The Placebo Effect On Weight Loss And Sports Performance

My fascination with the placebo effect began many years ago in a small but serious gym in Trinidad. Back home, steroids were very much a part of the weightlifting and bodybuilding culture. Everyone knew where you could get it and who you could get it from, but dealers were very discriminating in who they would or would not sell their wares to. One day, about two or three months from our Carnival, one of the young guys at the gym (who we will call Greg) decided that he was going to use steroids to get in shape for the coming festivities. He was not particularly liked and all of the steroid dealers had refused to sell to him at one time or another. He was however, annoyingly persistent, and so, partly to shut him up and partly because they didn’t really like him very much, they conspired to give him fake drugs. Thinking that it would be worth a laugh, they agreed to give him an injection of what they told him was testosterone propionate every week for two months. I can hardly express how happy he was. He was so looking forward to starting his cycle, and while I was appalled that they would play such a cruel trick on him, for purposes of self preservation (I wasn’t big and muscled back then) I held my tongue.

Dutifully every week, Greg and the guys would assemble in the men’s locker room to administer his shot. It was always an event, with most of them bursting at the seams trying hard not to laugh as he was injected with diluted vegetable oil and (hopefully) sterilized water. The joke, turned out to be on them. In spite of the fact that Greg was receiving a weekly dose of watered down vegetable oil, he put on a solid fifteen pounds of muscle in the course of two months, and when from being able to squat 225 lbs for six repetitions to 315 lbs for 12 repetitions. The weight on all of his lifts when up and not only did he get bigger, leaner and stronger, but he also developed an acne problem. A tell tale sign of steroid use! Utterly perplexed, the guys at the gym couldn’t understand what was happening. They eventually came clean and gave him his money back, flabbergasted and apologetic for having pulled a prank that didn’t pan out as expected, but Greg would not have it! He firmly believed that they were simply envious of his remarkable gains, how else could he have done what he did? The answer has fascinated me for decades and I have seen the astounding effects that placebos can have. Yet, aside from using it to sell supplements, snake oil and even pharmaceutical drugs, it isn’t studied as much as it should be.

What Is A Placebo?

A placebo as applied by medical science is defined as a preparation which is pharmacologically inert (such as a sugar pill) but which appears to have a therapeutic effect based solely on the power of suggestion.[1] In a medical setting, the placebo effect occurs when a patient or individual takes an inert substance, with some degree of suggestion either from a person or institution of authority, or from information about the pill that states that the pill will have a positive effect in the individual’s healing process and there is an improvement in their condition. Credible studies proving the placebo effect have been around since the late 1930’s, and yet it is largely ignored by the public. It is so powerful that the FDA requires it as a part of all drug trials and physicians regularly use it today as part of standard treatment. Almost 50% of the doctors polled in a 2007 survey admitted to prescribing medications that they knew were ineffective for their patients’ conditions or in doses too low to produce any possible therapeutic benefit but to provoke a placebo response.[2] It is disheartening that rather than viewing our innate ability to positively influence medical outcomes and changes in our bodies solely from suggestion as a positive aspect, most ignore it or see it as some sort of trickery. In so doing, many miss the wondrous potential locked within us all.

The More You Spend On A Placebo Product- The Better It Works

From a marketing perspective, this view is encouraged, as it puts the emphasis back on creating the need for a drug, pill or powder for everything from the common cold to weight loss.  The power of placebos is quite well known among makers of questionable products like supplements and even some pharmaceutical drugs.  A study published in the Journal of American Medicine, showed that the placebo effect was indeed directly proportional to the amount of money spent on the placebo. For the test, the subjects were given a serie of painful electric shocks. Participants were then asked to rate the pain they felt after each shock. They were then given a placebo pill that they were told had properties similar to codeine, a powerful pain medication. The pill given was completely inert and half of the patients were told that their treatment cost $2.50 per pill. The other half was told that their pills had been purchased at a discounted price of ten cents per pill. When they were then given a second series of electric shocks, and asked to rate the pain, 85% of the patients taking the $2.50 pill reported that the second set of shocks were less painful. In contrast only 61 % of those taking the ten cent pill said the shocks were less painful. The conclusion was unmistakable: the more expensive the pill, it seems, the larger the perceived effect — even when the pill clearly actually has no effect whatsoever.

