Science Plus Soul: How My Longevity Practice Relates to Peter Attia’s Approach.

Why I admire his work and how my North Framework adds awe, connection, and real-life flexibility.

By: Siobhan Gray, MD

Patients keep asking me a version of the same question:

“So… are you like Peter Attia?”

Short answer: I’m a big Peter Attia fan.

Longer answer: I’m deeply influenced by his work, but I practice longevity medicine in my own way; one that I think of as science plus soul.

In this post I want to share how I see Peter Attia’s framework, where I align with it, and where my own North Framework™ intentionally adds something different: more awe, more connection, and more room for being a human, not just a perfectly optimized data set.

Why Peter Attia matters for longevity medicine

Peter Attia has done something remarkable for the field of longevity. In Outlive, he argues that mainstream medicine (what he calls “Medicine 2.0”) is too reactive and waits until disease is well established before acting. He advocates for “Medicine 3.0” instead; a proactive, prevention-focused approach that uses personalized data, earlier screening, and targeted interventions to delay or prevent the major chronic diseases of aging.

He also organizes day-to-day longevity around several key domains:

• Exercise (his highest priority, including VO₂ max, Zone 2 training, strength, and stability)

• Nutrition and metabolic health

• Sleep

• Emotional health and mental well-being

I agree with him on the big picture:

• Healthspan matters as much as lifespan.

• Waiting for disease to appear before acting is a tragic waste of biology.

• Data can be incredibly powerful when used thoughtfully and in context.

I’ve read his book, taken his courses, and I regularly listen to his podcast. His work has absolutely shaped how I think about prevention, metabolic health, and exercise prescription.

So if you come into my clinic in Sisters, Oregon, and you see VO₂ max testing, strength assessments, lab panels you’ve never been offered in a 15-minute office visit, and conversations about healthspan instead of “you’re fine until you’re sick” – you are absolutely seeing the ripple effects of this Medicine 3.0 movement.

But that’s not the whole story.

Where I align with Attia

There are three big ways my practice overlaps with Peter Attia’s framework:

1. Proactive, prevention-first medicine

Like Attia, I am not content to wait for the “Four Horsemen” of aging: cardiovascular disease, cancer, neurodegenerative disease, and metabolic disease to show up before we act.

In practical terms, that means:

• Earlier and more nuanced screening for metabolic dysfunction

• Paying close attention to strength, muscle mass, and aerobic fitness as vital signs for aging well

• Looking at your labs, lifestyle, and history as a pattern, not a series of unrelated one-off labs

2. Evidence-informed, not trend-driven

Another thing I appreciate about Attia is his willingness to say “it depends” and to acknowledge uncertainty. His work emphasizes:

• Personalized strategy instead of one “perfect diet” or universal protocol

• Being evidence-informed rather than blindly following whatever is trending this week

That is very much how I practice as well. I am board-certified in Emergency Medicine and Obesity Medicine, and I take the science seriously. I spend a lot of time reading the primary literature, not just headlines and TikTok summaries.

We may not know everything, but we know enough to do much better than “come back when you’re sicker.”

3. Exercise as a cornerstone of longevity

If you’ve spent five minutes with my work, you know I care deeply about:

• VO₂ max and cardiorespiratory fitness

• Strength and power, especially as we age

• Movement quality and stability, so you can keep moving safely for decades

This is very consistent with Attia’s view that exercise is arguably the most powerful longevity lever we have, and that improving from “low” to even “below average” VO₂ max can dramatically reduce mortality risk.

You will absolutely see that priority reflected in my programs at PeakMD.

Where I intentionally diverge

Here is where my path starts to branch away from Peter Attia’s.

This is not criticism so much as orientation. If Attia’s framework is a highly engineered Formula 1 car, mine is more like a very well-tuned overlanding vehicle: still technical, still precise, but built for the varied terrain of real life, relationships, grief, joy, and seasons of burnout.

1. Trackers as tools, not tyrants

Peter Attia leans heavily into tracking: continuous glucose monitors, heart-rate variability, VO₂ max, detailed lab panels, and more. Used well, these can be incredibly valuable.

Where I differ is in how much authority we give the data.

