An Obesity Expert Tells Us What Really Works with Weight Loss

By , SparkPeople Blogger
One of the perks of writing for a living is being able to sit down with various experts on behalf of our readers. Recently, I chatted with Dr. Martin Binks, a clinical psychologist, obesity expert, and Clinical Director & CEO of Binks Behavioral Health, and Assistant Consulting Professor at Duke University Medical Center.

Sometimes it's difficult for non-scientists to sift through the abundant research on obesity, health, and wellness. It's equally difficult for some researchers to try to distill these complex studies and findings into a format that will both inform and educate the general public. I was excited to have a chance to talk about weight loss with Dr. Binks in a straightforward way--no dry data or journal articles, just a conversation. Here are some of the highlights:

Should we use special occasions as motivators?

"There's a good reason why people use special events, such as a family reunion or wedding as motivators," he said, they work in the short-term but too often people do unhealthy things, such as crash dieting, pills, or detoxes to achieve their goal which can be dangerous. In addition, "once the event is over, they often go right back to overeating and other unhealthy habits" and regain the weight.

"It's about a lifestyle change," he says of using milestones as motivators. "Use those things in a way that's sensible and well thought-out using good nutrition, healthy physical activity and most of all make sure you have a plan for your health the day after the event."

"It's hard to motivate yourself," he says. "For many people, the best way to stay on track is to have an event to aim toward." He likened it to how an athlete spends months or even years training. This usually involves a series of athletic events with ‘off-season’ training in between competitions. "Why shouldn't the average person use periodic events to boost their motivation as part of an ongoing healthy lifestyle plan in the same way athletes do?"

Is it better to set one large goal or smaller ones along the way?

"You don't get there if you just set the target as the final long-term goal," he said. "It's important to set daily, weekly and monthly goals as part of a complete plan, with one goal building on the next to achieve the larger, long-term goal."

Years ago, during one of his earliest year-long obesity studies, participants were given walking goals: "We started with walking a certain distance in 30 minutes. Initially each week they would walk the same distance, but with a goal that was 15 seconds faster. Once they got comfortable with that, we added more distance."

"We would encourage people each week to improve either the intensity or alternate that with walking a bit farther," he said. "We kept pushing people week by week to achieve those immediate goals that eventually led to their longer-term target."

And it worked.

When it comes to goal-setting, he believes in "celebrating them all large or small." Baby steps add up to giant leaps in health!

What goals should people set?

"People are bombarded with bad messages," said Dr. Binks. "They want to lose 10 pounds a week or exercise till collapse like they see in popular TV programs or commercials. While I do think that it's important to focus on ambitious goals, its best to realize that they can't reach those goals overnight."

Reputable weight loss programs spend a lot of time encouraging participants to set reasonable goals. For example, if a person is unable to do one pushup, setting a goal of doing 100 might be seen as unreasonable which is good, but sometimes they go too far by discouraging people’s "dream goals."

Plenty of people do reach those long-term "dream goals” goals, he says,"so who am I to tell them they can't" They'll start their weight-loss journey and say "within the next 2 years, I'm going to run a marathon." And they do!

Instead of "demotivating them in the moment by discouraging" that long-term plan, he looks at them and says: "OK – but what are we going to do this week?"

Those small goals fill the gaps between now and the brass ring that awaits.

What about the scale?

"People do focus on weight," he concedes. "At times we have tried to move people completely away from focusing on the scale," but that's not necessary or helpful.

"It's an important indicator and a valuable health goal; it's just not the only one." Weight loss is an important goal, but so are the choices in foods you're making, and the physical activity you're getting your blood pressure, blood sugar and overall quality of life.

He says: Weighing in "is a controversial subject among people who struggle with weight. Some still focus on the perhaps outdated notion that weighing more than once a week is harmful. The research actually supports that people who weigh frequently, even each day, have better success over the long term." However Dr. Binks stresses that you are the best judge of what works for you.

Dr. Binks first learned about daily weighing while working with Dr. Patrick M. O'Neil of the Medical University of South Carolina, a leading obesity researcher. There he discovered how to help people, to learn how to measure weight both frequently and appropriately.

"The reason that it's so controversial is that people beat themselves up about the number on the scale," he says.

What he recommends is pulling out a piece of graph paper or using an online program and creating a longer-term view on paper. This way you will learn to stop reacting to the daily fluctuations," and instead pay attention to the overall trends. It's OK to notice the fluctuations but don't see each one as a success or failure. Just look at how the line trends over the course of each month.

