why am I doing all of this? And so having to map out what those evolutionary algorithms are that are running in my brain to keep me from making mistakes became incredibly important. So one of them, and this is the lens that I view you. You really affected my vision of you, for sure. And how I should be thinking about health in our last episode, where you got me to stop thinking as much about diet and more about exercise. How much do you think that plays into this? How much of this is a problem with being sedentary, sitting and watching Netflix, playing video games, which, you know, I love. But I. I always want to know what's. What's causing the. The break. How much of this is sedentary and just not getting after it, killing things and dragging it back?

[Dr. Peter Attia]

Probably quite a bit of it, although I think there's probably a lot of things going on. So the modern world today, if you could imagine going back in time 10,000 years and bringing one of our ancestors forward here today, ask yourself the question, what would they recognize? Let's go through things. So they were sitting in this room with us. So it's you, me, and one of our ancestors sitting there. So he would. He wouldn't know what these things are that we're wearing like clothing. Like, what are these things on your face that have glass on them? Like, what is glass? What are these lights? Like, everything in this room would be. Everything in this world would be so foreign. Can you imagine what they would think when they looked out at Los Angeles? How long would that person survive? I just. I don't. I don't. I don't. I just don't think they could survive very long at all. Despite the fact that they would have everything given to them. They wouldn't be able to eat the food. It would probably. I mean, it would taste really palatable, but, like, it would be very foreign to them. Like, all these things would be foreign. And yet, from an evolutionary perspective, there's not much of a leap between us.

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[Dr. Peter Attia]

So when we sit here and think about everything you said, which I agree with, by the way, which is like, this idea that we. And I put myself in this category at the top of the list, it's so easy to get worked up about things that don't matter. And if you frame them through the lens of survival, you would take a step back and laugh. But it's also the privilege. We have to worry about stuff that isn't life and death because of the incredible society we live in. Like, that's kind of the. The. Like, if you're on the Titanic before it hits the iceberg, you can be worrying about whether they're. They're serving lobster or steak. Like, that's, That's. That that's a reasonable thing to worry about once you've hit the iceberg. Like, there's only literally one thing you're thinking about. Am I going to get into a lifeboat and live, or am I going to get in the ocean and die? And so I don't think we should be too critical of the fact that we are where we are. I think what we need to do is help realign. Like, how do we extract all the value from the modern world? Because I don't think you want to go back in time 5,000 years. Even if I told you you could, I just don't think you'd want to. I don't think anybody would really want to if they understood what it was like and how brutal the world was. I wouldn't want to go back in time a hundred years. Think about a hundred years ago, Tom. What was going on? See, we were five years. It was a roaring 20s, so the world was looking pretty good. You're five years away from the Depression, which was gonna.

[Tom Bilyeu]

You're also only a decade out. Well, depending on how deep into the 20s, from World War I, which was God awful.

[Dr. Peter Attia]

Right. So, yeah, you probably lost. Yeah, right. You had this influenza pandemic that kills, you know, whatever 10 of the population you've got, you know, World War II. You're. You're five years away from falling off a cliff for the next 10 to 12 years of the world' worst depression. That was less than 100 years ago. I mean, would any of us actually want to go back to that? No. So I don't. I don't have personally, a lot of nostalgia for that. I tend to take the view of, like, yes, there's a ton of stuff about the world today that I don't like, but I'm still. I just can't believe how lucky I am. You know, people sometimes have a hard time realizing how lucky we are in this sense. So There are about 8 billion people on Earth today. Do you know how many people came before us? So what's the total number of humans born in the last 250,000 years? That's about when our species showed up.

[Tom Bilyeu]

It's something roughly equivalent to how many people live right now at this very moment.

[Dr. Peter Attia]

Right? No, it's actually much more, and it's very counterintuitive. It's about 100 billion.

[Tom Bilyeu]

Whoa.

[Dr. Peter Attia]

Yes.

[Tom Bilyeu]

Okay, that's 10x what I thought.

[Dr. Peter Attia]

Yeah, exactly. Yeah, me too. I couldn't believe this when I first learned this a few years ago. There have already been 100 billion people on this planet who have lived and died before us. And so to think you're sitting here. I'm sitting here. We are one of the very, very lucky 8 billion people to have been born. Everybody who's listening to us right now, right out of the gate, that's a lottery ticket. Now, factor in how many of us are born in the United States, Canada, Australia, Western Europe, born into a country where you're not under some horrible regime that's completely taken away your rights. So go through that math. In how many countries would you like to be born into today? You've now reduced that Number even more so. We really have hit the lottery to be here where we are right now. And instead I like to think about, okay, how can I modify my current world to not be as, you know, not have as many of the unintended consequences of modernity as are obviously going to take place if I'm not deliberate about it?

[Tom Bilyeu]

Yeah. What really blows my mind so I'm totally with you. And as a student of history, I don't think there's any way that you could ever want to go back when you realize people were just slaughtered, put on pikes in front of the, you know, the road leading up to your town. I mean, it was just crazy. Genghis Khan killed 10% of the world's population, just killed them in the most brutal fashion that you can imagine. It's just absolute insanity. And that's.

