eli5 How did scientists prove the placebo effect actually exist?

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People in control groups are usually given a sugar pill and are observed to assess if any changes occur to their health during the experiments. How do we know that these changes, if any, were the result of taking the sugar pill and not just random changes that might have happened even without taking the placebo? Are there any studies that prove that the placebo effect really exist?

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There have been quite a number of studies on the placebo effect. We are still trying to figure out how it works and how we can make it better or worse. The idea of using a sugar pill for the placebo effect was the first idea we had. People eat a lot of sugar throughout the day so giving some patients just a tiny pill extra would not be significant. Even the pill under test likely have just as much sugar in it as the placebo. The sugar will therefore have no impact on the research. And some of the first research into placebo had one group take placebo drugs and the other take nothing, and the placebo group consistently did better.

We have now a lot more research into placebo. There are huge industries trying to come up with placebo drugs that match the real ones as closely as possible. And we have research comparing different placebo treatments to each other. For example if the patient is told they are on the placebo it does not work as well as if they are not told, however it still works better then if they get no treatment. And the worse the placebo is, such as bad tasting, having side effects, etc. the better it works. There are even research into placebo surgeries where they put the patient under narcosis, cut their skin, and suture it back together. And these surgeries sometimes works just as well as the real ones.

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