If people are willing each morning to "stand on the scale and put the dot on the graph, they might be a little more likely to make a healthy choice for breakfast or take a walk."

In other words, once again, small steps add up.

He also says: "There's a side that we never talk about, but when people have a really good number on the scale, it's sometimes seen as permission to go off the plan." Attending to long-term trends on the graph eliminates this, too.

Advocating such daily weigh-ins might have at times had some patients and colleagues wanting to "run me outta town" but Dr. Binks says that this method can--and has--taken the power away from the scale for countless people he has worked with over the years.

Weighing every week or two weeks and not knowing what number will appear is like playing Wheel of Fortune. Will it land on jackpot—a weight loss--or bankrupt—a weight gain?

Weighing daily and graphing it "keeps you aware of the long-term impact your overall plan has on your longer-term goals and keeps you from going off the program."

Morning is the logical time to do it, but weigh-ins can happen any time of day, as long as it's the same time each day.

"It helps you to teach yourself that the number is a variable, that it's not carved in stone," he says. "One day it's down, the next day it's going to spike up. It's a way to keep reminding yourself that it's just a number, one data point of the many you might track."

Even if a person sticks with the plan, daily numbers will rise and fall. Daily weighing proves that those fluctuations are normal, and by allowing a healthy weight range--say, a few pounds up or down--it allows someone to relax as long as it's within your typical ranges and the overall trend is downward.

If it's not trending down, then "maybe it's time to start monitoring and measuring and tightening up your plan a little."

Dr. Binks had more great tips:

On facing reality:

  • If somebody's goals are clearly unattainable, such as reaching the weight they were at 16--that person needs to choose a different goal. One helpful question he asks: "What was the last weight you remember where you felt good about yourself? If they say 'I was 20 pounds lighter last year,' that’s where he starts them."

    On diets:

  • "The bottom line is that if you don't learn the complete skill set required to maintain a healthy life overall, (maintaining a support network, stress management, active lifestyle, realistic goals setting etc) you will regain weight."

  • "Most diets work, just not for the long term. The nutrition plan must be realistic in the context of your lifestyle"

  • If there's "anything with the word detox in it, run!"

    His advice for "dieting veterans":

  • "Most people aren't gaining weight because they don't understand the things they need to do to be healthier. They're gaining weight because they don't do them." There are barriers in their life that need solving.

  • The changes that work are not complicated: reduce portions, eat more green stuff, moderate total fat, reduce unhealthy fats, eat healthier versions of protein and carbohydrate. "Much of the rest is a lot of noise that complicates and overwhelms people."

  • "Moving a little more is going to give them a lot of progress. There's too much focus in the popular media on regimented, painful exercise and less about simply moving more in a variety of fun and exciting ways."

    One key piece of advice on weight loss:

    "It shouldn't take up your whole life," he says. "Imagine if you had another medical condition. You do the treatment and go home, you take the medicines if needed and you avoid things that might aggravate the condition but you don’t necessarily make your whole life revolve around it…in fact just the opposite--you live life to its fullest without letting your condition take over your life."

    Part of the tactic he takes is to teach people to broaden their interests. A big advocate of "active leisure," he says healthy lifestyles stick when people weave weight loss into their lives rather than weaving their lives around weight loss. "I would love for people to only talk about their weight loss efforts for less than 30 minutes a day." The rest of the time, simply live a healthy life.

    Dr. Martin Binks is Clinical Director and CEO of Binks Behavioral Health PLLC. He is also Assistant Consulting Professor, Division of Medical Psychology, Department of Psychiatry & Behavioral Sciences, Duke University Medical Center. His professional activities include direct patient care, research, consultation services and the development of evidence-based obesity and health promotion programs for healthcare, research and corporate wellness environments.

    Dr. Binks received his Ph.D. in clinical psychology from Fairleigh Dickenson University, trained at the Bronx VA Medical Center and completed pre and postdoctoral training in behavioral medicine at the Medical University of South Carolina. He is the former Director of Behavioral Health, Research, and New Business and Strategic Alliances at the Duke Diet & Fitness Center. Dr Binks has worked extensively in the areas of obesity, health & wellness promotion, neuropsychology, substance abuse treatment, post-traumatic stress disorder and spinal cord injury. Dr. Binks has authored and co-authored multiple research publications and the book The Duke Diet and has appeared on MSNBC Countdown with Keith Olberman, ABC news "On Call”, NPR, Lifetime Television, WGN, 700 Club and is a featured contributor on He is regularly called upon for commentary on a wide range of health and psychological topics in a variety of national publications and websites including USA Today, Washington Post, LA Times, Oprah Magazine, GX Magazine, AOL Health, Fitness, Men’s and Women’s Health Magazines Reuters and the Associated Press. Dr. Binks has been a contributor with the Army National Guard Decade of Health and Wounded Warriors Programs and is a member of several corporate advisory boards.

