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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    I would be interested in what he has to say about gastric bypass patients after surgery gaining their weight back. I am one of those people. We were told before surgery we never have to DIET again..... Report
    "The research actually supports that people who weigh frequently, even each day, have better success over the long term."

    Thanks for this wonderful interview. I am weighing myself almost daily in the morning and I find it very helpful. By doing it every day, it ceases to have as much drama as the once-a-week weigh-ins had.

    Spark People has their own article about weighing-in in which every expert claims that weighing in daily is a bad thing. Perhaps Spark should re-do that article. Report
    great article. I like the fact that the Dr. says it is about more than the numbers on the scale, but about maintaining a healthy life. So true and spot on.

    "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."
    It really is all about balance...and the struggle to stay balanced in life. Report
    Great article! The thing that is so aweful about dieting is that we seem to have to obsess about food all, by pre-planning once a week for the whole week helps. I use a Little Black Book-Daily Food Diary with their Personal Choice Menu template I filled in with 'yes' foods and calories counts of portions. I actually get hungry for my pre-planned healthy choices! Report
    Thanks - i used to weigh myself daily as I felt it was a motivator for me when I saw the number go down, however I have just recently decided to let go of that and just weigh in 1x/week. I am trying not to get wrapped up in the number on the scale as I don't like the feelings that come when I see the number go up slightly - it stays in my mind for the day and is not helpful and I've learned it's not a true reflection of what I am doing or not doing. I want to start using other measurements such as goal achievements, spark streaks, energy levels & self confidence to rate how I am doing! Report
    Good advice, though not really anything I haven't heard/read before aside from avoiding anything with the word detox in it. I thought occasional detoxing was a good thing depending on the methos. I will have to look deeper on this issue... Report
    Pretty funny, since the first thing this site wants to know is your weight, even if you are just looking to live healthier. It is also the first measurement taken on dr visits. It is an index, one of several that contribute to healthiness. Most of our ways to determine healthiness still involve numbers-like walking a couple of miles without feeling winded, or riding a stationary bike for half an hour on inclement days. The number on a scale has been used by many as THE big indicator of how a person is doing. For anorexics and those of us who struggle with weight, overall health is more important than that number indicates. Report
    I really enjoyed reading this article aloud to my DH; we are on this weight-loss journey together - found some good ideas here. Report
    I changed to weighing myself once or twice a month and that was so frustrating that I stopped weighing myself altogether. I've recently went back to weighing once a week, same day-same time, but again the fluctuations can be so extreme! I like his idea of weighing daily and graphing the trend. This way, if I see a spike either way, I can go to my food log and exercise log and perhaps see a correlation. Great Article! Report
    This article contains some of the most useful advice I've heard or read. Thanks! Report
    I agree with weighing daily to keep track of the trend. If I weigh only once a week, and that happens to be the day my weight fluctuates up, then I may have missed the trend of actual loss and be disappointed and frustrated. Also, weighing daily gives an opportunity to increase exercise or decrease calories that very day to stop a gain in its tracks without ever getting your feathers ruffled. Report
    This is a great article. Love the focus on setting small goals to acheive as that will keep motivation high to reach the one at the end. I wanted to add that I think it is also important to be happy with yourself along the way... too often people "hate" themselves until they reach their goal weight. Not helpful. About the daily weigh-in... I am a bit skeptical on the benefit of DAILY. Because of the normal weight fluctuations one experiences, I would think this would be a mood defeater. Weekly is perfect to really keep track of progress without obsessing about the numbers and the scale determining one's mood. I work with eating disorders, and this can become a very unhealthy and obsessive thing, plus it is does not take into consideration if you are gaining muscle, yet losing sizes.
    I really enjoyed this article. I have been off track for months (not losing, not gaining and not trying). I have been beating myself up for not being on top of my game. It was a good reminder to live life, focus on the positives and be healthy while doing it. It made getting back on track seem more manageable and less impossible. Thanks! Report
    I really needed this today. What he said about weight fluctuations was exactly what I needed to hear since I was up 2 pounds this morning. I agree with what he says about just living a healthy lifestyle and not center your life around every tiny detail of weight loss. The last week I have been focusing more and more on my weight loss and I needed to this to put me in check. I need to stop obsessing about it and just live my life the healthiest and to the fullest that I can. Report
    Today was a great day for me to read this interview. I have struggled with weighing in weekly. I think that the weekly model has affirmed my own negative notion that 'The Number was a measure of how well I did rather than weighing in as a 'tool for tracking. I own that as my own issue. All the suggestions are reasonable, basic and good reminders to focus on lifestyle rather than markers and tools as measures of success. Report
    Lots of common sense. Especially the part about people gaining back weight because they didn't do the right things, not because the didn't know the right things to do. Report
    I weigh myself every morning, it helps me set my pace for the day. I never thought about graphing my progress, but it makes sense and is a great idea. I will start doing that very soon. Helpful and informative article. Thanks. Report
    Excellent advice overall. But as a person who has lost more than 100 pounds and kept it off for a long period of time (and counting), I disagree with the advice on daily weighing and think that newer research than discussed in the blog no longer supports daily weighing as an improvement over longer time periods. I often hop on the scale in the week but my "official" weigh-in is once a week; sometimes I vary that period or the day of the week to fit a schedule but I feel it is more sane and useful to me to monitor my weight weekly rather than daily. There are simply too many fluctuations over the course of a few hours or days to be able to tell if I've really lost, gained or maintained.

