Hotel Maids Challenge the Placebo Effect
by Alix Spiegel
Morning Edition, January 3, 2008
In a recent study, Harvard psychologist Ellen Langer decided to look at whether our perception of how much exercise we are getting has any effect on how our bodies actually look.
As any casual observer of the hospitality industry knows, hotel maids spend the majority of their days lugging heavy equipment around endless hallways. Basically, almost every moment of their working lives is spent engaged in some kind of physical activity.
But Langer found that most of these women don't see themselves as physically active. She did a survey and found that 67 percent reported they didn't exercise. More than one-third of those reported they didn't get any exercise at all.
Perceptions Matter
Langer says, despite the fact all of the women in her study far exceeded the U.S. surgeon general's recommendation for daily exercise, the bodies of the women did not seem to benefit from their activity.
She and her team measured the maids' body fat, waist-to-hip ratio, blood pressure, weight and body mass index. They found that all of these indicators matched the maids' perceived amount of exercise, rather than their actual amount of exercise.
So Langer set about changing perceptions.
She divided 84 maids into two groups. With one group, researchers carefully went through each of the tasks they did each day, explaining how many calories those tasks burned. They were informed that the activity already met the surgeon general's definition of an active lifestyle.
The other group was given no information at all.
One month later, Langer and her team returned to take physical measurements of the women and were surprised by what they found. In the group that had been educated, there was a decrease in their systolic blood pressure, weight, and waist-to-hip ratio — and a 10 percent drop in blood pressure.
One possible explanation is that the process of learning about the amount of exercise they were already getting somehow changed the maids' behavior. 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.
Essentially, what Langer is talking about is a placebo effect. She says that if you believe you are exercising, your body may respond as if it is. It's the same as if you believe you are getting medication when you are actually getting a sugar pill — your body can sometimes respond as if a placebo is actually working.
Placebo Effect Limited?
But Martin Binks, director of behavioral health at the Duke Diet and Fitness Center in North Carolina, says, "There's a very high likelihood that [the maids] behaved differently after they received that information, and they were being more active and eating more healthfully. And that resulted in their improvements in health."
But Binks has a more substantive criticism.
"Generally what placebos work on is subjective types of findings," he says.
In other words, a placebo can help change something like your perception of pain or perhaps your sense of whether you feel depressed, but it can't do something objective like shrink a tumor or cut three pounds off your waistline.
Or can it?
Howard Brody, the director of the Institute for the Medical Humanities at the University of Texas Medical Branch and the author of the book, The Placebo Response, has spent years looking at this issue. He says that a number of relatively new studies challenge the old assumption that the placebo effect alters only subjective perception.
For example, Brody notes one study where researchers gave asthmatic patients a drug that actually makes asthma worse. When they gave the drug to the patients, they told them that it relieves asthma.
"A significant number of those patients said that my asthma got better when you gave them the drug," Brody says, "and they measured better when you measured the lung findings."
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