Is Peter Attia Wrong About Longevity Drugs?
Peter Attia, MD, one of the best known voices in longevity medicine, is known for his data-driven, personalized medicine 3.0 approach. His book and podcasts provide deep dives into exercise physiology, nutrition, and metabolic health. My reading of his recommendations and the research that continues to be done on topics that he discusses is that Peter Attia is right the vast majority of the time. Did you know that Attia is so sought after that estimates indicate that it costs about $150,000 per year to be a patient of his concierge longevity practice! But in recent years, Attia has had to reverse his positions on a number of issues and some people have asked: Is Peter Attia wrong about longevity drugs? More specifically—was he wrong about metformin, and is he right about rapamycin, GLP-1 receptor agonists, and growth hormone and peptide therapies?
Let’s take a look at what Attia has said, what the evidence shows, and how to think about these drugs in the context of precision medicine. But before we dig in, let me be absolutely clear that if you are not currently eating a whole foods based diet, prioritizing sleep, tracking some key lab markers of metabolic health, and checking all three exercise boxes – lifting heavy weights twice weekly, doing 3 hours of zone 2 training per week, and completing 1 or 2 high intensity interval sessions per week – you are missing out on the vast majority of all of the potential longevity and wellness gains that are available from your life! The gains from those actions are HUGE and the gains from any longevity drugs available right now are small in comparison.
Metformin: From Longevity Darling to Cautionary Tale
What Attia Used to Say:
A few years ago, Attia very much surprised me when he was openly prescribing metformin for longevity to many of his metabolically healthy patients, based on:
Data in type 2 diabetics showing reduced cancer, cardiovascular disease, and all-cause mortality
Animal studies suggesting mTOR modulation and other anti-aging effects
Low cost and relatively benign side-effect profile
But there were no studies supporting this practice in healthy adults without diabetes or metabolic syndrome!
Why Attia Changed Course:
Attia has since stopped routinely using metformin in healthy individuals for longevity, citing:
Data from Konopka et al. (2019) showing metformin blunts some of the mitochondrial adaptations to exercise
The fact that its benefits may not extend to non-diabetic populations
Concerns that its effect on glucose control comes at the cost of exercise-induced insulin sensitivity
I am glad that I never bought into this idea, because we now have evidence that metformin BLUNTS the benefits from exercise and we don’t have any proof that it extends life in humans. Therefore, Peter Attia now argues that unless there’s clear metabolic dysfunction (e.g., insulin resistance, elevated A1c), the case for metformin as a blanket longevity intervention isn't strong enough.
“I was using it very liberally before... I wouldn’t do that now.” — Attia on a recent podcast episode
Bottom Line:
Attia was wrong — not because metformin is useless, but because the context matters. But he adjusted his stance when better data became available. That willingness to change course in the face of compelling data is what we want from a physician thought leader operating in the health space.
Rapamycin: Proceeding with Curiosity but is There Enough Caution?
Rapamycin is regarded by many as the most promising anti-aging compound we've seen in species from yeast to fruit flies to mice! It:
Extends lifespan in virtually all animal models studied
Targets the mTOR gene, a central regulator of growth and aging
May reduce cancer risk and preserve cognitive function
What Attia Says:
Attia has publicly said he has personally been taking rapamycin for four years, and that he does prescribe rapamycin, but to “fewer than 10%” of his patients under controlled protocols. He emphasizes:
Intermittent dosing may be safer and more effective than chronic use
We still lack reliable biomarkers for mTOR inhibition in humans
The drug’s effect on immune function and wound healing are potential concerns, especially in older adults
He's not against rapamycin, but he’s also not calling it ready for prime time as a universal longevity drug.
“The risk is probably low, but the uncertainty is still high.” — Peter Attia on rapamycin
Bottom Line:
Attia is both taking rapamycin and clear about the caveats. However, I would advise using extreme caution by reminding you about what happened with metformin (which also affects the mTOR/AMPK pathways that rapamycin affects). I worry that rapamycin could ALSO reduce mitochondrial and strength adaptations to exercise. You should also know that famous tech billionaire and longevity “guru” Bryan Johnson has announced that he has stopped taking rapamycin after 5 years because it didn’t work and caused him harm! So, I would definitely not say that Attia is wrong — he seems to be approaching it cautiously in the way you would want a physician to be when you’re dealing with a compound that is so strong of an immune modulator that it is used to prevent organ rejection in transplant patients.