[Dr. Peter Attia]

But even go one step further tomorrow, let's say I said you can go back 500 years ago and be the King of England. Okay, so now you're the most powerful person in the world 500 years ago. How's that working out for you in your dark dingy castle with like nappy ass food and disease and like war? Like, none of it's good. None of it's good. Like, we're so much better off, no doubt.

[Tom Bilyeu]

And yet deaths of despair. And so what I find so interesting is looking at all of the improvements that we've made elongating life. Obviously we have not fallen back to where the average age is 40, but there is something really emotionally distressing about seeing that line begin to bend down. And so I start asking myself, okay, what are the things that I need to do to make sure that I am not falling prey to the things that cause issues? So I'm going to lay out the things that I think are most problematic. Let me know what you think about this list. So I would have, in fact, if I'm honest in my soul, I still think that diet is problem number one. So you've got, you said very eloquently that diet has. It is huge downside if you get it wrong, but limited upside if you get it right. So I think that we're getting that wrong. So I think that's the first problem number two. Exercise, you have to manufacture it. And so now people just aren't doing it. Meaning and purpose, obviously you already talked about that. I think that one is huge, but somewhat ironic given that people are going to spend a lot of their time working to get money to theoretically live in this modern world, but somehow they're not attaching. They're not taking the conscious action of attaching that to. I do this for this reason, and I think that that probably has a large part to do with the dissolution of the family unit. So few people are having kids now, comparatively, so that becomes a big problem. But then you also have things like industrialized farming, highly processed foods, things where it becomes almost impossible to get around, things that are creating a problem for you. And so now you have to be. There's no default setting that just works out from a health perspective. Whereas before the default answer was you wanted to have sex, so you were going to end up having kids. You were part of a social fabric that made huge demands on you in terms of taking care of the group, taking care of your kids. So you were just sort of forced into a role that would be wildly emotionally advantageous for the average person. Of course, some people are going to hate it, but for the average.

[Dr. Peter Attia]

And let's not forget that those of us, that those of our ancestors who couldn't bend to those norms were killed or isolated and killed. Isolated and died from a social pressure, social perspective. Right. So I was actually talking to somebody a while ago, and they asked me, why are we as humans? So, like, the, the question came up in the context of why is it. If I look at my YouTube comments and there are 2000 good ones and one negative one, it's the only one I think of. And I'm sure you can relate to this. I can relate to comments for that reason, but. Yes, but. And totally understood. And I said it's. It's called negativity bias and we're hardwired to it. It's evolutionarily very adaptive because in that setting that you describe in our tribe, you had to be way more attuned to when you were upsetting people than when you were pleasing people. Because if you are upsetting people and you get cast out, you don't have too many days of life left. You're not going to survive on your own. Like, that's, that's sort of the human gift is our ability to work together. So we're hardwired to accept that. And so my only point there is, like, a lot of weeding out took place during this process to get us to where we are for good and bad.

[Tom Bilyeu]

Yeah, no doubt.

[Dr. Peter Attia]

Because natural selection and evolution, we're optimizing for our genetic lineage, not our happiness. It's very important to understand this difference. Natural selection does not care if you're happy, doesn't care at all. It cares how fit your genes are. That's it. Unless you're so unhappy that you will kill yourself before you can pass on your genes, you would have a negative pressure to get that gene out. But if the answer is like, you're not happy, you're not satisfied, who cares? Can you procreate and pass on your genes? That's the only pressure that is maniacally driving evolution forward.

[Tom Bilyeu]

Yeah. And once people wrap their heads around that, it becomes a lot easier to structure their life in a way that's actually going to make sense. So given that, given that clarity, what should somebody do that is facing that basket of goods that we just went at least through a partial piece of that. How should a guy who sees the numbers of deaths, of despair skyrocketing, how do they begin to structure their life such that they deal with the biological realities and the psychological?

[Dr. Peter Attia]

