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

在过去的几十年中，超重和肥胖已经成为世界范围内人群的主要公共卫生问题之一，与发病率和死亡率以及经济负担相关。不同的方法来减轻体重进行了讨论，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。由于安慰剂是以一种隐蔽的方式给予的，因此关于患者-医疗保健提供者关系的伦理问题是已知的。然而，最近有趣的研究表明，即使知道正在服用安慰剂（开放标签安慰剂），安慰剂也可能有效。例如，这已经在抑郁症、慢性疼痛、焦虑和压力中得到证明。在最近的一项有71名参与者的试点研究中，我们已经证明，开放标签安慰剂成功地减少了饥饿感，并增加了想要减肥的非肥胖参与者的社会支持感。目前的建议与此相关，旨在研究开放标签安慰剂对肥胖个体的影响。我们将研究与对照组相比，开放标签安慰剂是否有助于减轻体重和饥饿感。此外，我们想比较开放标签与传统隐藏安慰剂的效果，并检查开放标签安慰剂中期望和信念的作用。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症影响的首次研究结果将有助于我们理解安慰剂效应，并代表着朝着帮助肥胖患者的可能新方法迈出的又一步，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.