    His research interests include technology-based healthcare delivery, obesity treatment, non alcoholic fatty liver disease, and overall health promotion. He serves as a reviewer on several scientific journals Dr. Binks contributes to healthcare provider education through his work with students and trainees and by lecturing nationally in the areas of obesity management, health promotion and behavioral medicine. Dr. Binks is currently active in several leadership positions at the national scientific organization The Obesity Society. Dr. Binks also serves as a member of several corporate advisory boards.

    What do you think about his advice?

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    SAVO47 4/8/2021
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    SNUZYQ2 4/16/2020
    Sound advice for all we shape-shifters. Thank you for sharing your insight! Report
    Such great, simple advice and I think it takes the fear out of weight loss. I am a once per week weigh-in gal. That just works best for me since I have a slow metabolism and it takes a week to lose a pound. I can see the wisdom in his suggestion for daily weigh-ins but I’ll stick with once per week. The exercise part just made me happy. I don’t want a big chunk of my day filled with exercise. I want my lifestyle to be active. Thanks for a great article. Report
    Excellent article very practical Report
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    good info and I also like daily weigh-ins but only record weekly on SP. I had tried only weighing weekly but it wasn't working for me so was happy when read the people who weigh daily keep the weight off better than those who don't Report
    Great article, thank you very much! Report
    Common sensical myth-busting advice! Report
    When I was in WW it was a weekly weighing & that was okay. Currently since I have made a lifestyle change, I only weigh myself monthly or every few weeks. I don't have a deadline just slow steady progress to eat mostly healthy & move daily. I am creating a list of motivating slogans, & a tracking chart for my room since I'm a visual person & like color. Once I get that going I may add some graph paper & try weighing in daily. My concern is that I will then start to let things relax a little & that would be a step backward. As Dr Binks noted, many people fail because they simply don't follow the rules. If you keep doing the same thing over & over, don't be surprised to not get a different outcome - that is the definition of crazy. Report
    Slow and steady Report
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    I like the simple way of explanation, and common sense of the Dr. Good info. Will start every day tracking. Thanks Report
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    A lot of sensible advice here! I tend to become obsessed and this article addresses this issue quite effectively. Thank you! Report
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    I knew most of this stuff. I chose to ignore it but I knew it. The reminder is helpful! Report
    I weigh in daily. I expect the scale to fluctuate. I do have to give myself pep talks when the numbers aren't what I want. I can see the overall numbers are going down. It helps me stay on track Report
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    I love the common sense advice given by an expert! Report
    Great article! This one's a keeper. Report
    Will save this article. Report
    I weigh-in daily (morning), and definitely recommend it. Wake-up, pee, waddle to the scale, track number. Done. Some days are up; some days are down. I don't let the number define me. Daily morning weigh-ins give the number context (what happened yesterday: food/ exercise). I usually know what to expect. Weekly (or worse, monthly) weigh-ins are a total crap-shoot for me, completely lack any useful context, and give the scale more emotional power over me than it deserves. Everyone has to decide what works for them. For me, daily weigh-ins are the way to go. Report
    I am scale phobic. The only weigh in I do is once a month at the Dr's office. I judge how I'm doing by how I feel and how my clothes fit.i' in the minority but getting on a scale freaks me out. Report
    I enjoyed this blog and am glad to say that daily weigh-ins is what ultimately led to my weight loss success. It keeps me accountable, and I can make adjustments quickly. I use sparkpeople to track my weigh-ins which provides you with a graph. Report
    Great blog! Daily weigh-in each morning is what has made the difference for me! That way, I monitor what's happening more closely. Report
    I have to weigh in daily. If I skip days, I start eating whatever I want. Weighing every morning makes me more aware of what I'm eating. Report
    I would like to track my weight daily via sparkpeople as I am afraid totally of the scale if I gain and if I lose use as permission wt ok and cheat would like to learn to weigh daily even though scared about it but if I graft it would take power away from scale Report
