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I was scourging the Internet today and noticed a NPR article entitled, “Hotel Maids Challenge the Placebo Effect” that caught my attention. The article is in reference to a study by Harvard psychologists, Ellen Langer and Alia Crum entitled, “Mind-Set Matters: Exercise and the Placebo Effect.” I do not like articles like this that do not have the study information. As much as I like NPR, I want to read the underlying study myself to see if I agree with the gist of the article. I had to search by the researchers name along with the word maid and I finally found the name of the study. I then connected to my alma matter (university) library and pulled a copy of the study. I will evaluate this study from a layman’s perspective (I have a MBA and while I can read this study and draw some conclusions, I am not a psychologist).
While researching this topic I did find the link to the Surgeon Generals Health Weight Advice for Consumers here. The advice in a nutshell is to have a goal, keep active and eat well. The page has a lot of information that can assist a person to make wise decisions about diet and exercise. I will go over this study and point out some areas I think have merit as well as a couple of logical problems. I think anyone interested in this study should read the actual study for yourself but I will be glad to venture my opinion.
The study mentions other previous studies that have noted that belief can play a role in results. A couple of studies are mentioned where a persons negative belief of their health, affects their mortality as well as another study that showed perception was actually a good indicator of mortality, regardless of health. Both studies led these researchers to the following question, “We wondered whether the well-known benefits of exercise are in whole or in part the result of the placebo effect.” That led to the hypothesis (paraphrasing) that increase belief has the effect of increasing the benefits of exercise.
The study selected groups of maids and tried to account for all varibles. I looked the design of the study and was satisfied that the researchers tried to keep everything between the informed and control group as even as possible. They even went to the length of keeping the groups separated by motels (so no accidental contamination of informed group to the control group.
Here is basically what they did on the first visit; the researchers went into the different motels with questionnaires and conducted test to get the raw data (blood pressure, weight, measurements and such). They (the researchers noted that the to be informed group as a whole, did not regard their job as exercise. The researchers then educated the informed group that the Surgeon Generals guidelines showed they were getting enough exercise to be active. They were set to come back in back in one month to take the data again.
One month later they had the maids fill out the exit questionare as well as take measurments again. The informed group lost two pounds, had a lower percentage of body fat as well as dropped their blood pressure 10 points. The control group remained the same.
The researchers admit it is possible the informed group changed their behavior but noted they (the maids) said they did not change anything. The motel management did not change the maids work flow. Based on the articles I read and this studies conclusions (stating the placebo effect possibley affects exercise benifits), more study is indicated. I did not note any other critiques other than the researchers could not vouch that the informed group did not change anything.
Well on the face of this study - it looks significant. I did note a couple of problems. The first issue is the mean age of the two groups of women were different. The informed group had a mean age of 34.12 and the control group had a mean age of 42.40. This was noted in a foot note and I did not see this mentioned in any of the articles.
The second problem as I see it is the researchers depended on questionnaires to validated the informed (and contol) group did not change anything. The informed group participents may have unconsciously started eating better food choices or smaller portions because they were feeling better about their health.
I also noted that in the review of other studies, it was noted that there may have been problems because the subjects were self reporting. In this study the researchers did take their own measurments before and after but did depend on the participents to report generically if they changed anything. I would have thought at minimum total calories consumed and minutes of exercise per day would have made the results less suspect.
Now I do generally like the question, methods, and think the results followed the proper process of a study, I think the main area that negates much of this study is the mean age of the two groups. let me explain, younger people have faster metabolisms and older people have slower metabolisms. Couple this fact with the knowledge that calories and extra exercise were not tracked, means to me that the younger people may have lowered their portions and increased their exercise consciously (to please the researchers) or unconsciously (because they felt better about themselves) and skewed the results.
What do I think? I think this and the other studies show that our perceptions can lead to a placebo effect (meaning what we think can affect our results). I do not think this study proves that but it hopefully will lead to other researchers doing further research of this question and contol the variables so the results will be more meaningful.
So I don’t know about you but I think I am getting plenty of exercise! I am down thirty-five pounds since the beginning of the year and quite willing to believe things are going well. I do have a positive attitude about goals and don’t worry too much if I have set backs. Who knows… maybe this belief (placebo?) is increasing the benefit of my exercise? I’ll take any help I can get! Hang in there all.