So one quick anecdote before we do that, and obviously we could talk about this for so long, because I think that's the essence of. Of everything. Several years ago, I interviewed an amazing doctor on my podcast. His name is Tom Katana. So he's a. He's a US Physician who became a missionary. So he's now a physician in Sudan, in the Nuba Mountains of Sudan, where the government is, you know, killing its own people. So there's an area in the mountains where there's a million people who don't have any medical care. And he provides all the medical care to these million people by himself. He now has a little bit more help. He has some nurses and stuff. And, and. And so a group of us support his work there. And he's doing incredible work. I mean, he's truly one of the most amazing human beings I've ever met. Right. Very rarely would I meet somebody and think, like, I'm not sure I deserve to be in this guy's presence. Like, there's such a gap between us as human beings. And one of the things I remember, Tom, when I was asking this, this question, I said to him, because he's going through just what the hellish life is like. I mean, to be clear, bombs are being dropped on these people routinely. So half the stuff he's doing is taking care of kids who have had their legs ripped off from shrapnel. Like, it's just, you know, they have. They have holes they have to be able to jump into when the government is like, you know, dropping these bombs on them and stuff like that. And I said, tom, it sounds horrible. I mean, like, what is the suicide rate there. And he's like, oh, in the entire time I've been here, there's only been one suicide. And it was someone that we later found out had a really bad brain tumor. And we actually just wonder if it was the brain tumor that had kind of altered his behavior. And I was like, and these aren't people that are all dying in their 30s. I mean, yes, some of them do, but also, many people survive into their 70s and 80s. So it's not just that you can say, well, you know, we don't have deaths of despair because we're all dying from trauma. No, there's something else going on. And I think about that all the time, because here you have people living today who are living in a situation that is abject misery, and yet somehow it doesn't cross their minds to end their lives the way it would cross our minds. I'm sure, like, if I said to you, tom, I'm going to ship you over to Sudan for the next 10 years, like, yeah, or if you sent the same thing to me, I'm like, I don't know that I can do this. Right. So what is that? Like, to me, that's super interesting. And I think a lot of the things you talked about are covered, right? So even though they're eating not that much, they don't have great food. You know, it's a very bland diet that is, you know, lots of rice and beans and, you know, they're eating meat that's not particularly wonderful and flavorful, and they're probably eating the same food every single day when it's available. You know, they. They have the Internet, but it's obviously not a huge part of their lives. Their family is very important, right? So lots of kids, Family is very important to produce the food and build the shelter and all of the stuff that they. That they survive in there. So clearly that gives them a purpose, even though in the eyes of the world, they're not building businesses, they're not building companies, they're quote, unquote, changing the world. So purpose doesn't really have to be necessarily on a world scale. So I say that only as a foray into the question of, well, what should we do with the privilege we have now, which is amazing, to mitigate some of the downsides of it. And honestly, I don't think it's like that much of a mystery. Right. I think the nutrition, sleep, exercise piece is so obvious that I just. I think to ignore it is problematic. But I also don't know if we really need to talk about it because is there anybody who would honestly be listening to us at this point who wouldn't agree with the notion that if, if, if you're thinking about eight hours of sleep versus six hours of sleep, which one's going to produce better mental and emotional health? If you're thinking about being sedentary versus not being sedentary, if you're thinking about eating well versus not eating well, these things are really clear now. Part of the question becomes how do you motivate yourself to do those things? If you're starting in the low spot where it's like, I don't want to do these things, like, I'm isolating myself, I'm lonely, or I'm working too hard and I can't make the time to do these things, how do I prioritize them? I think that's a discussion worth having. I think in terms of sense of purpose, maybe that's one of the most difficult ones to manufacture. And honestly, I just don't know that. Like, I don't know that I'm enough of an expert in that area. I feel fortunate that that's not something I've ever struggled with. I've always kind of felt like I know what I'm supposed to be doing, whether it's.

[Tom Bilyeu]

Do you have people that come into your practice that lack motivation? They've got the money?

[Dr. Peter Attia]

Yeah, I think, look, there are people who come into my practice who certainly struggle with the motivation for how they can look after themselves. Right. So there's definitely, I think it's independent of education, independent of wealth status, anything like that, that sort of intrinsic drive for self with respect to the sort of variables that we talked about. And again, I think that that's where you kind of have to start with something that's a win. You got to give people a win, I think. And I tend to always gravitate towards exercise because I think that gives most people, maybe not everybody, but I do think that most people, when they get into a routine of exercise, really start to experience physical benefits and psychological benefits. And the physical benefits are evident. Right. So when people look better, when they feel better physically, that's reinforcing. But the actual act of exercise is typically followed by a period of not necessarily euphoria, although in some people it can be, but just a, you know, there's an increase in dopamine, so you're going to actually feel better transiently and that becomes rewarding and self reinforcing. So I always think that exercise is a great place to start building habits for people. And I also think that, you know, if you take a person who says, well, I'm not really to take that step yet, I don't really want to exercise, Peter, what can I do then? I think being outdoors is very important. One of the things that is pretty jarring about this world is the, the overabundance of symmetry and right angles and things like that. Again, going back to the example of the guy who shows up in our, who's sitting over here from 10,000 years ago, that's something that's going to be very jarring. He's not used to having seen straight lines and right angles and perfectly symmetric. Right. He's seen sort of fractal geometry everywhere. So there's some literature on this. It's not the most robust literature because it's very difficult to study, but there are some literature that suggests that people who spend a period of time outdoors every day in nature actually experience benefits in terms of brain chemistry. So it's, it's, again, it's, it's, it's challenging to test because it's challenging to measure, but it's actually quite plausible and it makes a lot of sense. Again, going back to the fact that our brains are still kind of 10,000 year old brains, an obvious example of this is our response to fear. A lot of times we still, you and I both, I'm sure all day long experience the midbrain fear, right? Like the amygdala based response, the limbic system response as opposed to the cortical response to things. And that's clearly a vestige of, of our evolution. Like we, we needed to be able to have a fear response quickly before thinking. Most of the time today we don't need that, but certainly we needed that, you know, 10,000 years ago. And so a lot of times we still have to think about how can I nurture and feed that brain, that part of my brain that is still there.

[Tom Bilyeu]

What are the health consequences of laziness?

