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?

    Follow stepfanie on Twitter