In my clinic:

• I love using wearables, CGMs, VO₂ testing, and advanced labs.

• I also care deeply about how they make you feel.

If a tracker nudges you toward curiosity and experimentation, wonderful. If it pushes you into anxiety, perfectionism, or shame, that is not good medicine in my view. Your body is more than a dashboard. I want my patients to develop interoception, the ability to feel and trust signals from their own bodies, alongside understanding their data. The device is a tool. You are the authority.

2. Science plus soul

Attia’s work, understandably, is heavily weighted toward physiology, biochemistry, and risk curves. He does talk about emotional health, and Outlive includes a thoughtful section on mental and relational well-being, which I appreciate.

My own practice is built around what I call The North Framework™, which explicitly weaves science together with purpose, awe, and connection.

Very briefly:

• North – Purpose & Mindset: Why do you want to live longer and feel better; what are you orienting toward; what gives your life meaning.

• East – Mindfulness & Presence: Nervous system regulation, stress, sleep, and the mind–body connection; how you relate to your own thoughts and emotions.

• South – Body & Vitality: The deeply “Attia-friendly” territory: exercise prescriptions, strength, metabolic health, labs, hormones, recovery strategies.

• West – Connection & Belonging: Relationships, community, joy, play, and the role of being known and supported by other humans, your higher power and nature.

Everything we do at PeakMD sits inside this compass.

So while I absolutely care about your Lp(a), VO₂ max, and deadlift, I am equally interested in:

• Whether you have people to call when life hits hard

• How much time you spend in nature or in states of genuine awe

• Whether your health habits are driven by fear or by a sense of alignment and possibility

Longevity without meaning, connection, and a felt sense of aliveness is not the goal for me.

3. Making space for imperfection and seasons

From the outside, Peter Attia’s world can look very precise. His centenarian decathlon metaphor, detailed workouts, structured protocols, and disciplined routines are inspiring; they can also feel intimidating for real people juggling kids, aging parents, demanding jobs, and limited resources.

In my clinic, we explicitly acknowledge seasons:

• There are seasons to push and seasons to heal.

• Seasons where tracking everything is helpful and seasons where less is more.

• Seasons of grief and burnout where “your best” looks very different, and that is okay.

I do not want you living in a constant state of self-surveillance. I want you living in a state of curious engagement with your own life. Sometimes that means precise macros and a progressive strength plan. Sometimes it means walking by the river without your watch, feeling the sun, and letting your nervous system exhale. Both are longevity medicine.

How this shows up when you work with me

So what does all of this look like in practice if you’re a patient at my longevity clinic?

You can expect:

1. Yes, we will go deep on the science

• Advanced lab testing when it is truly helpful

• VO₂ and metabolic testing, strength and mobility assessments

• A real conversation about risk, tradeoffs, and evidence

You will not be told “you’re fine” based solely on a normal basic panel. We will get granular, especially around metabolic health, cardiovascular risk, sarcopenia, and cognitive risk factors.

2. We will also talk about your actual life

We will ask different questions:

• What do you want your 80s and 90s to feel like?

• Who do you want to be able to show up for?

• What do you love doing that you’re afraid of losing?

• Where are you already exhausted or stretched too thin?

Your goals become our “North.” The protocols come second.

3. We will use data, but we will also deliberately step away from it

• We might run a 3-month experiment with a CGM.

• We might track sleep and HRV for a while.

• Then we might intentionally practice not tracking, and see what you’ve internalized.

The goal is not perfect compliance. The goal is a sustainable, embodied way of living that you can carry through different phases of life without feeling chained to a device or a spreadsheet.

Attia’s framework and mine can coexist

If you love Peter Attia’s work, you will probably feel very at home with much of what we do together:

• Strong emphasis on exercise and muscle

• Early, nuanced prevention

• Data-driven decision making

You do not have to choose between “Attia-style” rigor and a more contemplative, awe-filled, relationship-centered approach. My practice is essentially a bridge between those worlds.

Think of it this way:

• Peter Attia helps us understand the science of how we might live longer and better.

• The North Framework™ helps us decide what “better” really means for you – and how to live it in a way that feels human.

If that blend of science plus soul resonates with you, you are exactly the kind of person I built this clinic for.