[Dr. Peter Attia]

Well, there's obviously the physical consequence of it, right? So the body does need to have a hormetic stress. And, and that's true in virtually everything we do. I mean, most of the times a stressor that's temporary produces a more robust organism following the stressor. So in that sense, exercise is just one of the most remarkable examples we have of stressing the system. If you think about it, in the acute state of exercise, everything that's happening is actually taking the body out of equilibrium. So heart rate goes up, blood pressure goes up, body temperature goes up. All of those variables are actually going out of the area that produce, that the body wants to be in normally. So the body has to kind of counteract those things. And the counteracting of those things produces a response that makes the body stronger. So if a person is sedentary, and again, it's obviously easy to be sedentary in the world today, that wasn't an option for our ancestors, who, by the way, were quite sedentary when not working. Right. So it's not like we exercised. We were. We were conserving energy as much as we could. But, you know, we were still probably walking a lot and doing a lot of physical activity even when we sat, by the way, like, think about it. So you and me are sitting how, like, are we actively sitting or passively sitting?

[Tom Bilyeu]

I feel pretty passive.

[Dr. Peter Attia]

Super passive. Right. But how did. Our ancestors obviously would sit, but they would sit in a low squat. So if you've ever sat in a low squat on the floor, it's, you know, it's still sitting, but it's very active.

[Tom Bilyeu]

So you're saying people weren't sitting on their ass, they were actually would sit

[Dr. Peter Attia]

on their ass, which is still way more active than sitting in this chair.

[Tom Bilyeu]

Say more. Well, think about more uncomfortable.

[Dr. Peter Attia]

Super uncomfortable. Right, but why is it uncomfortable? You have to still, say, somewhat active to support your body. You have to keep your back forward. Right. You have to keep your hips in a certain position. Sitting on a log, sitting in just a very low squat as you're sitting over the fire, as you're cooking, as you're preparing something. Everything that they did just at a low level of activity was significantly more than what we're doing. Right. This is, you know, this chair is designed to make us as relaxed as possible, as comfortable as possible. And again, you know, some people will take that to the level and say, look, don't sit on chairs like this. Don't sit at a chair that has a back. Just sit on a chair that only has a platform so that you are forced to engage your core to sit up. That's. That's great. But you get the sense that you could go through life quickly realizing little things that you can do to work around that. I sit on a chair with the back, but I also make sure I'm going to exercise every single day so that I can sort of offset the damage that comes from turning into a piece of wagyu beef.

[Tom Bilyeu]

Very fair. Do you worry at all about the way that people manipulate their dopamine Loops with things like pornography, Netflix, video games.

[Dr. Peter Attia]

Yeah. And again, not an area of my expertise. So I come at this through the lens of a consumer of information. I've obviously talked about this on podcasts and interviewed people who are the experts on this. So I don't know if you've. Have you interviewed Anna Lemka from Stanford?

[Tom Bilyeu]

I have, yeah, A while ago, but yes.

[Dr. Peter Attia]

Yeah. So, look, I think it is problematic, I, I think when you. I think dopamine responses to things that are unnatural tend to produce too much of a counter effect where the deprivation of dopamine following the stimulus creates more discomfort than the comfort you gained through the stimulus.

[Tom Bilyeu]

Say that one time again, English.

[Dr. Peter Attia]

Yeah, yeah. So, well, let's start with the right way to get to manipulate dopamine. The right way to manipulate dopamine. Again, let's go back to that idea that about, like you have this idea of homeostasis is this very important part of the human body. So the, you know, a lot of this stuff I'm sure you know, but maybe just to make sure listeners understand, like how tightly the body regulates every process. So temperature. So if we. Assuming you're not sick right now. I'm not sick right now. We put a thermometer in our ear, on our mouth. You know, you and I are going to be within one degree of each other, and we're going to be within one degree. We're going to be between 98 and 99 degrees Fahrenheit. That's going to be our body temperature right now. And that's going to be the case almost under any circumstance until what happens? Right. If we're sick, we are going to push the envelope of that and get higher and higher. 102, 103, 104. Anything beyond that and we're in trouble. Right? You go much beyond that, you're going to die. If you're outside in the cold, freezing. If you're in water and you're freezing and your temperature drops much below about 92, you're pretty much going to die. So high regulation of body temperature is an amazing power of the body. Similarly, how much we can regulate acid base balance in the body is even more impressive than temperature. Truthfully, how you can regulate glucose levels, the difference between a person who's about to die of hypoglycemia and a person with type 2 diabetes is still actually a tiny amount of glucose. In the grand scheme of things, it's literally teaspoons of glucose spread across the whole body in the plasma level. So our ability to regulate every single thing is remarkable. So now if you look at the brain, dopamine is actually something that needs to be kind of regulated. And so a lot of times painful stimulants, things like exercise, cold water therapy, they create enough discomfort that the body actually increases dopamine production as a way to offset that discomfort. Right. We have to give you a little bit of pleasure for that pain. And so when you remove that stimulus, you still get a little bit of the lingering dopamine, but it's not a super high spike. That is unnatural. And so over time, that doesn't become problematic. Now, a lot of the things that you mentioned are kind of hijacking the system. And again, it sort of comes back to evolution. Like we didn't, you know, have slot machines and video games and porn and you know, pick your favorite drug that really hijacks the system, like cocaine or something like that. And so what these things do is they're creating such a surge of dopamine along with other hormones as well. It's a bit over simplistic to just say dopamine, but you know, norepinephrine, epinephrine, all these other things that when this, when the stimulus is removed, the drop in that dopamine is so high because as you've experienced that huge spike, your body is pulling its dopamine down. Right. Again, it's homeostasis. We have this huge spike of dopamine. Well, our body is saying that's too much. We're going to make less, so less endogenous production of dopamine. Then that stimulation is gone and you're in a dopamine deficit. So one of the things that actually Anna talks about is when she encounters somebody who's dealing with this is they do. I think she calls it a dopamine fast. Right. So if a person says like, I can't stop playing video games, she's like, okay, we're going to do 30 days of no video games and this person will go through withdrawal. They will literally go through a painful withdrawal that is no different then the withdrawal that, you know, if you remember train spotting, when you watch like, you know, when those guys are trying to get off heroin, like how painful that.

