Questions you may have wondered about: do you need your belly button, what causes butterflies, is chocolate really the love drug and placebos – who do they work best on?

by Dr Cindy Pan

The human body is a pretty amazing creation. We each have one but how many of us really fully understands how every little bit of it works?

While many are willing to simply accept that some mysteries will never be solved, others refuse to give up that easily, and when they can’t get satisfaction from Google (or even the ultimate in definitive references for generations past, World Book Encyclopaedia) they turn to their GP or better still, just wait until they come across anyone vaguely medical, be it at a cocktail party, in a lift or even in a queue for the powder room! Here are some of the hairy questions I’ve been asked in recent times that have made me smile and wonder, ponder and blink, blush and giggle, nod and wink.

Why are some belly buttons innies and others outies? Do we actually need our belly button?

The belly button, or umbilicus as it is more formally named, is simply a bit of scar tissue from where the umbilical cord was cut at birth. Depending on how the scar heals from that first cut – arguably the kindest cut of all – it will result in a different appearance, such that no two belly buttons will look quite the same, much like fingerprints. Even identical twins –whose fingerprints will be identical 95% of the time – will never have identical umbilical scars!

You actually don’t need your belly button for any practical purpose; it is purely ornamental really. In fact when people undergo abdominal lipectomy (a cosmetic procedure for severe obesity, specifically when there is a large overhanging ‘fatty apron’ which the person wants removed) their plastic surgeon may ask them whether it is important to them to preserve the umbilicus. Interestingly most people respond resoundingly in the affirmative and are generally quite appalled by any suggestion that they should lose their belly button, despite the fact that there would be absolutely no functional loss. It might be just an old scar, but most of us are quite attached to it, literally and figuratively.

What causes butterflies in your stomach?

The feeling of butterflies in your stomach tends to occur when you feel anxious, nervous, apprehensive or emotional and the sensation is thought to be caused by the blood leaving your stomach and gastrointestinal tract and going instead to your muscles, as part of the ‘fight or flight response’. The idea here is that in evolutionary terms, if you were under threat and needed to prepare to flee, fight for your life or make a run for it, you needed to prioritise getting good blood supply to your limbs rather than pumping it into your gut to digest and savour the latest meal. That’s why generally if you are feeling anxious and tense you will be edgy and fidgety, not wanting to sit down, possibly pacing a lot and not wanting to eat. The fluttery feeling of butterflies is the blood fleeing your gut and making its way to the limbs where, at least in prehistoric times, it may have been needed for the purpose of racing through the forest or doing hand to hand combat with a grizzly bear!

Is it true that eating chocolate produces biochemicals and neurotransmitters that mimic the feeling of being in lurve?

Chocolate does contain phenylethylamine, the same mood-elevating chemical produced by the brain which is widely believed to promote feelings of love, bliss and even euphoria. However the problem is that when taken orally (and after all, the only way to really enjoy chocolate is to eat it…), the phenyethylamine is rapidly metabolized such that concentrations reaching the brain are insignificant. So all the theories about chocolate having aphrodisiac qualities or the ability to induce or mimic romantic ecstasy are probably largely bunkum…or possibly placebo effect. But what a delicious placebo! Give me a tablet of creamy chocolate over a plain old sugar pill any day.

Is everyone equally prone to the placebo effect? If not, why are some people more prone to the placebo effect than others?

Placebo effect was once thought to occur in around a third of people however more recent research has found that up to 70% of people will respond to ‘dummy’ cures. Researchers have found that the placebo effect is more marked in people who are more sensitive to ‘external cues and outside pressures’, in other words, those somewhat more gullible folk who are every advertisers’ dream.

Such people tend to be more easily manipulated and are highly susceptible to marketing. Their tendency to be highly suggestible and to believe the advertising pitch for phony products, no matter how far-fetched and OTT, may however be a real boon. After all studies repeatedly show just how effective placebo alone can be, at least in the short term. For example, in trials for a hair growth treatment, 42% of balding men taking a placebo either increased or maintained the amount of hair on their heads and in a Japanese study, people exposed to fake poison ivy developed rashes.

The effects of mind over matter, expectation, belief and motivation are significant factors in modulating placebo effect. In addition, researchers have found that taking placebos can cause a sudden surge of endorphins in some people. Unfortunately these effects are not long-lasting. Furthermore, when people reporting positive effects from placebo are informed that the treatment is a phony one, their condition deteriorates rapidly.

The power of positive thinking is certainly a great force to have on your side but just make sure you are not simply being manipulated by clever marketeers to buy a product the purchase of which benefits them far more than you!