An article in today's NY Times discusses a recent study which strongly suggests that what you believe about your genetic predispositions towards diet and exercise may have a bigger influence on how your body responds than your actual genetics. From the study's abstract: "...learning of one’s genetic risk may evoke physiological changes consistent with the expected risk profile," and "Effects of perceived genetic risk on outcomes were sometimes greater than the effects associated with actual genetic risk."
We coaches know that what an athlete believes about themselves, the program and the circumstances exerts a powerful influence on performance. In medical research, the placebo effect has sometimes shown a more powerful clinical result than the actual medical intervention being studied. (Kaptchuk et al., 2009)
Maybe doctors need to think more like coaches, wherein the therapies they prescribe are presented as something along the lines of training programs which need to be "bought into" by their patients to be optimally effective. Even if a Rx'd therapy turned out to be mostly "sugar pills" in the end, who would be wrong if the therapy worked?
Kaptchuk, T. J., Shaw, J., Kerr, C. E., Conboy, L. A., Kelley, J. M., Csordas, T. J., … Jacobson, E. E. (2009). “Maybe I Made Up the Whole Thing”: Placebos and Patients’ Experiences in a Randomized Controlled Trial. Culture, Medicine, and Psychiatry, 33(3), 382–411. https://doi.org/10.1007/s11013-009-9141-7
Turnwald, B. P., Goyer, J. P., Boles, D. Z., Silder, A., Delp, S. L., & Crum, A. J. (2019). Learning one’s genetic risk changes physiology independent of actual genetic risk. Nature Human Behaviour, 3(1), 48–56. https://doi.org/10.1038/s41562-018-0483-4