[Tom Bilyeu]

So you're saying there's a literal physical withdrawal period from dopamine loops, whether games, porn, whatever, whatever.

[Dr. Peter Attia]

Yep. And again, you have to differentiate between there are certain dope, there are certain times when these, these withdrawal symptoms are so difficult that they actually even require other medication. That's usually not the case with something like video games, gambling, and porn. But we know, for example, it could be the case with alcohol. So if you took a person who's drinking an enormous sum of alcohol and they want to quit cold turkey, they actually have to do that stuff under medical supervision.

[Tom Bilyeu]

Is that dopamine, though? I was assuming that was something else.

[Dr. Peter Attia]

Well, I mean, dopamine is part of it, but. But they actually. It's. It's actually probably more GABA related. So those people actually end. To end up needing to be on sort of benzodiazepines to help cope with that.

[Tom Bilyeu]

Jesus.

[Dr. Peter Attia]

Yeah, Otherwise it can actually. Actually be fatal. They can develop. They can develop fatal arrhythmias if they are. If they withdraw off alcohol too much. To be clear, that is not the case for most people. So if you're. If someone's watching us and they're, you know, they're in a habit of drinking two to three drinks a night, you can stop that cold turkey. But I'm talking about people who are drinking, like, you know, a 40 of jack every single day. It's for breakfast. Yeah. Those people need to be under medical supervision as they. As they.

[Tom Bilyeu]

What is the benzo doing? Does it slow their heart rate? Like, I don't understand.

[Dr. Peter Attia]

Yeah, so it's probably balancing out the GABA agonism that that ethanol was doing for them, because GABA is a. Ethanol is a huge GABA agonist as well.

[Tom Bilyeu]

So basically, the body is trying to compensate for the. The suppressive nature of the alcohol. So you technically have this, like, overabundance of go, go, go from what?

[Dr. Peter Attia]

Blood pressure, heart rate, catecholamines. Yeah, the whole thing.

[Tom Bilyeu]

Interesting. So the body is relentlessly trying to balance the scale, so it's just jumping on go, go, go. And as soon as you stop the depressant, now it's gonna throw you so hard. Yeah, that is fascinating. I never stopped to run the math on that. Okay, that's very interesting. So, all right, putting this all back in context, we're living in this modern world. It is a world of joy and abundance. And I have a fascinating relationship with this because as I've moved over into developing video games, people will come be like, yo, bro, I thought you were about mindset. Like, what are you doing? You're giving people a drug? And I'm like, what? My thing is, the modern world is so full of these amazing things to, like you said, go back in time. I don't want to do that. That's not interesting. So I want to have a relationship with these things. But I want a good relationship now. For better or worse, I did not have discipline as a young person. I'm talking into my mid-20s. So as somebody who developed discipline, learned how rules can be super beneficial, I've developed a relationship with what I'll call gamification. It's the thing that makes games fun, but I apply it not only to games, but to other areas of my life. And so I'm like, I want to see people have a good relationship with this. Now, as a father, have you thought about, like, do you just try to deny your kids access to this stuff or do you have a method by which they can do all the fun things that the modern world has to offer but do them well?

[Dr. Peter Attia]

Yeah, I think being a parent today is probably a bit more challenging than being a parent 40 years ago, which is to say it might even be more challenging in 40 years. Although I'm sure everybody thinks that their time is the most difficult time. So. And this is the situation, this is what I think about more than anything. So to me, this is, this is the jugular question, right? Is what, what do I do to give my kids the best chance of being well adjusted adults? Like that's the thing that actually matters, right? I'm not asking the question what do I do to give my kids the greatest chance to be successful? Because I, you know, how do you define success? Like, do I give a shit if my kids, you know, go to the best university or get the best degrees or get the best jobs or make the most money? I don't care about any of that stuff. Like all that stuff is garbage if they are unhappy and if they're not well adjusted human beings. So I don't actually want them to make the mistakes I made where you don't think about that and all you think about is the pursuit of success. And success. And success. I don't. So I want to make sure that they don't repeat my errors and, and, and, and sort of. So what can I do as a parent to set them up for that? Because at the end of the day, they're going to make their own choices. So, you know, one, I don't think that complete abstinence is the right strategy because, you know, as my really good friend Rick Elias said to me on a podcast five or six years ago, parenting is like playing a game of tug of war that you have to lose after 18 years.

[Tom Bilyeu]

That's a great analogy.