There are other social factors involved in the efficacy of the placebo effect. Over the years, it has been shown that the placebo effect is in fact getting stronger and that it differs greatly from culture to culture.[3] One reason why the placebo effect continues to grow could be the omnipresence of marketing for both pharmaceutical drugs and pseudoscience products here in the United States. Since 1997 when the FDA lifted its restriction on direct-to-consumer advertising, we have been deluged by ads promoting the effectiveness of numerous pharmaceutical drugs. Ads designed in part to increase the placebo response of the drugs themselves and in some cases the marketing has backfired. So strong has the placebo response become for some popular antidepressants and statin drugs,  that if they were tested today against inert substances they wouldn’t pass the FDA requirements for working better than a placebo.[2] To counter this, many companies have moved their test trials to other countries with lower placebo responses to get their drugs approved.

How The Placebo Effect Can Make It Seem Like Everything Works For Weight Loss

For vitamin, herb and supplement manufacturers, this created a goldmine of opportunities. With the right pricing, the right athletes or celebrity endorsements and the right advertising campaign, they could make outlandish claims about their products and always find an audience who would swear that their products work. Thanks to the placebo effect. Over the years, everything from boron to bee pollen has been marketed to improve muscle building and fat loss. Each time a new product is released, there are those who swear by the results they see. Even though, as time goes on, the products are shown to be completely ineffective. Back in the 90’s, as an impressionable teenager, I used everything from Mexican sarsaparilla to linseed in the quest to get bigger and stronger without resorting to anabolic steroids or prohormones.

As ineffective as they were all shown to be when everyone else was using it, we all felt that we saw some results.

In my personal training practice, I have seen the placebo effect as a powerful psychological tool for weight loss. I have always maintained a strict no supplement or fat loss supplement policy with my clients as they either don’t work or are potentially harmful. However, a number of bodybuilders and fitness models who I worked with in preparation for competitions or high end photo shoots, would complain that other athletes had an edge over them since they were using fat burners. To counter this, I would find a fat burning product with the least harmful looking ingredients (which wasn’t easy) and tell them that while I did not recommend it, if they had to take anything they could take 1/9 the dosage prescribed on the bottle to help them lose body fat. In every case, they felt better and claimed the supplement helped them lose more body fat. After the contest or photo shoot, I would inform them that not only the supplements they used were worthless in terms of fat burning, but that even if it could work the dose was far too low for them to experience any significant effect. All the positive results came from their training and dedication to their diets. The best part of my little trick is that for all other shows or shoots in the future, they never felt like they needed anything else to help them get into shape as they understood that the power always came from within.

References:

1. Gensini GF, Conti AA, Conti A (April 2005). “Past and present of what will please the lord: an updated history of the concept of placebo”. Minerva Med 96

2. Silverman S. The Placebo Problem. Wired

3. Moerman DE (2000). “Cultural variations in the placebo effect: ulcers, anxiety, and blood pressure”. Med Anthropol Q

Kevin Richardson is one of the most sought after NYC personal trainers and creator of Naturally Intense™ High Intensity Training. Get a copy of his free weight loss ebook here.

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5 Reasons Why You Should Never Take Weight Loss Supplements

The prevalence of obesity in the United States continues to increase at alarming levels with one third of the adult population currently overweight or obese. Not surprisingly 15% of the American population uses dietary supplements for weight loss [1] yet in spite of the wide variety of products that purport to induce weight loss, the most one common aspect that they share is their abysmal failure rate. Weight loss is of critical importance to many people, but consumers often lack the information necessary to make informed decisions about the use of potentially harmful products like weight loss supplements. My stance against weight loss supplements is one that is seldom shared by other athletes on the payroll of companies in the industry, but it is one that will never waver. (You wouldn’t waver either if you had to visit your friends in the hospital several times over the course of 20 years thanks to readily available over the counter weight loss supplements.) Here are five reasons why you should never use weight loss supplements:

1. Weight Loss Supplements Don’t Work

It is that simple. Regardless of the widespread and ever present promotion of non prescription diet aids that are supposed to do miraculous things like stop fat absorption from your foods, block carbohydrates and increase your metabolism, the truth is that weight loss supplements will not bring about long term weight loss. Using them is not only a waste of money but a risk to your health as well. In twenty three years in the weight loss business I have yet to see a weight loss supplement help anyone achieve and sustain their ideal bodyweight. Back in the days when dangerous drugs like ephedra were included in weight loss stacks people did see a temporary reduction in their bodyweight while from the use of a powerful and (we know now) potentially deadly drug. But any weight loss quickly went away after stopping it.