GLP-1 Agonists: A Useful Tool, Not a Shortcut
Attia has spoken favorably about GLP-1 receptor agonists (like Ozempic, Wegovy, Mounjaro) for:
Patients with visceral adiposity (abdominal fat)
Those struggling with appetite regulation, diabetes, or insulin resistance
Cases where lifestyle change alone hasn’t worked
But he’s critical of:
Off-label use in lean, athletic individuals
Lack of attention to muscle mass preservation
Using them as a short-cut instead of addressing root lifestyle causes
People should also be aware that, in the right patients, research shows that GLP-1s can also successfully treat sleep apnea and lower cholesterol and insulin levels in beneficial ways, in addition to potentially leading to significant weight loss. In summary, Attia’s approach aligns with the data: GLP-1s improve metabolic markers and address many longevity boosting issues, but loss of lean mass and possible rebound weight gain post-discontinuation remain major concerns.
Growth Hormone and Peptides: Precision, Not Panacea
Dr. Attia has spoken about using growth hormone (GH) and specific peptides (like BPC-157) in targeted situations, such as post-surgical recovery, but not as general longevity enhancers.
GH: A Surgical Recovery Tool, Not a Longevity Drug
Attia has discussed using short-term GH therapy to accelerate tissue repair after orthopedic surgery. Growth hormone stimulates collagen synthesis, supports tendon healing, and may prevent lean mass loss during periods of immobility. However, he does not advocate long-term GH use for anti-aging due to concerns about:
Insulin resistance
Potential cancer risk
Lack of long-term safety data in healthy individuals
“I used GH after surgery as a tool to recover.” — Peter Attia, from podcast discussion (note that it was not used for longevity!)
Peptides: The "Wild West" of Regenerative Medicine
Attia has expressed cautious interest in peptide therapies, especially those aimed at joint repair, tissue healing, and inflammation. He has mentioned BPC-157 and others anecdotally but is clear that:
Most peptides lack rigorous human data
Many of these are prescribed off-label, often without adequate supporting human research, standardization or regulation
These are often quite expensive and you have virtually no idea what is actually in drug you are taking
The field is currently a “wild west” in terms of quality control and efficacy
Attia’s stance is one of guarded curiosity: peptides may hold promise, but clinical rigor must catch up before they’re ready for mainstream use.
Bottom Line on GH and Peptides:
GH may be valuable short-term for tissue recovery, but not appropriate for long-term anti-aging use in otherwise healthy individuals
Peptides may offer therapeutic benefits, but should be used selectively and scientifically
Attia continues to watch these therapies closely, prescribing them only in specific contexts with a strong emphasis on monitoring and individualized care
So, Is He Wrong?
About metformin?
Yes — he was but he changed his mind, and he was early to revise his stance as better data emerged. That’s not a weakness — it’s a sign of integrity.
About rapamycin?
Unclear — he is taking it and prescribing it, but in a limited group. He seems to be one of the few longevity-focused physicians treating it with the nuance it deserves: hopeful but not hyped.
About GLP-1s?
Not at all — he discusses them as a powerful tool, not a cure all.
About GH and Peptides?
No — he describes them as potentially useful for tailored uses right now, but is waiting for better studies before determining if they are effective for improved longevity.
Takeaway: In Longevity, Evidence > Hype
If you're trying to extend healthspan, there’s no magic pill… yet. But the most powerful levers – personalized nutrition, ample exercise, excellent sleep quantity and quality, strength training for muscle mass, and improving metabolic health markers on lab testing – do not cost $150K per year and are available to everyone. Drugs like metformin, rapamycin, GLP-1s, GH, and peptides may play a minor role for some people, but they are expensive, have limited data to support them, and should be used only if applied precisely, for the right patient, at the right time.
Attia’s greatest strengths may be that he focuses on lifestyle optimizations over medications, and he continually updates his recommendations. In a field where science is still catching up to the promise, that’s exactly what we need.
If you would like to discuss how to extend your own healthspan, make an appointment to see me. I would love to help you achieve your health and performance goals!