[Dr. Peter Attia]

Yeah. Now how do you lose it? You can't let go of the rope all at once. You can't hold onto the rope for dear life. And when they're 18, just let go. Because what's going to happen, they're going to go flying. So you have to slowly, slowly, slowly, slowly lose, such that by the time they head off to college or leave the house, whenever that is, they won the game, but they won it slow. And so, I mean, I think about this so much with my daughter who is 16, and obviously we have a very different set of rules for her than my 10 year old and my 7 year old. And you know, so for example, it has to do with letting her make choices that I think are wrong. But you know, in three years, she's not going to live with us anymore. She's going to be able to make all the choices she wants. So it's probably better under my roof that she figures out some of these mistakes. So let's use alcohol as an example. I didn't drink in high school because I was a health nut, right? So it's like it just none of, like nothing about like the normal things of high school. Like, I didn't go to parties. If I did, I didn't, I rarely went, I didn't drink. Like all I did was train, train, train, train, train was the only thing I did. So in a way, I can't really relate to my daughter wanting to go to parties because I was like, you know, in my head I'm thinking, why would you want to go to a party? You could just study and train. But that's also, that's pretty dumb. So I also realize it's pretty naive of me to say, like, go to this party but don't have a sip of alcohol even if everybody else is drinking. It's probably much better for me to say, what do you think about drinking? Like what? You know, what are your thoughts on it? What are you curious? I mean, you clearly watch mom and dad have a glass of wine a couple times a week. You know, we have tons of alcohol in our house. It's not like you don't know what this stuff is. But have you seen other kids drink? Do you want to try it? Anything you want to try with us? Right here. This is a really good glass of wine. I promise you they won't have this at the party, right? And then talk about, well, what could happen to you if you drink too much. What happens when kids drink and get in cars? So instead we just sort of talk about all of these things because what we really want to do is get to the point where she's going to basically be able to go and make her own decision. And if her own decision is like, I'm gonna have some nasty drink, I want to make sure she holds on to the drink. She never drinks anything that someone gives her. You kind of go through all the rules that you would go through for a young girl who's drinking to make sure that something catastrophic doesn't happen to her. And she also gets to know that at any time of day or night, if you need a ride, you can call us and there'll be no questions or judgment. So I mean, that's just one example. But like, I'm kind of giving you a. How would I do that now? Would I have that, that type of thinking with my kid, with my boys who are younger, Not a chance in hell. We're way more restrictive with what those guys do because we're still holding onto the rope. Because if we didn't, they could kill themselves at any given day by accident

[Tom Bilyeu]

just because their brains are not developed. And they'll do stupid.

[Dr. Peter Attia]

Exactly. Like, they're still at the point where if we're walking them to school and they're fighting, they can easily fall out onto the road and get hit by a car. So they're just like, they're, they're still in the stage of like, they could kill themselves any given day. Like, and you know, you just have to decide like, okay, well, if they really want to climb that tree where that branch is going to break. And I've warned them six times that branch is going to break. But they don't want to listen. It's only a three foot fall. Okay. That's a lesson they might have to learn.

[Tom Bilyeu]

It's interesting. So I don't know if you know Brett Weinstein, but he has a fascinating rule for his kids. I hope I get this right. This is directionally correct. If it's not literally correct, you can do anything that doesn't cause like cervical damage or brain trauma. Like, it was like these really specific things. If you're putting yourself at risk of breaking a finger or an arm or a leg, cool. But if it could damage your neck, your back or your head, absolutely out of the question. I was like, that actually makes a lot of sense now. It scares the light.

[Dr. Peter Attia]

I just, I just don't know how you, I mean, it's, it's, it's, it's in theory a nice rule, but I don't know how you would adjudicate that in the real world. Like, you know, is falling off a three Foot branch likely to damage your C spine or your skull? No, but look, theoretically, it's possible, right? Like riding a bike and a scooter, really, really fast. Even with a helmet, you can still really cause some damage. So it's. It's probably a nice heuristic. I'm not sure how I would. How I would put it into practice.

[Tom Bilyeu]

Yeah, it's tough because ultimately you are. You're certainly running that calcul with your boys now about what branch you've tried to tell them, and they're gonna just keep pushing. It's interesting. That is one of the many reasons that I did not have kids like that. That is terrifying. I don't know how I survived childhood, just to be completely honest. And I was tame in the extreme like you. I did not drink. I didn't do drugs. I was quite literally terrified of all that stuff. And yet still, when I look back, I'm like, bro, there was one time, my friend, just like. Like, we had these beanbags. And when my parents were gone, of course, we would run down the hall, jump off the chair, the arm of the chair, and then, like, do a flip or whatever onto the beanbags. And there was one time he landed, like, face first. And the. This probably isn't literally true, but this is what it seemed like at the time. His heels hit the back of his head. Just to give you an idea of how far he bent.

[Dr. Peter Attia]

Oh.

[Tom Bilyeu]

And I was like, he's paralyzed or dead. And then he, you know, gets up and he's fine. But you have this moment where you're like, my life just changed in this incident because of a dumb thing that we're doing. Almost ran over a girl that I really liked. Long story, but obviously on accident, showing off, just crazy, crazy, crazy. It is all.

[Dr. Peter Attia]

I feel the same way. I feel an immense sense of gratitude for how much of a role luck has played in my life. How many stupid, stupid things I did as a young boy, you know, as a teenager especially, was probably peak stupidity. And, like, how many car accidents I almost got in because I was doing something totally stupid. And. And by the way, it's not just that I could have died. It's. How is my life different if I had killed somebody in a car? And so I, I, Yeah, I. I just. That. That's. You're right. That's the hardest part about being a parent, is you just. You want to protect them so much, but at the same time, you know that you have to let them make some mistakes or else they will never learn.

