Learning one’s genetic risk changes physiology independent of actual genetic risk
Open accessAbstract
Millions of people now access personal genetic risk estimates for diseases such as Alzheimer's, cancer and obesity 1. While this information can be informative 2-4, research on placebo and nocebo effects 5-8 suggests that learning of one's genetic risk may evoke physiological changes consistent with the expected risk profile. Here we tested whether merely learning of one's genetic risk for disease alters one's actual risk by making people more likely to exhibit the expected changes in gene-related physiology, behaviour and subjective experience. Individuals were genotyped for actual genetic risk and then randomly assigned to receive either a 'high-risk' or 'protected' genetic test result for obesity via cardiorespiratory exercise capacity (experiment 1, N = 116) or physiological satiety (experiment 2, N = 107) before engaging in a task in which genetic risk was salient. Merely receiving genetic risk information changed individuals' cardiorespiratory physiology, perceived exertion and running endurance during exercise, and changed satiety physiology and perceived fullness after food consumption in a self-fulfilling manner. Effects of perceived genetic risk on outcomes were sometimes greater than the effects associated with actual genetic risk. If simply conveying genetic risk information can alter actual risk, clinicians and ethicists should wrestle with appropriate thresholds for when revealing genetic risk is warranted.
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Self-fulfilling prophecy effects do not necessarily take much time to unfold but can happen swiftly in a single interaction right after the ascription.
“Moreover, these effects don't necessarily take much time to unfold but can happen swiftly in a single interaction (e.g., in interview settings; Word et al. 1974) right after the ascription (Turnwald et al. 2018: 49).”
From What Is the Function of Confirmation Bias? (2022) · cites this paper as Turnwald et al. 2018
Some relevant effects may also come from natural science generalizations, yet the social psychological mechanisms behind them are probably different.
“Some of the effects relevant here might also arise from natural scientific generalizations (for example, that endocrine disrupters cause infertility).However, the underlying social psychological processes are likely to be distinct; see also(Turnwald et al. [2019]).”
From Science Communication and the Problematic Impact of Descriptive Norms (2023) · cites this paper as Turnwald et al. [2019]
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Self-rated amygdala activity: an auto-biological index of affective distress
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Genetic feedback for psychiatric conditions: Where are we now and where are we going
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Polygenic risk scores associate with blood pressure traits across the lifespan
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Capturing additional genetic risk from family history for improved polygenic risk prediction
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Discouraging Elective Genetic Testing of Minors: A Norm under Siege in a New Era of Genomic MedicinePreprint
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Implication of DNA methylation during lifestyle mediated weight loss
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Szalanczy, A., Chuang, C., & Woods, L. C. S. (2021) · The Journal of Nutritional Biochemistry · doi:10.1016/j.jnutbio.2021.108928 · Cited by 17 · see citing works
When does precision matter? Personalized medicine from the perspective of public health
Wilson, J. (2022) · Oxford University Press eBooks · doi:10.1093/oso/9780198863465.003.0013 · Cited by 16 · see citing works
Practitioner warmth and empathy attenuates the nocebo effect and enhances the placebo effect
Barnes, K., Wang, R., & Faasse, K. (2023) · Applied Psychology Health and Well-Being · doi:10.1111/aphw.12497 · Cited by 18 · see citing works
Physical healing as a function of perceived time
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Science Communication and the Problematic Impact of Descriptive Norms
Peters, U. (2023) · The British Journal for the Philosophy of Science · doi:10.1086/715001 · Cited by 13 · see citing works
Gainsburg, I., & Lee, J. (2023) · Psychological Science · doi:10.1177/09567976231194537 · Cited by 14 · see citing works
Rethinking Clinical Trials and Personalized Medicine with Placebogenomics and Placebo Dose
Özdemir, V., & Endrényi, L. (2020) · OMICS A Journal of Integrative Biology · doi:10.1089/omi.2020.0208 · Cited by 14 · see citing works
It is not just the drugs that matter: the nocebo effect
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The advent of automated medicine? The values and meanings of precision
Prainsack, B. (2022) · Oxford University Press eBooks · doi:10.1093/oso/9780198863465.003.0015 · Cited by 10 · see citing works
Kleinendorst, L., van Haelst, M. M., & van den Akker, E. L. T. (2019) · Experientia supplementum · doi:10.1007/978-3-030-25905-1_19 · Cited by 10 · see citing works
CRISPR—a challenge for national and international regulation
Nicol, D. (2022) · Oxford University Press eBooks · doi:10.1093/oso/9780198863465.003.0014 · Cited by 9 · see citing works
Vogt, H. (2022) · Oxford University Press eBooks · doi:10.1093/oso/9780198863465.003.0005 · Cited by 9 · see citing works
The future of individualized health maintenance
Steinhubl, S. R. (2019) · Nature Medicine · doi:10.1038/s41591-019-0443-1 · Cited by 8 · see citing works
Qiu, Y., Mao, Z., & Yun, D. (2021) · Applied Psychology Health and Well-Being · doi:10.1111/aphw.12315 · Cited by 7 · see citing works
Exercise Response Efficiency: A Novel Way to Enhance Population Health?