Today’s supplements don’t have ephedra anymore and their active ingredients have been proven to be useless as an aid to weight loss. A German study presented at the International Congress on Obesity in Stockholm had 189 either obese or overweight middle aged men and women participate in a weight loss program for eight weeks using nine of the major weight loss products on the market. Half were given commercially available weight loss supplements and the other half took a sugar pill. At the end of the eight week period researchers found that the weight loss supplements were no more effective than the placebo pills.
This study was one of the most rigorous scientifically credible tests of weight loss supplements to date and included common ingredients such as L-carnitine, polyglucosamine, cabbage powder, guarana seed powder, bean extract, Konjac extract, fiber, sodium alginate, chitosan and certain plant extracts either alone or in combination. What we can infer from this study is that weight loss supplements are effective in helping you lose money- not weight.

2. Weight Loss Supplement Companies Are Allowed To Lie

You hear the commercial on television, you see the ads in the magazines and you see your favorite celebrity or athlete endorsing the product or book- but when you tried it you really didn’t see much in the way of weight loss. How could that be when so much is made of the efficacy of the product? Simple- weight loss claims by supplement companies, programs and products are not regulated and their claims do not have to be proven by clinical trials 4. That’s correct; in one of the most developed countries in the world there are no laws that demand truth in advertising when it comes to weight loss supplements or any weight loss product for that matter. Unfortunately the minor snag that the products don’t really work and that the ads are a bit far from the truth doesn’t stop us from spending 1.6 billion dollars on weight loss supplements each year!

Why do we keep spending money if the results are less than advertised? There are two reasons- one is if you are overweight and suffer everyday from the type of negative body image than can be associated with being obese you desperately want to believe that it will work. Not unlike the drowning man reaching for a straw. The ads work by highlighting young men and women that are in phenomenal shape- which makes someone that is overweight even more self conscious and creates a strong awareness of their problem. Thus you are far more apt to believe that the supplement that you are buying really will help you lose weight. This type of emotional manipulation is sadly the cornerstone of marketing today and is far more powerful than most people realize. The other reason why people keep on buying is that weight loss companies always have a steady stream of ‘new and improved’ products coming out, and with them come the growing hope that this new breakthrough formula will be the one that finally helps you lose the weight and keep it off- but it won’t.

3. The Science Of Weight Loss Supplements Is Compromised By Conflict Of Interest

According to Ano Lobb from the Dartmouth Medical School, “trials used to determine product safety and effectiveness…tend to be small, of short duration, and frequently lack financial conflict of interest disclosures.”[2] He goes on to say that “these factors could conspire to place consumers at risk, especially when published research cited in advertising cloaks products with the suggestion that their safety and effectiveness have been proven by science.”[2] In a paper published in the World Journal of Gastroenterology that included analysis from studies published by Hasani Ranjbar et al.[3] Ano Lobb went on to take a critical look at studies passed off as sound science for the promotion of popular weight loss supplements such as:

• Xenadrine- was cited for a study that were far too small (only 47 participants) and far too short a duration (6 weeks) to be clinically credible. The studies used for product promotion also did not have any mention of an independent funding source- so the reader has no way of knowing whether there is a conflict of interest.

• LeptiCore -The material used to market their weight loss product cited a study[4] that followed 62 participants that supposedly reported losing weight, body fat, a reduction in waist size and lowering of their cholesterol, however one of the authors appeared to be a chief scientific officer of a dietary supplement company, and was listed as the inventor of a weight loss supplement whose patent was held by the very same company that he was employed by.

• Hydroxycut Advanced -Studies cited in marketing materials for Hydroxycut were according to Lobb’s paper ‘small and of short duration and reported no serious side effects. In spite of this, Hydroxycut was withdrawn from the market in 2010 after being linked to 23 cases of liver toxicity and one fatality.[5] Again there were no financial conflict of interest disclosures or evidence that funding for the studies were not received by the supplement manufacturers themselves. (Note that after a change of ingredients- Hydroxycut is once again on the market shelves).