[Tom Bilyeu]

Speaking of potential mistakes. How do you think the mass adoption, I don't know, the right word of weed is going to play out over time. And do you like, when you think about your daughter, is it different between alcohol and weed or how's that going to play out?

[Dr. Peter Attia]

Yeah, so I kind of don't have the, I probably don't have the popular point of view on this. So I think we need to be pretty concerned with the ubiquitous adoption of thc. I think there are a couple of things going on that are not properly being distinguished. Right. So do I think that if you told me that you smoked a joint every night before you went to bed or, you know, whatever in the evening or whatever like that to me is a very different situation than, than, than maybe what we talk about. So, so, you know, with someone who's, you know, a fraction of your age. Right. So I think we have to sort of think about this through the lens of a developing brain versus a developed brain. I think we also have to think about the mode of delivery. So what's, you know, smoking a joint versus, you know, a much more potent concentrated thing that you're vaping? I think, you know, we have to think about quality control, which is like the difference between edibles in which you have no idea what you're getting sometimes where it's like, you know, batch to batch variability can be quite high. You know, things that are being basically bred to be more and more potent. So, you know, we, when we look at a lot of the epidemiologic data, it's based on what THC, what marijuana looked like 20 years ago, but that's not necessarily what it looks like today. And again, it also just begs the question, like, what are we numbing? Right. So what do we want people to be numbing with this experience? So I also think that there is, I think the evidence is not completely solidified yet that. Put it this way, Let me restate that, that I don't think it's, I don't think it's entirely clear that we can say that marijuana provides no gateway to other drugs. Right. So if, if you, if you take people on either extreme of this debate, and I don't consider myself on either side, I'm kind of more in the undecided, but I would really like more data. You have people on one side that say marijuana is a gateway drug and kids that smoke marijuana are much more likely to go on to do other hard drugs. Well, that's undeniably true. But the question is, is the marijuana causally related to that. That's what's not clear. Right. And then people at the other end of the spectrum say, no, that's just categorically not true. And they're basically saying the causality is categorically not true. But again, we don't know this for certain. So that's the question that I would really want to understand is it's not that kids who smoke marijuana are more likely to do harder drugs later that are problematic. It's did they do that because of the marijuana, or did they do the marijuana because they were more predisposed to do that other drug later on? On Very important question. I. Yeah, I've talked to my daughter about this a lot, and I've said, honestly, like, alcohol is an absolute toxin. But, you know, I think marijuana is a slipperier slope. And, you know, I've given her all the reasons why I think it's just not worth doing until you're older.

[Tom Bilyeu]

Tell me about those reasons, because that was going to be my next question. Is there a mechanism of action that you're worried about with thc? Is it ingesting a flammable material into your lungs? Like, what's the concern, Rob?

[Dr. Peter Attia]

No, I'm assuming I'm even taking all of that off the table because I think all of those are fair points, right? Which is, you know, toxicity and all sorts of things. I'm thinking more through the lens of anxiety, right? And. And I'm thinking that, as, you know, like, I mean, we've all smoked pot at some point. It's. I mean, it can be a drug that produces, obviously, a euphoria and a great feeling. It can also produce a lot of paranoia as well. And if you look at the literature on kids that smoke a lot of pot, you're seeing a higher prevalence of anxiety. Now, of course, the question is causality. We don't know the answer. Are the kids who smoke pot more anxious because that's the reason they're smoking pot, they're smoking pot to manage their anxiety? Or is chronic use of pot associating causally with more anxiety? Actually, this is, you know, going back to Anna Lemke. She wrote. She wrote an interesting case study about this in her book about a girl who was. Was, you know, using ever, ever more increasing amounts of pot, and her anxiety was getting worse and worse and worse. And basically, you know, when Anna got her to stop smoking pot, the anxiety went away. Now, that was a difficult detox, but it became clear that. That it was the other way around, that the pot was actually making her more anxious. So, you know, again, I, I think you have to take a nuanced approach to these things, which I know people don't want to hear, but it's, it's. I would just be very cautious using that in kind of a developing brain, both boys and girls. And, and that window of development is a bit longer in boys. And I would always just come back to the question of why, like, what's the itch we're scratching here? Right? Like, I know, for example, when I drink alcohol, which I drink, the primary itch I'm scratching is the ritual and the taste. Like, I actually don't care for any form of inebriation.

[Tom Bilyeu]

Whoa.

[Dr. Peter Attia]

But I really love the taste of certain types of alcohol. Now, that said, non alcoholic beer has become a great thing for me now because it still gives me something special to do. Because all day I'm sitting there drinking soda water, right? Like, I'm drinking Topo Chico all day.

[Tom Bilyeu]

Because Topo Chico is dope.

[Dr. Peter Attia]

I mean, I love it.

[Tom Bilyeu]

That stuff is amazing. I wish it was here.