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Xu, Y., Zou, X., & Mei, J. (2022) · Applied Bionics and Biomechanics · doi:10.1155/2022/1666792 · Cited by 7 · see citing works
Impacts of Learning One’s Own Genetic Susceptibility to Mental Disorders
Ahn, W., & Perricone, A. M. (2023) · Current Directions in Psychological Science · doi:10.1177/09637214221127225 · Cited by 6 · see citing works
The Necessity of Philosophy in the Exercise Sciences
Hickson, M. (2019) · Philosophies · doi:10.3390/philosophies4030045 · Cited by 5 · see citing works
CRISPR's Twisted Tales: Clarifying Misconceptions about Heritable Genome Editing
Darnovsky, M., & Hasson, K. (2020) · Perspectives in biology and medicine · doi:10.1353/pbm.2020.0012 · Cited by 5 · see citing works
Placebo and the law of identification
Bierman, S., Weil, A., & Dahmer, S. (2024) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2024.1474558 · Cited by 4 · see citing works
Individual differences and influences on learning
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Classifying Genetic Essentialist Biases using Large Language Models
Reimann, R., Lynch, K. E., Gawronski, S. A., Chan, J., & Griffiths, P. E. (2025) · Review of Philosophy and Psychology · doi:10.1007/s13164-025-00770-3 · Cited by 3 · see citing works
Alexander, D. R. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108566520 · Cited by 3 · see citing works
The problematic side of precision medicine
Boniolo, G. (2022) · Oxford University Press eBooks · doi:10.1093/oso/9780198863465.003.0004 · Cited by 3 · see citing works
Personalization, individuation, and the ethos of precision medicine
Barilan, Y. M. (2022) · Oxford University Press eBooks · doi:10.1093/oso/9780198863465.003.0007 · Cited by 3 · see citing works
Genetic Risk Information Influences Risk-Taking Behavior
Wheat, R., Vess, M., & Holte, P. N. (2022) · Social Cognition · doi:10.1521/soco.2022.40.4.387 · Cited by 3 · see citing works
Kaya, D., Savitskaya, U., & Bloom, N. (2025) · Psychiatric Genetics · doi:10.1097/ypg.0000000000000396 · Cited by 3 · see citing works
Prophesied Future and Redefined Past in the Genomic Era
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Predicting Individual Differences in Cognitive Ability from Brain Imaging and Genetics
Anderson, K. M., & Holmes, A. J. (2021) · Cambridge University Press eBooks · doi:10.1017/9781108635462.021 · Cited by 2 · see citing works
Potential challenges to doctor–patient trust posed by personalized medicine
Cohen, S. (2022) · Oxford University Press eBooks · doi:10.1093/oso/9780198863465.003.0012 · Cited by 2 · see citing works
What 21st century medicine should be—history, vision, implementation, and opportunities
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Pharmaceutical contributions to personalized medicine
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Reconciling art and science in the era of personalised medicine: the legacy of Georges Canguilhem
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The Dark Side of Body Sensations
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Genetic placebo effect on psychological resilience: the moderating role of self-compassion
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Foreign Experience of Legal Regulation and Protection of Relations in the Sphere of Genome Editing
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Philosophical Issues in Sport Science
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The historical background of personalized medicine
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Testes Farmacogenéticos e Farmacogenômicos na prática clínica:
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The role of mindsets in placebo effects and healthcare
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Self-citationMitochondrial DNA Mutations and Epigenetic Regulation in Type 2 Diabetes Mellitus Development
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In Defense of Direct-to-Consumer Genetic Testing.
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Genetic Information and How It Flows
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Genomics and precision medicine
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Arvelig fedme - hvor mye vekt skal man legge på gener?
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Gay Genes? Genetics and Sexual Orientation
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Placebo Influence of Expectation and Time of Day on Human Cognitive Performance
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Der Mensch beeinflusst seine Biologie – wie Weltbilder die Zukunft formen
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Definitions of Technical Terms
Alexander, D. R. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108566520.015
- Authors
- Turnwald, B. P., Goyer, J. P., Boles, D. Z., Silder, A., Delp, S. L., & Crum, A. J.
- Affiliations
- Stanford University (US)
- Corresponding author
- Turnwald, Bradley P.
- Venue
- Nature Human Behaviour
- Published
- 2018-12-10
- Volume
- 3
- Issue
- 1
- Pages
- 48-56
- ISSN
- 2397-3374 (ISSN-L)
- PMC
- PMC6874306
- OpenAlex
- W2903243478
- Cited by
- 142
- References
- 63
- Citations by year
- 2026: 3 · 2025: 9 · 2024: 10 · 2023: 15 · 2022: 37 · 2021: 13 · 2020: 39 · 2019: 15 · 2018: 1
- FWCI
- 10.26
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- Locations
- Nature Human Behaviour (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- Funders
- National Science Foundation
- National Institute of Biomedical Imaging and Bioengineering (U54EB020405)
- National Center for Complementary and Integrative Health (DP2AT009511)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Genetics and Physical Performance
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Genetic Associations and Epidemiology
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Nutrition, Genetics, and Disease
- Keywords
- genetic risk disclosure, self-fulfilling prophecy, placebo effect, nocebo effect, perceived exertion, running endurance, satiety, genetic testing
- MeSH terms
- Alpha-Ketoglutarate-Dependent Dioxygenase FTO, Cardiorespiratory Fitness, Adult, Exercise Test, Physical Exertion, Female, Genetic Testing, Humans, Male, Obesity, Risk, Exercise Tolerance, Cyclic AMP Response Element-Binding Protein, Genetic Predisposition to Disease, Young Adult
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