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Let me introduce myself. My name is Mark Sisson. I’m 63 years young. I live and work in Malibu, California. In a past life I was a professional marathoner and triathlete. Now my life goal is to help 100 million people get healthy. I started this blog in 2006 to empower people to take full responsibility for their own health and enjoyment of life by investigating, discussing, and critically rethinking everything we’ve assumed to be true about health and wellness...

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May 01, 2014

Does the Placebo Effect Apply to Exercise?

By Mark Sisson
38 Comments

Box JumpA couple weeks ago I highlighted a nutrition study that suggested even the body’s hormonal responses (not just self-reported “feelings”) could be impacted by how we perceive a particular food we eat. It’s the kind of thing that I feel like opens up life and health in an amazing way. Let me be clear that I’m not claiming people can abuse their bodies and then erase it all with the magic of positive thinking. I think most people understand it’s positive thought in tandem with positive action that makes for significant, long term benefit. To a point, I’ve always felt there was something to the psychological overlay in health. We’ve all seen it. People give up on their lives after losing a spouse. They approach their lifestyle changes with resentment and cynicism. On the other hand, some people’s health or weight loss takes off once they address underlying emotional issues even though their routine is generally the same. As an elite level athlete, I knew glaringly well how much my mental attitude influenced my performance. As a trainer, I saw every day how much my clients’ expectations helped or hampered their progress. I’ve been curious lately about the measurable impact behind these general observations. Can we, say, examine fitness and the placebo effect beyond intuition and find actual evidence? What does research say, if anything, about the placebo influence on our body’s exercise benefit – and what should that mean for us?

I mentioned previously, of course, the much cited housekeeper study that measured otherwise unexplained gains in the research sample of hotel housekeepers who were told their daily work met the federal standard for daily exercise. It’s a good place to start because I think too often we apply the concept of positive thinking solely to performance level activity (e.g. marathon winners, Olympic swimmers, etc.).

Yet, the truth is much of the research revolves around performance – and in many studies performance with placebo supplements. Sometimes the placebo effect is studied in a session after a real supplement has been administered in the previous session. The subject then “remembers” and imposes the same benefit (verbally cued by researchers in the second session) onto the “clean” session. It calls into question what exactly constitutes preconditioning in the holistic sense. In one study, for example, lifters improved their output by 3.5-5.2% when they (erroneously) believed they had been given a steroid as they’d experienced in a previous session. Another study found participants doing quadricep work with the suggestion that they’d received a caffeine supplement showed 11% enhancement to their work compared to their previous session. Cyclists produced more power (up to 3.1% over baseline) when they believed they’d ingested a high dose of caffeine. Finally, runners who believed they were being offered “super-oxygenated water” (and watched a video about its purported, but debunked, benefits) ran a 5K session an average of 83 seconds faster (PDF).

This brings me back to everyday fitness endeavors….

The studies out there are few and far between when it comes to general fitness as opposed to performance sessions, truth be told, and they aren’t always consistent. One study sought to replicate the same set-up as the housekeeper research with university custodians. At the end of the study period, however, the two groups showed no significant difference in health measures.

Yet, research is generally consistent in demonstrating psychological effects of exercise even when it’s a matter of perceived versus actual exertion. One study sought to measure the difference in mental well-being in two groups that participated in the same training program. One half was told their program was specifically designed to enhance their psychological well-being, while the other received no message. Although the two groups showed the same VO2 max improvement at the end of the study, the primed group showed a significant advantage in self-esteem assessment.

In a letter to the editor regarding the self-esteem exercise study, one psychologist suggested that the way we think of medical placebo doesn’t entirely match up with psychologically enmeshed situations and that psychological healing and enhancement can come when we are willing to emotionally accept them – the benefit of “effects based on expectations.” One researcher in the area of fitness and placebo even offers that some of the benefits we attribute to better physical functioning are actually the results of psychological effect that comes with exercise. Of particular note, subjects who perceived themselves as more physically fit were better able to cope with stress regardless of actual activity levels (measured by a device during the study period). The mind-matter question is perhaps more nuanced than we tend to give it credit for.

So, if we can measure the placebo effect as we observe it with food, exercise (and even sleep), is there anything the power of the mind doesn’t influence in terms of functioning on some level? I’m interested to read a new book out just this week by behavior change writer, Dr. Joe Dispenza called You Are the Placebo, in which he not only accounts his own healing from a major accident from which he was never to fully recovery but outlines the research (and a protocol) around placebo and health.

Finally, on a non-exercise but (I think) relevant note, the results of a larger, more general study, showed subjects’ perceived assessment of overall health appears to have an impact on our mortality – a more influential factor than actual health itself. Participants who rated their health as poor were six times more likely to die in the nine-year study period than those who described their health as excellent even when perception didn’t match measured medical reality. If our thinking or the psychological suggestions we accept can apparently impact our mortality risk itself, their potential for influencing our quality of life might be one of the best practices we can cultivate for ourselves.

Thanks for reading, everyone. What say you? How has attitude or suggestion influenced your fitness or performance?