[Dr. Peter Attia]

So. So when nighttime comes, if it's like six o', clock, I need something different. I just don't want to drink another Topo Chico. So sometimes I'll drink a Topo Chico where I'll put like this gia in it, which is like this thing I really like. That is like a. The, it's kind of like the skin of grapes. So it's a. It's a pretty potent little g H I A. I have no affiliation with them, but I love it. So I'll pour that, like, I'll pour, you know, whatever, two ounces of that into a glass. Throw a top of tea, sugar. Nope, it has no calories. Just. It's a very bitter thing. Yeah. You're drinking so little of it that it has no calories. Right. Or like have a non alcoholic beer or I'll have a glass of wine or something like that. Right. But so for me, there's part of it is the ritual. Like, I like ritual. I like taste. So I always just ask people, like, okay, well, if you're smoking, what are you smoking for? Oh, I need to relax. Okay. Why do you need to relax? Like, that's the question I want to understand. Okay. Is there something else you could do to relax? And of course, people love to point out that alcohol is more toxic than pot. And it probably is on a per use basis at a high enough dose of alcohol, meaning, like, you know, 60 grams of ethanol, which is what you'd have In a bottle of wine is undoubtedly more toxic than smoking a joint. But again, do you have to drink that much? Like, you know, you know, I mean, you just kind of get into the dose, you get into the, the dose effect.

[Tom Bilyeu]

It's interesting. So my wife introduced me to marijuana I had never tried. That was like on my list of reefer madness. And even though I'm too young for that, I'm old enough that I suppose I still had a sense of like, that is a hard drug. And my wife really liked it, likes, she loves it. And I was just, I don't know, she got me to try it. Anyway, long story short, I was like, oh, this is interesting. So sometimes it will break bad and it will give almost a panic attack. And what's fascinating is the amount of control that I can exert over that, that I, I can feel it coming and I'm like, hold on, that won't be fun. And I'm just absolutely not going to tolerate that. That. And you can normalize it, but you can still feel it there, like trying to mess with you. Very, very interesting. But by way of like, if my wife is like, I, this is going to be me representing her in a way that she would not represent herself. But my wife, I think thoroughly enjoys the manipulation of her brain chemistry. So when she's got a day off or whatever, she's going to want to play with her brain chemistry in some way. So if I said, hey, let's have a few drinks, she'd be like, cool. If I said let's smoke some weed, she'd be like, yeah, cool. But she's going to want to do something on special occasions. And I've just found that the day after I feel way better if we've smoked weed versus if we've had alcohol. And now admittedly I don't drink just to like enjoy the taste. That's why I was like, you like it for the taste. I hate everything about the way alcohol tastes, but I absolutely love the way it makes me feel. It makes me feel like I'm suppressing the urge to dance on a table. It is one of the most fun feelings ever. And if it didn't have a knock on effect the next day, I would probably drink weekly. But it does. And so I have it a few times a year and that's that. But with weed I'm like, I don't feel bad the next day at all. Now I don't smoke a lot, I'm a cheap date in that sense. But I, the way that it has been embraced by culture. Worries me now. Maybe I'm being overly paranoid, but it just seems impossible when you hear like how much people smoke. Some people, but the people that are very popular. I'm just thinking of people that talk about it in typically songs, Right. That it's just like morning, noon and night. I'm high all the time and I'm like, I am paranoid. I'm the guy that won't. I try not to take anything daily. I only drink things that we've been drinking for thousands of years. I just have a paranoia about ingesting exogenous substances regularly.

[Dr. Peter Attia]

Yeah, I mean, I, I'm not sure that that's my concern. I, I think that it's more. You hit on something a moment ago that I think not enough people probably understand, which is the lack of reproducibility of their response is also a little bit alarming.

[Tom Bilyeu]

What do you mean?

[Dr. Peter Attia]

You don't. It's really nice when you ingest a molecule and it always produces the same response when the response is. Is predictable. That's. That's desirable. What's not desirable is I'll do the same input five times and I get three different responses. That's not necessarily desirable, especially if any of those responses are unfavorable.

[Tom Bilyeu]

And you're saying weed has that variability.

[Dr. Peter Attia]

Yeah. I mean, just think about like you described it, like you sometimes can take it and you end up kind of going down that more paranoid path. Now the fact that you can kind of rescue it is great. Not everybody can. I think the same is true with psychedelics. And I'm not here to say psychedelics are good or bad. I, I think they're very interesting tools, but they're. It's like, it's like riding a lion. I mean, it's not, it's. It's, you know, so, so the real. The difference between taking sort of, you know, regular standard pharmacology and taking psychedelics is pretty significant in dose response and lack of predictability. And, and just, you know, sort of the way in which they work. Right. They're a much bigger punch. So you have to sort of be ready to kind of roll with those punches.

[Tom Bilyeu]

Yes.

[Dr. Peter Attia]

And accept the fact that sometimes more, More harm is done than good.

[Tom Bilyeu]

Yeah. That is a very interesting question. The developing brain versus developed. That is fascinating given the, like, if you have a history of psychosis in your family, don't do weed. That always scared me in terms of what the actual effect that it's having on the brain is.

[Dr. Peter Attia]

And I would, I would extend that to not just.

[Tom Bilyeu]

Just.

[Dr. Peter Attia]

I wouldn't do weed. I wouldn't do psychedelics, if that's the situation, certainly not at a young age.