    But to each their own. Report
    Great suggestions! I like the part about not letting WL consume your life....."talk about it for only 30 mins/day and spend the rest of your time living a healthy life. " Good one! Report
    Great article! Report
    this was very helpfull information,, I have always been told,, weigh in only once a week, not to beat your self up weighing every day. and I always felt that the scales "owned" me when I had to report to it each day.. but I can see where he is going with this ,,,, great stuff, the more I learn on my journey of weight loss is that much closer for me to forgive my self of past failures and this time,, my path is straight forwards, and not giving up!! Report
    An extremely interesting and helpful article - full of good information. Confirms that I am doing the right thing. Report
    This is one of the most helpful articles I have ever read about weight loss. It covers the gamet of problems that people seem to have with their weight loss struggles. VERY helpful! Report
    I really think this article is great. I weigh in daily in the mornings. I have found that seeing were I am at daily keeps me motivated to workout harder and a little longer anytime the scale goes up which has kept me from platoing!!! = ) Report
    I get weighed in once a week at my weight loss group, and don't even own my own scale anymore. I am aiming for a healthy body and lifestyle over-all and weighing in daily will just stress me out more than I need to be. Been there, done that. I need to do what is best for me and focusing on nutrition, not the scale, is my healthy choice, as long as the outcome is losing weight. Just coping with the fluctuations of my body weight weekly is enough, and can't imagine dealing with daily fluctuations ever again! For some people it might work, so to thine own self be true! Report
    Excellent article! I will try the daily weigh-in and see if it helps. Report
    This was truly a remarkable article and the very first time I have EVER heard anyone say it's okay to weigh in daily if it works for you. I am a daily weigher because that IS what works for me - just nice to hear an expert tell me it's okay. I'm new to Sparkpeople and at age 66, I feel it's finally my shot - maybe my last one - at a chance to be healthier for the remainder of my life and that is due mostly to logging in daily and entering my food info for the day and having it tell me exactly what I SHOULD be eating and then what I DID eat. It's helps just like the daily weigh-ins. What can I do to improve the following day? Lots of good info - but I can't get beyond the "okay to weigh daily" comment. Report
    This was awesome advice! I am feeling much better about this lifestyle change I am about to embark on! Report
    I am one of those people that weigh every day. If the number goes up, I work really hard the next few days to get it go down. I'm at my goal weight now so I'm maintaining and even if it goes up 1/4 of a pound, I'll be back at it to keep the weight off. Report
    Good article/advice. I do weigh myself every morning -- and that way the number is NOT such a big deal . . . just a daily reminder to continue my healthy lifestyle. Also would comment that living a healthy lifestyle (again, not "dieting") is something that involves choices all day long -- not just once a day (like, taking medicine for some medical condition). All day long we choose what to eat, what activities to engage in (hmmm, should I watch TV or go for a walk?). Many of these choices become habits, but it's still something that I need to think about all the time. I don't think of it as obsessing, but continuous, conscious choice-making. Report
    Another great common sense article from Sparkpeople. I'm a secret daily scales person and this is the first time I've read an expert explaining why its good for me! I only record my weight once a week but at the daily weigh I NEVER expect it to go down - so when it does - whoopee! Report
    It was interesting reading about all the different motivators--extrinsic-getting something -clothes,trip,etc.for losing each 5 lbs. along the way-20 total-- being the MOST motivating for ME!! Logging in every day & weighing in EVERY day was a necessity for me! Report
    The worst thing for me to do is weigh daily! I have to stay off the scales because I cannot handle it it I have not lost. Since I have started weighing once a month, I always have a loss and I always feel good and successful. For those of you who can handle the weighing daily...more power to you! Report
    Wonderful article with much good and practical advice. Report
    I have lost 15 pounds in the past 9 months. While the loss has been excruciatingly slow, I have not gained more than two-four pounds during this timeframe. I weigh myself almost daily, & for me, this has been a big part of the key to success. I am in my mid 50s & have essentially been on a "diet" for the past 45 years! I have been trying to "psych" myself into exercising, but without success so far as I have Fibromyalgia which complicates things. Report
    "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."