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38 Comments on "Does the Placebo Effect Apply to Exercise?"

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Serena
2 years 7 months ago

This makes sense in light of the studies that show that the main thing supercentenarians have in common is that they don’t worry.

Wenchypoo
Wenchypoo
2 years 7 months ago

You Are the Placebo…indeed! Fascinating what the little computer between our ears can do for us, like creating our own “Matrix” worlds. Who needs to swallow a colored pill, when the brain does it all for us?

BFBVince
2 years 7 months ago
However, I feel like its a little like Inception. It’s very difficult to ‘incept’ a thought. It has to be organic. You have to think you thought of it. I find it hard to make myself think something is a placebo (and get some sort of mental benefit) when I know its really not. It’s the whole rub of the idea of a placebo, you have to genuinely think it is going to work but how is that possible? That’s probably the beauty of our brains, the fact that we are grounded in reality and can’t just trick ourselves at… Read more »
C L Deards
2 years 7 months ago
That’s not entirely true. If you have a good attitude to begin with then you are more likely to realize the benefits. For instance, years ago I was in a horrible bicycle accident. During the recovery period I got up every day and did the occupational and physical therapy. Without fail. Every day. Even with my brain addled by medication and head trauma I felt that I had no other choice. I was told by doctors and nurses that some people just give up. Attitude makes a big difference. Your point though is if you are in the pit of… Read more »
BFBVince
2 years 7 months ago

I do agree there is a sense of shaping your own reality and I certainly don’t deny the power of our minds. Maybe Mark is using the placebo effect to get across a much broader concept of maintaining the right attitude.

Clay
Clay
2 years 7 months ago
You don’t need to believe in a placebo 100% to make it work. Smiling is a good example. The act of smiling causes positive chemical changes in the brain and body. When you smile, even if you don’t feel like it, you are telling the brain that you must actually be happy (even though you aren’t) and the brain will act accordingly. The whole fake it till you make it concept. I think the big question though,is since the placebo effect accounts for about 25% of the success of any treatment, is it malpractice for a doctor to NOT prescribe… Read more »
Groktimus Primal
2 years 7 months ago

So those God damned happy morning people are going to outlive me then?

Tommylee
Tommylee
2 years 7 months ago

Yes! Next question?

Rick
Rick
2 years 7 months ago

The good news is, after you croak you won’t be unhappy about it, and after they croak they won’t be happy about it. : )

Nocona
Nocona
2 years 7 months ago

Hmmm. It appears to me that ornery, grouchy people never die…

another way
another way
2 years 7 months ago

my grandma used to say “what a pill!” when confronted by grumpy people–even then she knew a good attitude was better than a pill….and she’s still going strong at 99.

sean
sean
2 years 7 months ago
It really has nothing to do with positive thinking, it has to do with the “reality” you’ve chosen. “Positive thinking” in the face of a negative situation that can’t be processed in any other way but negative (like being stabbed or death in the family), is just emotional suppression. Emotional suppression is very strongly linked to stress and chronic disease. What you “choose” after that negative event is coping. Functional coping requires you to choose between “equally true” realities. In regards to the previous example, if a family member dies (after grieving) you can choose to feel defeated over the… Read more »
Kate
Kate
2 years 7 months ago

I agree, but I wouldn’t call it choosing a “reality” exactly, but choosing the story about the situation… I was just listening to this:
http://www.bbc.co.uk/programmes/b041yjnw

Vince G
Vince G
2 years 7 months ago

That makes a lot of sense, Sean; and I agree. I have often been told to “think positive” in certain situations, but I feel that defeats the purpose of intelligent comprehension of the situation. If I was given a logical “choice”, it would negate the need to dispel the “positive thinking mythos” and give my brain something concrete to grasp… even if it wasn’t real. Humans=weird.
But, ya know, whatever works!

Paleo Bon Rurgundy
2 years 7 months ago

I keep telling myself that 20oz curls count towards exercise.

another way
another way
2 years 7 months ago

You mean Venti curls?

Dave
Dave
2 years 7 months ago

This all makes me think that we could do humankind a great service if we would randomly approach each other and say the most positive thing we can think of. Like, “You are so beautiful/handsome!” or “Wow! You really look healthy!” or “You look like you feel really good about yourself!”

Doesn’t matter if it’s true or not. Just make it positive.

By the way, MDA readers are the brightest, healthiest, most caring people in the world.

Don’t ya feel better?

Krissy
Krissy
2 years 7 months ago

Can we not do that? I’ve been known to do that relatively often… still societal propriety has me catching myself more often than I’d like and preventing me from doing it. But when I do stop someone I don’t know to say something like “You are an extremely beautiful woman” or “Your outfit looks phenomenal” because I truly mean it, not only do they seem pretty chuffed by it, but I feel freaking fantastic for making someone’s day too. Why do we not do this more????

Rhonda the Red
Rhonda the Red
2 years 7 months ago

I totally agree!!! I embarrass my daughter regularly by complimenting complete strangers. But it makes the person so happy I do it anyway.