4. Weight Loss Supplements Can Kill Or Seriously Harm You

Unlike the far stricter laws applied in Europe and in Canada, manufacturers of dietary supplements here in the United States are not required to conduct any trials to establish the safety or efficacy of their products. All that is required is that a copy of their label is sent to the Food and Drug Administration (FDA) for review[6,7,8].  What this means to you the consumer is that you become a lab rat in the post marketing trial of every weight loss product’s safety. Reviews have shown that the FDA only gets about 1% of the harmful events resulting from supplement use by consumers and there is no coordination between the FDA and the Poison Control Center to regulate ill effects from weight loss supplements.[9]

Factor in as well that weight loss supplement companies created for the sole purpose of turning a profit are not always honest and forthcoming about the safety of their products. The manufacturers of the weight loss supplement, Metabolife 356 withheld over 14, 000 reports they received over a 5 year period that documented serious side effects associated with their weight loss supplement product which contained ephedra, including myocardial infarction, stroke, seizure and death[6]. It took 155 deaths before ephedra was banned here in the United States by the FDA, all the while several supplement companies were fully aware of the dangers and continued to sell ephedra to the public.[10]

As mentioned earlier, Hydroxycut, was the number one weight loss product in its market selling just about a million bottles a year[11] was recently pulled from shelves after 23 cases of liver damage and one death[4] and it took only a few months before they were back on the shelves with a ‘new and improved’ formula. That’s how the industry operates- when one ingredient (in this case Garcinia cambogia) is found to be responsible for the sickness and or death of several members of the public, the product is simply reformulated with something else. Lawsuits and other fines from people injured by their products are part of the cost of running their business and is a small drop in the bucket compared to the profits from their weight loss supplements.
5 Weight Loss Supplements Distract From The Real Steps Needed For Long Term Weight Loss

There are no secrets. No magic exercises or magic foods or harmless pills or powders that will help you lose weight. You have to make healthy and sustainable changes in your eating habits and find a way to incorporate exercise into your daily life. Sustainability is a word often associated with our interaction with the environment, but it is time that it is used more frequently with regards to how we approach diet and exercise. You can’t take a weight loss supplement for the rest of your life, nor can you follow an extreme diet or workout for any significant period of time. Don’t be mislead by the temporary weight loss some of these methods may bring about- as any decrease in weight (if any at all) won’t be sustainable. It isn’t easy- if it was we wouldn’t have obesity as a national epidemic, but staying away from weight loss supplements and their instant-weight-loss-cousins gives you a better chance of doing it the right way.
Thanks for reading and I hope you share this article with your friends and family members.

References
1.     Blanck HM, Serdula MK, Gillespie C, Galuska DA, Sharpe PA, Conway JM, Khan LK, Ainsworth BE. Use of nonprescription dietary supplements for weight loss is common among Americans. J Am Diet Assoc.
2.    Lobb A. Science of weight loss supplements: Compromised by conflicts of interest? World J Gastroenterol
3.    Hasani-Ranjbar S, Nayebi N, Larijani B, Abdollahi M. A systematic review of the efficacy and safety of herbal medicines used in the treatment of obesity. World J Gastroenterol
4.    Kuate D, Etoundi BC, Azantsa BK, Kengne AP, Ngondi JL, Oben JE. The use of LeptiCore in reducing fat gain and managing weight loss in patients with metabolic syndrome. Lipids Health Dis
5.    Lobb A. Hepatoxicity associated with weight-loss supplements: a case for better post-marketing surveillance. World J Gastroenterol
6.    Consumers Union. Dangerous supplements: still at large. Consum Rep 2004; 69: 12-17
7.    Morrow JD. Why the United States still needs improved dietary supplement regulation and oversight. Clin Pharmacol Ther
8.    Gardiner P, Sarma DN, Low Dog T, Barrett ML, Chavez ML, Ko R, Mahady GB, Marles RJ, Pellicore LS, Giancaspro GI. The state of dietary supplement adverse event reporting in the United States. Pharmacoepidemiol Drug Saf
9.    Gardiner P, Sarma DN, Low Dog T, Barrett ML, Chavez ML, Ko R, Mahady GB, Marles RJ, Pellicore LS, Giancaspro GI. The state of dietary supplement adverse event reporting in the United States. Pharmacoepidemiol Drug Saf
10.    Moran M. Did delay of ephedra ban cause unnecessary deaths? Psych News
11.    Weight control a high priority. Chain Drug Rev

Kevin Richardson is the creator of Naturally Intense High Intensity Training 10 Minute Workouts™ and one of the most sought after personal trainers in Manhattan. Get a copy of his free weight loss ebook here.

