His father is a former Olympic rowing champion who was one of the early advocates of a whole-food, plant-based diet in the prevention and reversal of heart disease.

[2] In 1997, he retired as a triathlete and turned his attention towards becoming a firefighter and emergency medical technician, joining Engine 2 of the Austin Fire Department.

This experience eventually led him to write The Engine 2 Diet, which begins with a foreword by T. Colin Campbell, author of The China Study (2005).

[20] Esselstyn appeared, along with his father and T. Colin Campbell, in the 2011 American documentary on whole foods, plant-based eating, Forks Over Knives.

He later developed and starred in the follow-up documentary, Forks Over Knives Presents: The Engine 2 Kitchen Rescue with Rip Esselstyn.