The diet and fitness industry is sadly so deep in pseudo-science and marketing that for the ordinary member of the public, sorting the truth (or the fact) from the fiction is almost impossible unless they are able to spend time looking beyond the claims of many a snake oil seller or ‘revolutionary’ new diet plan. Could it be though, that the actual efficacy of these plans is in part due to the mindset of the individual carrying it out or the practitioner prescribing it, rather than the actual plan itself? Many a book/supplement/exercise device has been sold on the promise of new and powerful information, which is usually as old as the hills or backed by questionable science. All too often we obsess over the content of the training/diet/supplement plans we create when in fact the key factor may be our clients actual belief in the plan to actually work. I will be the first to admit that as a trainer I have had a few failures with clients, who despite hours spent pouring over their training programmes, diet plans, and food diaries ad nauseum, still haven’t produced the results I had hoped for. For someone known to be a touch obsessive/compulsive such as me, this sort of end product can be deeply vexing. Discontent with my own inadequacy as an explanation, I have gone in search of an answer. Might it be that those who fail to see great results while others thrive have predisposed themselves to failure through negative mindsets? Could my insistence on objectivity and honesty have swayed belief in the methods undertaken? Can thinking you are not losing weight actually stop you losing weight and vice versa?
In medicine this is known as the placebo and nocebo effect, both taken from latin meaning ‘I shall please’ and ‘I shall harm’ respectively, and they have been extensively studied (well the placebo far more than the nocebo at least, as a little thing called ethical approval stands in the way of deliberately trying to make people sick). Probably the best example of the placebo effect in relation to exercise is a study featured in the book ‘Bad Science’ by Ben Goldacre carried out on hotel workers in 2007 by Crum and Langer and if you haven’t already seen this study then prepare to be surprised. They took 84 female room attendants at seven different hotels and told one group that their daily work was in line with recommendations to improve health, even going to length to explain how. The other group got told nothing. Four weeks later the informed group (without actually changing their behaviour) perceived themselves to be fitter, and bizarrely they were. In fact, compared to the other group they had seen reductions in weight, blood pressure, BMI, waist-hip ratio, and body fat.
The arch nemesis of the placebo effect is called a nocebo and it has been discovered more through statistical analysis than the use of sham treatments. Ethical standards in health research make studying this effect difficult, you can’t set out to make people ill after all. However, studies have found instances where a group has been given information (such as a negative side effect of a drug or treatment) while another group hasn’t and in turn the group with that ‘negative’ information has experienced a far higher rate of actual negative outcomes. One study even found that women who believed themselves likely to die of heart disease were four times more likely to die than a group of women with exactly the same risk factors but without the fatalist viewpoint. It has also seen to be a strong effect in conditions like Parkinson’s disease as well. A slightly less depressing example of the nocebo effect is often seen with dentists, who many of us hold a pathological fear of and hence tend to twitch and perceive a pain response before the offending tooth has even been touched.
Could it be that these two effects are at work surreptitiously in the fitness industry, both reinforcing and undermining our work. Could it be that those with previous history of failing at weight loss or maintaining a healthy weight have low expectations of success and as such are setting themselves up for failure once again, a failure that even the best training and nutritional programme could not prevent? Similarly could it be that the success of some (heaven forbid all) of what we do could be down to the client’s level of belief in themselves and their trainer to succeed? This isn’t as much of a leap as we might think, given the prevalence of this effect already in the medical industry where modern imaging techniques allow researchers to observe the brain’s response to placebo treatments in vivo and have already demonstrated this.
The truth is that the most powerful tool of the modern fitness professional is not a convoluted training and nutritional approach that NASA themselves would be proud of. It lies instead in our ability to encourage and nurture change, positive thinking, and belief in our methods to produce results. Of course, a powerful argument is that the more science is involved, the more powerful this effect can be, and this may well be true although we lack any evidence to really prove this. All too often though the effect of peoples mindset on producing results is lost, where in cases of success the practitioner takes credit (as it must be their amazing ‘system’) and in cases of failure the client is often blamed (clearly they have been ‘cheating’ or not following the programme right?). Could this extend even further than weight loss into muscle gain? Can the ability to gain size, our reaction to supplements, our response to a training protocol differ so greatly between individuals based on previous history and belief levels? Time maybe to stop obsessing on methods and simplify, instead taking time to assess if our client has the fundamental belief in their ability to reach their goals as a lack of this will almost certainly ensure failure, even with the best training tools at their disposal.