Amy B.
2 years 6 months ago
Right on — I once read that you should never pass up an opportunity to give someone a compliment. It might be the only nice thing they hear all day, and you never know how badly they need it right at that moment. (Happened to me the other day, actually — it wasn’t a compliment, but just someone passing me in the hallway of my office, smiling and saying hello, rather than walking with their head down and not acknowledging the existence of other humans, like usually happens in that building.) I don’t think we should *fabricate* compliments, but we… Read more »
Jed Stream
Jed Stream
2 years 7 months ago

Its all about attitude!
http://youtu.be/FLf51-hZwR8

Janet
Janet
2 years 7 months ago

Wisdom that has been around for a long time. 🙂

Proverbs 17:22 ESV

A joyful heart is good medicine, but a crushed spirit dries up the bones.

Proverbs 23:7
For as he thinks in his heart, so is he. (NKJV)

Pdawg
Pdawg
2 years 7 months ago

Love that verse. Have it hanging in my laundry room.

Duncan
Duncan
2 years 7 months ago

placebo is very powerful, for an excellent review this lengthy paper is worth a read.
http://physrev.physiology.org/content/93/3/1207.full-text.pdf+html

Dr. Anthony Gustin
2 years 7 months ago

Maybe not actual physical adaptations, but perhaps effort put in in relation to RPE?

Jenna
Jenna
2 years 7 months ago

My dermatologist had told me about this effect of the mind on the body. Crazy stuff!!!

Eric B
2 years 7 months ago

About a year ago I had an upper GI done for a possible hiatal hernia. While imaging my abdomen, the radiologist told me to think about my favorite food. After asking why, he told me that’s all that was needed to start contractions in the stomach to help move around the imaging junk I drank. He said that’s been known for a long time.

If just thinking about food can elicit a physical effect like that, I’m sure thinking can have other physical effects too.

Nocona
Nocona
2 years 7 months ago

When I just think of coffee in the morning, it makes me poop.

Kay
Kay
2 years 7 months ago

Wonder what effect would be of writing my Friday Success Story before I am actually the success… I’m going to give it a shot!

granny gibson
granny gibson
2 years 7 months ago

Like 😉

Krissy
Krissy
2 years 7 months ago
That’s actually a brilliant idea! It’s exactly the same concept as the task my life coach has gotten me to do with building a new business. Write my synopsis of my business as I imagine it to be in 10 years. But write as if it’s happened and I’m writing an article etc. It was very powerful… And this was 6 months ago, still trapped in my shitty old job and miserably unhappy… here I am having quit and started. It really gave me the motivation to do it. When you put the language in present/past tense it really does… Read more »
Clare
2 years 7 months ago
I read an interesting book years ago that I’ve been meaning to dive into again, which is linked with this idea. It’s specifically about Self-Hypnosis (writing and then recording your own hypnosis scripts, because what voice do you trust more than your own?) but hypnosis generally works on this same concept I think. You’re attempting to tap into your sub-conscious to influence your physical body in ways your conscious mind can’t. It’s apparently useful (according to the book, at least) for conditions far beyond quitting smoking or other habit change – I first tried it because I was freaking out… Read more »
Angelina Sophora
2 years 7 months ago

I believe that a positive outlook in life goes a long way. Such an interesting post you have here. I personally think that placebo really is something. The power of BELIEF might be strong enough to make our bodies alter itself. Or maybe it’s just the willpower. or just pure luck?

Rhonda the Red
Rhonda the Red
2 years 7 months ago

I kickstarted a huge weightloss for myself several years ago by using EFT (meridian tapping). Dumping the emotional baggage set my body free to recalibrate itself. I highly recommend.

Michele
2 years 7 months ago

I 100% believe this to be true. It’s just so hard to measure, but experience tells the story. Believing you can do something and refusing to entertain the idea that you can’t will almost always result in success. The hard part is really believing, I guess.

Chris Malcolm
Chris Malcolm
2 years 7 months ago
When 20 years old I fell about 30 feet off a cliff landing on my back. After resting for about 2 hours I was in great pain but able to walk while holding my breath. I walked the few miles to the hospital by hyperventilating while standing still and then walking holding my breath. I should have called an ambulance but I wasn’t thinking clearly. Due probably to pain and shock my color vision was greying out and I was also losing peripheral vision. I had the idea that if I stopped walking I might die. The hospital fixed my… Read more »
Benjamin Thomas
2 years 6 months ago

Wow, what a story. You overcame quite the obstacle. I was doing a hike the other day and I was passed by a group of 70 year olds. I was just enjoying myself and not going as fast as I could, but they had a fast pace and they weren’t winded at all.

The Tempered Sole
2 years 6 months ago
In my experience mindset absolutely does impact the results of physical activity. The right mindset is essential for a strong hormetic reaction (which is IMO the ultimate goal of a workout) but also makes people much more aware of using the body correctly. I see a lot of people laying on benches while half assedly doing leg raises while surfing on their phones. Of course nothing is derived as the individual is simply laying in a dis-coordinated pile, technique and a controlled stress response are the tools to changing physiological and psychological composition. The housekeepers in the study perfectly mirror… Read more »
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