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Without Regulation Supplements Are Always A Risk

Here in the United States a legislative loophole makes it possible that health food products ranging from protein powders, to energy bars, fat burners and a wide range of bodybuilding supplements are allowed to be produced without any real oversee with regards to its marketing claims or its content. Most would be surprised to learn that some supplement companies got started in someone’s basement, and that there is no such thing as pharmaceutical grade whey protein/creatine or any such product as such companies don’t make the type of products you would find in at a GNC or Vitamin Shoppe. The American Food and Drug Administration (FDA) classifies dietary supplements as foods and are thus exempt from the stringent manufacturing practices required for the pharmaceutical industry. Quality control is thus left to the discretion of the individual manufacturers, which is why so many products are often found to be harmful or containing harmful ingredients after being on the shelves for several years. In Europe all such supplements are banned due to the potential health risk posed by many of the unregulated vitamins, herbs and supplements that we here in the United States use on a daily basis and with good reason.

There are no such safeguards in place to protect the general public here in the United States, as a supplement can be made with no safety assurances, without having to answer to any quality control standards, and the product need not have any scientifically proven benefit. The argument is not really about whether these products are effective or not, or even whether they should be available to the public at large- more so the question is truly why they are exempted from safety testing and standardized quality controls. In the end it is a matter of safety.   Every search on this subject will result in pro-supplement propaganda, as the supplement industry rakes in over 13 billion dollars a year, and a lot of money is funneled towards keeping you, the consumer believing that these products are not only healthy, and scientifically validated in their effectiveness, but are also an essential part of a healthy lifestyle, and nothing could be further from the truth. In the end, the numerous recalls on supplements found to be harmful as well as the lack of long term research on the safety of many mainstream supplements are more than enough reason not to use them. Besides, I have seen hundreds of people achieve their health and fitness goals, many reaching the highest achievements possible in terms of performance and the human physique, and they did due to their consistency and hard work, not from taking a pill or a powder. 

Kevin Richardson is the creator of Naturally Intense High Intensity Training 10 Minute Workouts™ and one of the most sought after personal trainers in New York City. Get a copy of his free weight loss ebook here.

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The Naturally Intense Seal of Approval

NYC Healthy Restaurants Review-Eva’s Restaurant

  

Eating healthy does not at any time mean having to sacrifice your social life- in this installment of the NYC Healthy Restaurant Reviewwe take a look at an easy one- health food restaurnts with a reveiw of Eva’s Restaurant. The great part about our reviews is that although a particular restaurant in New York is reviewed each week, you can still use the guidelines listed for any restaurant of that type as the rules for the particular type of cusine mentioned are more or less the same for restaurants across the country.  Thank you for supporting my blog and do be sure to subscribe so you don’t miss a weekly review or the tons of great weight loss and health and fitness information posted weekly on this blog.

Overview:
Eva’s Resturant- 11 W 8th St, New York 10011 (Between 5th & 6th Avenues)
Food Type: Health Food
Price: Very reasonable not at all expensive.
Quality Rating: I give the food 3 and stars out of 5 and the décor and ambiance 1 star.
Diet Friendly Rating: 5 stars. If you are looking for a place to eat well, then this is it!
Health Rating: A high passing grade from the NYC Department of Health.