    LOVE this approach. Enough talk; action is key! Thanks for the great article.

    I have tried the weigh myself every day thing and it is less traumatic than dieting for a week or two and then finding out I only lost 2 ounces! At least every day I get a boost to do better, no matter what the scale says. Report
    Very good article. I'm one of those people who get on the scale almost every day and if it doesn't go down, I get upset. And, if it goes up, I get upset. I know
    weight fluctuates daily, I don't know why I get upset. Sometimes I get upset enough to say I'm going to quit this diet thing and eat whatever I want, whenever I want. But, I don't. I know that's stupid thinking. So, I plug along, still trying to get healthy, even with my backsliding, I always try to do better. Taking small steps is best for me. Short term goals are way better than one long term goal. Report
    excellent article and really pulled together all the important points relating to weight loss and maintenance. The part about veteran dieters really hit home with me--I know all about how to eat properly, I just don't do it. Report
    It removes all doubts and myths however, didn't we really know the truth anyway?! It's all in what we're willing to do to keep it off for the long hall, consistency. This is good information and with everything, it's a mind set, to start and one day at a time! Thumps up! Report
    This is the most common sense article I've read on Spark--especially the part about the most a person should spend in thinking about their "plan or program" is 30 mins. Spark, itself, can be very costly when it comes to time on the computer. Report
    This was a ton of good advice. It super bothers me that restaurant portions are so incredibly huge, and often full of fat and grease and salt and other not good for us things. I currently work at a resort, and we have mostly realistic portion sizes, but it's still super hard to eat well while I'm here. I have already started using the small goals and such, and this just helps me know I am on the right stage. Report
    Good Advice, but nothing new. What bothers me is the constant SOCIAL war against calorie- huge restaurant portions and the "more for your money" mentality food industry generally. Why can't an approximately 300 calorie sized breakfast portion; about a 500 calorie sized lunch portion and an approximately 1000 calorie dinner be the norm for a complete meal in every restaurant? Competition to save the customer money is NOT the best social objective here. We need to re-think economics. Report
    Best article I have ever read about weight loss!!!!!!!! Report
    A+ on this article/blog. It's great to hear some common sense from a doctor and expert who isn't into the latest trends or scare tactics. He sounds like he really cares about people and is realistic about how the average person lives and can change. Report
    Excellent article. I am experiementing right now with not weighing myself for a month. I am just trying to feel good about following the program and staying within my calories and exercise goals, without the dread of the scale. I have been worried that going a long period between weigh-ins will hurt me in the long run. At the end of this month I think I will try weighing myself every day and see if that removes the anxiety. Report
    Excellent article! I weigh every day. At first I got upset when the numbers didn't go steadily downward. But I realized after awhile that the weight was moving in a downward trend, so I quit worrying about the individual numbers. But I never allow a lower number to mean that I can over-indulge or slack off. BTW, for those of you who liked the idea of graphing for trends, SP already does that for you! If you ask for a report on your weight loss, you'll see two lines on the graph, one for how you should be losing to meet your goal, and one for your actual weight loss. I just love this website!!!! Report
    I used to hate to weigh myself Period. Now I give myself permission to weigh whenever I like. The numbers don't throw me off and the weigh ins keep me focus and motivated. I love this article. It is very encouraging indeed!. Report