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Fontaine and colleagues review effect of placebo-related factors in trials

April 28, 2016

Kevin R. Fontaine, PhDKevin R. Fontaine, PhD, professor and chair in the Department of Health Behavior, observed in the commentary “Placebo Effects in Obesity Research,” published online in March 2016 in the journal Obesity, that the effects produced in clinical trials by many medications and medical procedures are often identical to those produced by placebos. In reviewing placebo-related factors (PRFs) and their influence on changes to diet and lifestyle, Dr. Fontaine and his co-authors suggest that clinicians can improve the outcomes of obesity treatments by establishing a solid relationship with individual patients and then supplying information that encourages confidence in a successful therapeutic response. This proposal contrasts studies suggesting that physicians who work with overweight and/or obese patients tend to demonstrate low levels of emotional support, which may weaken the patients’ resolve to persevere with their prescribed regimen and, therefore, also diminishes the efficacy of the course of treatment.

The researchers recommend that future study designs incorporate the measuring of possible factors related to placebo responsiveness such as genetics, neurobiology, and psychophysiology which may function as biomarkers. Additionally, they advise scrutinizing the reliability of tests and fidelity to research protocols on a continuing basis to minimize the influence of PRFs in modification trials designed to determine the direct effects of the intervention, while noting that exploiting their influence in clinical care may be advantageous to improving treatment outcomes.

Co-authors of the commentary are Michelle S. Williams, PhD, MPH, CHES, postdoctoral trainee in the Department of Health Behavior; Teri W. Hoenemeyer, MSHA, Director of Education and Support Services at the UAB Comprehensive Cancer Center; and Gareth R. Dutton, PhD, associate professor in the Division of Preventive Medicine; as well as Ted J. Kaptchuk, MA, professor of medicine at Beth Israel Deaconess Medical Center.