    I've always weighed in weekly, and will continue to do so, because it works for me. I do it Friday mornings, and over the weekend I give myself permission to eat a more high calorie dinner (while staying within my calorie range). Then Monday-Thursday, I try to stick to the low end of the range. I like this because I do feel like I don't have to be as strict all the time, and if I was weighing in every day, I certainly would feel that way. Report
    Great advice! "Simply LIVE!" "Move more!" "Pick the last weight you felt good at and set that as your goal." "People fail, not because they don't know HOW to do it, but because they DON'T do it." Report
    "... only talk about weight loss efforts for less than 30 minutes per day." Wow! Powerful message for me. I have a tendency to obsess and when I can let that go, I do so much better! Thank you for that. It really does amount to making healthy choices a part of your life as opposed to focusing on weight. Report
    I weigh daily during the weekday to monitor the effects of water retention and general weight of different foods, to determine how much I'm retaining during menstrual cycles, and to use the scale for accountability. I skip weighing over the weekend but maintain making healthy choices at the restaurants we visit then weigh again on Monday morning. For me, "out of sight" does mean "out of mind" and I'm more likely to make unhealthy choices if I know I'm not going to see the results on the scale for a week convincing myself that I can "make up" for the unhealthy choices later in the week which I don't do and before I know it, I've gone back into a habit of unhealthy choices. I can lie to an accountability partner. I can't lie to the scale. Report
    I had so much to lose in the beginning, that I would weigh in once a month. I'd focus on my other goals, moving more, portion sizes, etc. I would be far more motivated to see that I had lost 5 pounds in a month, than to see the scale drop .5 or one pound a week. I now weigh once week, as I still focus on the "other" things rather than focus on the number on the scale. I think it is important to learn how to focus on all the healthy things you need to learn. It is the baby learning steps that are the most important. Report
    Weighing in daily helps me,,, I do it a number of times thru the day. Pretty much my #s are stable, If I notice they are going up, and I'd not eaten,, and sorry, but had been in the ladies,,, than I know to watch my calories instead of eating. I do this especially when i want to eat badly, it helps to avoid that,,,,YEAH FINALLY an article which AGREES with what I have KNOWN to work for me. U'd be surprised how much SLACK I can take for this ! But, it WORKS "for me". Report
    Obviously, the advice jury is still out on whether to weigh or not weigh every day. It becomes a personal choice, whatever works for you! Report
    Great article! I especially like the part where he says to only talk about your weight for no more than 30 minutes a day, then go live your life. Good advice. I spend way too much time worrying about my weight and not enough on enjoying my life. Just moving around to get plenty of exercise, was also encouraging. Report
    I have been weighing myself every morning as part of routine to help me remember my medication. I will add the graphing because lately I have noticed some variations in my weight at different times of day. Does anyone know how much "The spirit of heaviness" weighs? I ask because there are times when I step on the scale and the numbers are lower than I expected. So, I step back and close my eyes and check it again. There it is... that's my number... What happened? Is there something wrong with my scale? Well, I jump off the scale and run to my room to put on my "garment of praise". I am thankful for another day, for food to eat, a roof over my head, and choice to try again.

    Thanks for the article, I know what to do, and now is the time to do it. Report
    Excellent article. I sort of stumbled on a lot of this my own self and think it is a big reason why I was able to lose 80 pounds and stay at my goal for over a year. Weighing several times/week and keeping a chart works for me. I expect to be heaviest on Tuesday and lightest on Thursday. Over the years the trend line has gone down. Report
    We are often told to weigh in weekly but that definitely is not a good idea for me....what this guy says, weigh in daily, that keeps me accountable and motivates me. Report
    I love the idea of fitness instead of weight loss....for example, I couldn't do any push-ups but now I can do 15. I didn't try to do 100 at first. I just tried to do 5. And I have made such great progress! I definitely use weight as my basis for measuring but there is so much more to consider! Report
    I particularly like the wisdom to weigh daily. And to set small short term goals. I'd really like the graph report for weight to show up on the weight tracker page just above where I enter my weight. It shows my weight loss over time with the goal line and most of my progress lightly below it. I don't often thing to go look at the graph. Can it be put on the same page as the tracker?

    And for setting a final long range goal, but be able to set 1 month goals of 3-5 pounds that wouldn't flip the calorie requirements over to maintenance calorie levels until we actually approached our long term "final" goal. Report