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RENEE MONTAGNE, host:

This is MORNING EDITION from NPR News. I'm Renee Montagne.

STEVE INSKEEP, host:

And I'm Steve Inskeep.

Today in Your Health we're going to hear about a science experiment that explores the power of the mind. Thousands of studies have shown that a significant portion of people given a sugar pill will respond to that sham treatment just as if it were actual medication. Their symptoms get better. It's known as the placebo effect. Now, the question is whether a suggestion, just a few words, could have that same effect.

NPR's Alix Spiegel reports on an experiment involving hotel maids that suggests the answer is yes.

ALIX SPIEGEL: There are four flights of stairs at the Adam's Inn in Washington D.C., each with around 14 steps. Mariana Palanca(ph) works at the inn as a housekeeper. And so she knows these steps pretty well. She explains that she climbs the stairs nine or 10 times a day.

Ms. MARIANA PALANCA (Housekeeper): Every day I bring vacuum up there - and wax.

SPIEGEL: Palanca was a smallish woman and the vacuum, a large yellow contraption, is almost half her size. Once at the top of the stairs she wields it into position at the lip of the door and begins her routine.

(Soundbite of vacuum)

SPIEGEL: Palanca first vacuums the rug, then bends to reach the area under the bed. She moves the furniture, vacuums more, then dusts every surface at the room. This is followed by scrubbing the bathtubs, the toilets, the sinks. You get the idea. After 30 or so minutes, her routine is complete and she stands at the top of the stairs, her vacuum in one hand, a sack of dirty bed linens in the other.

Ms. PALANCA: Now we go to laundry.

SPIEGEL: Of course there are thousands of women like Palanca, hotel maids do spend their days lagging heavy equipment around endless hallways, women who literally spend almost every moment of their working lives engaged in some kind of physical activity.

But according to Ellen Langer, a psychologist at Harvard University who decided to use hotel maids to investigate the relationship between weight and mindset, most of these women don't see themselves as physically active people.

Dr. ELLEN LANGER (Harvard University): Sixty-seven percent of them reported that they don't exercise. More than a third of those said that they didn't get any exercise. Now, given that they are exercising all day long, this seemed to be bizarre.

SPIEGEL: What was even more bizarre to Langer was despite the fact that all 84 women in her study far exceeded the surgeon general's recommendation about amount of daily exercise, the bodies of the women didn't seem to benefit from their activity.

Langer and her team measured their body fat, their waist-to-hip ratio, their blood pressure, their weight, their body mass index.

Dr. LANGER: On all of these indicators they matched their perceived amount of exercise rather than their actual amount of exercise.

SPIEGEL: And so Langer wondered what would happen if you changed their perception. To figure this out, she divided the group in two. With half the women the researchers sat down and carefully went through each of the tasks they did each day, explaining how many calories those tasks burned and informing the women that they already met the surgeon general's definition of an active lifestyle. The other half got no information.

One month later, Langer and her team returned to take measurements and were surprised by what they found in the group that had been educated.

Dr. LANGER: A decrease in their systolic blood pressure, a decrease in their weight, a decrease in their body mass index, and a decrease in their waist-to-hip ratio.

SPIEGEL: In fact, blood pressure alone dropped 10 percent on average.

Now, one possible explanation is that the process of learning about the amount of exercise they were already getting somehow changed the behavior of the maids. But Langer says that her team surveyed both the women and their managers and found no indication that the maids had altered their routines in any way, which led Langer to this conclusion.

Dr. LANGER: The only to thing to which we could attribute this improvement was their change of mindset.

SPIEGEL: Essentially, Langer is talking about a placebo effect. She is saying that if you believe you are exercising, your body will respond as if it is, in the same way that if you believe you're getting medication when you're actually getting a sugar pill your body can sometimes respond as if it is.

Now, to be clear, Langer is not arguing that you can sit around eating chocolate all day, believe that the chocolate will lead to weight loss, and end up skinnier.

Dr. LANGER: I'm not saying that the effect we can have over our health and well-being is unlimited. What I'm suggesting is that we don't know what those limits are.

SPIEGEL: In fact, Langer talks about the study as part of a larger body of research which explores the connection between mind and body. For example, research about the effects of emotional stress on physical well-being and health.

But Martin Binks, a director of behavioral health at the Duke Diet and Fitness Center, feels that at least in terms of this particular study, the connection between the mind and the body remains unproven.

Dr. MARTIN BINKS (Duke Diet and Fitness Center): They can't really claim what they're claiming.

SPIEGEL: Binks, who spent most of his professional life at the diet and fitness center trying to track the reasons people do and do not lose weight, says that though he agrees the changes in the women's bodies were real, because Langer only used a questionnaire to track the women's eating and exercise practices during the period of the study, she can't definitively say that the only thing that changed was their mindset.

Dr. BINKS: There's a very high likelihood that those people behaved differently after they received that information and they were being more active or they were eating more healthfully that resulted in their improvements in health.

SPIEGEL: But Binks has a more substantive criticism. He does not believe that placebos are capable of producing the kind of objective change in the physical body that Langer is claiming.

Dr. BINKS: Generally, what placebos work on are subjective types of findings.

SPIEGEL: In other words, placebos can help change something like your perception of pain or perhaps your sense of whether or not you feel depressed, but can't do something objective like shrink a tumor or cut three pounds off your waistline, as the Langer study claims. Or can it?

Dr. HOWARD BRODY (University of Texas): The idea that you see a placebo when it's subjective but you don't to see a placebo effect when it's objective really doesn't hold up.

SPIEGEL: This is Howard Brody, director of the Institute for Medical Humanities at the University of Texas, and author of the book, "The Placebo Response." Brody, who has spent years looking at this issue, says that focused research into the possibilities and limits of the placebo effect is actually relatively new. Apparently placebo research didn't really take off until 2001, when the National Institutes of Health convened the conference on the subject.

Since then, however, our understanding of placebos has advanced significantly, and there are now a number of studies which challenge the old assumption that the effect can only alter subjective perception. Brody points to just one example.

Dr. BRODY: They have given asthmatic patients a drug that tightens up your airways and makes breathing harder - a drug that worsens asthma - and they've given it to asthmatic patients and told them it was a drug that relieves asthma. And a significant number of those patients said my asthma symptoms got better when you gave me the drug, and they measured better when you measure the lung findings. So the idea that the placebo effect is restricted only to subjective states of the brain I think is really one that we have to dismiss.

SPIEGEL: Brody agrees with Binks, however, that there appeared to be real limits to what a placebo can accomplish. For Brody, those limits involve the intensity of disease. He uses the metaphor of a gently-moving stream versus a raging torrent.

Dr. BRODY: If the disease process you're trying to intervene and change is a gently-moving brook or stream, you can see how the placebo could be very powerful. If the disease process is more like a raging torrent or a waterfall, you can see how the placebo might not be very effective in reversing it. So most cancers, for example, are much more like the raging waterfall than they are like the babbling brook. And so that would explain it's going to be very unusual to see a placebo that shrinks a tumor.

SPIEGEL: Fortunately for hotel maids and the rest of us who spent time each week hauling dirty laundry and toiling over the kitchen floor, the placebo effect just might apply here, and perhaps listening to this story will knock a couple of pounds off the scale.

Alix Spiegel, NPR News, Washington.

INSKEEP: Just in case that's not enough for you, you can find a vitamin to boost your brain power, or find out what the real secret is to a long life by going to our Web site, npr.org/yourhealth.

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