Read on Twitter
Peter Attia’s podcast would be great if it was addressed to scientists as a discussion of hypotheses many of which will be disproven. Yet it is directed toward a general audience which is wildly inappropriate. Whether something is quackery is decided by context not content.
Peter uses many of the hypotheses he talks about on his patients to the tune of $50-100K/year/patient. Bypassing clinical trials and jumping directly to clinical application based on mechanistic plausibility and animal studies is bad medicine with a high chance of harm.
To doubters, let me ask this question: if he promoted hydroxychloroquine, colloidal silver, garlic extract, etc. for COVID, would “acknowledging uncertainty” be adequate to erase the impact of creating this kind of confusion? Especially if he made these sound really exciting?
The answer is no. The general public hears excitement and gets excited. Peter has training from Stanford, Hopkins, and NIH and uses these treatments, so a general audience believes that the balance of benefits and risks must be in favor of the speculative treatment.
When it is disclaimed that “this is just an hypothesis and uncertainty exists”, the public rightly believes that this is a mere formality and that the balance still lies in favor of the treatment.
Here is the problem. Peter’s assessment is wildly at odds with what we know about the historical success rate of hypotheses in clinical trial and is likely to create a kind of medicine that is ineffective or harmful. This is why most doctors do not practice medicine this way.
To actually accurately convey the problems with Peter Attia’s content, Peter should discuss just how controversial and frowned-upon by many or most physicians it would be to practice medicine in this way. And he should note that he is in a small minority.
And that many doctors would be horrified and incredulous to hear that he doses his patients and himself with rapamycin, metformin, SGLT2 inhibitors, week-long fasting for “autophagy”, etc. for “longevity”.
And that many of his main hobby horses such as NuSI, metformin, etc. turned out to be duds or falsified by actual human data when tested and much else of what he speculates upon and practices will be similarly qualified or falsified.
If he communicated things like that—not that there is “uncertainty” but what I wrote directly above—that would be sufficient qualification to communicate the practical reality of his content: hypothetical, hypey, dangerous, untested.
Instead he gets to create his own special Peter Attia bubble where he decides what makes sense and what doesn’t and his listeners take for granted that his judgment is correct—despite just how tremendously controversial these things would be in the medical community.
BOOM