If you are really looking for a restaurant where you don’t have to worry about blowing your diet, then Eva’s is the place to go and it is the subject of this weeks healthy restaurant reviews.  Established in 1978, Evas is one of the first real healthfood restaurants in New York City, and to this day you can see everyone from top bodybuilders to fitness minded celebrities eating there. It has been one of my Manhattan haunts for the past fifteen years, providing low sodium and trans fat free foods that are bothtasty and convenient. As always before we even go into the offerings of the restaurant, we will take a look at its Department of Health Inspection record and Eva’s passes with flying colours with only 10 points on its inspection (industry standard is 14 points and anything over 28 points denotes a serious health violation.) You can check out their report here and always check the inspection reports of any restaurant that you frequent- you might be surprised at what you find!

Step into the lobby of most serious gyms in the area and you will see a stack of Eva’s takeout menus- as it is very much the default health food stop for those serious about getting in shape, as evidenced as well by the numerous bodybuilding and fitness stars gracing their walls.At Eva’s you have a choice of  everything from breakfast selections, Eggs, Bagels, & Muffins which are served all day long for the late risers and the omelets are baked, not fried. For dinner or lunch Eva’s has a selection of  High Energy Protein Plates which are high protein and low fat dishes ranging from Nature Burger, Lemon Chicken, Turkey Burger, or Baked Tofu(which I am not too crazy about), which are usually served witha choice of brown rice, pasta and come with vegetables included. Besides the tofu offerings the only items on the menu that I would stay away from would be the protein shakes (which I have always campaigned against since they are nothing but milk shakes with great publicists- you can read more here), other than that almost everything is great!

What do I get at Eva’s? My standard would be the Tenderloin Steak, a  lean sliced steak sandwich served on a whole wheat pita (I never eat the bread though) which comes with their famous Tahini that every Eva’s goer knows and loves. It doesn’t take that long for them to make it, and I can always count on having a low sodium easy meal whenever I am on the go in that neighbourhood- and since my base of operations is at the 19th Street Gym in the Flatiron district, I am usually not too far away. I am not big on supplements so their vitamin store located at the back of the restaurant doesn’t have much of an appeal for me, other than that it is a great place to check out!

Health Food Rules For Staying In Shape

Not much to say here except for be wary of the protein shakes (read Kevin’s article about protein shakes here)

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Lose weight, build real muscle and get Superfit training only 10 minutes 3 times a week! That’s the slogan and the 100% guarantee of the Naturally Intense System of Diet & Exercise™ created by visionary NYC personal trainer, internationally renowned natural bodybuilder and fitness expert, Kevin Richardson. Get a copy of Kevin’s free award winning weight loss ebook here!

Over The Counter Testosterone Products

For starters, they are not at all effective, and if they were, they would actually be harmful, as evidenced by the numerous side effects of the prohormones that came to the market a few years ago and were subsequently banned by the FDA as a result. Other so called testosterone boosters are still around, ZMA being the most popular, with claims of being able to significantly boost testosterone levels.
However, the only study to ever document any changes in testosterone was done by a group of researchers using football players as the test subjects. All the hype regarding this product comes from this study and this study alone, which found up to 400% increases in testosterone as a result of using ZMA. Unfortunately, as I always say, one must ask the question, ‘cui bono’,- ‘who stands to gain’ before taking any such research seriously, especially when it seems so very much tailored to sell a product.

Sure enough, the study was done by researchers that included Victor Conte, who by coincidence had stock in the first company to sell ZMA commercially as a supplement. Sadly, all other studies have not replicated any of the first studies claims, and I can honestly say, that if it was such a great product, all natural bodybuilders using it would have seriously messed up endocrine systems, the same way a regular steroid user would, and there would be a sudden surge of pimple riddled and dramatically size increased athletes on stage, (which did happen to a degree when the prohormones came out). Those are the side effects of any sudden testosterone swings, and ZMA does no such thing.
Some say it helps them sleep, but I would attribute that to the placebo effect, which is very powerful in and of itself. The bottom line is that it does not work, and you really should not want to boost your testosterone levels in the first place, as there will be serious side effects to deal with, unless you had a glandular problem, which I am sure is not the case.

Disclaimer: Information contained in this article is not meant to treat, diagnose illness, nor substitute for medical counsel, and is intended for purposes of information and education only. Consult your physician before modifying your diet and or starting any exercise program.

Celebrity NYC personal trainer, Kevin Richardson is an award winning health and fitness writer, natural bodybuilding champion and the creator of Naturally Intense High Intensity Training™. Get a copy of his free weight loss ebook here.