Effects of open-label placebos on weight loss and feelings of hunger in obesity

在过去的几十年里，超重和肥胖已经成为全球人口中主要的公共卫生问题之一，与发病率和死亡率以及经济负担有关。讨论了不同的减肥方法，包括节食、药物干预和手术。此外，已经证明，安慰剂治疗可能会对减肥或试图减肥时的饥饿感产生影响。由于安慰剂是以隐蔽的方式给予的，因此关于患者与医疗保健提供者关系的伦理担忧是众所周知的。然而，最近耐人寻味的研究表明，安慰剂即使在人们知道正在使用安慰剂的情况下也是有效的(开放标签安慰剂)。例如，这已经在抑郁、慢性疼痛、焦虑和压力中得到了证明。在最近一项有71名参与者参与的初步研究中，我们证明了开放标签安慰剂成功地减少了饥饿，并增加了想要减肥的非肥胖者的社会支持。目前的提案与此相关，旨在检查开放标签安慰剂对肥胖者的影响。我们将研究与对照组相比，开放标签的安慰剂是否有助于减轻体重和饥饿感。此外，我们想要比较开放标签安慰剂和传统隐蔽安慰剂的效果，并检验期望和信念在开放标签安慰剂中的作用。最后，我们将观察这些变化的持续时间。这项关于开放标签安慰剂对肥胖影响的首次研究结果将有助于我们理解安慰剂的效果，并代表着朝着可能的新方法帮助肥胖患者迈出了又一步，肥胖患者是一个不断增长的群体，也是我们卫生系统面临的最大挑战之一。

In the last decades overweight and obesity have become one of the leading public health problems in populations worldwide, associated with morbidity and mortality as well as an economic burden. Different approaches to reduce weight are discussed, including dieting, drug interventions, and surgery. Moreover, it has been demonstrated that a placebo treatment may have an impact on weight loss or feelings of hunger when trying to reduce weight. Since placebos are given in a concealed way, ethical concerns with respect to the patient–healthcare provider relationship are known. However, intriguing recent studies show that placebos can be effective even when one knows that a placebo is being administered (open-label placebos). This has been demonstrated, for example, in depression, chronic pain, anxiety, and stress. In a recent pilot study with 71 participants we have demonstrated that open-label placebos successfully reduced hunger and increased perceived social support in non-obese participants who wanted to lose weight. The present proposal ties in there and aims to examine the impact of open-label placebos in obese individuals. We will examine whether an open-label placebo will help to reduce weight and hunger feelings compared with a control group. Moreover, we want to compare the effects of open-label with those of conventionally concealed placebos and examine the role of expectation and belief in open-label placebos. Finally, we will observe how long-lasting the changes are. The results of this first study on effects of open-label placebos in obesity will contribute to our understanding of placebo effects and represent another step toward possible new ways to help obese patients, an ever-growing group and one of the greatest challenges for our health system.