Walking Guide

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 EverydayHealth.com. 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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    Comments

    MIYAMO 10/2/2018
    Good information. Report
    JOHNMARTINMILES 9/25/2018
    A great read! Report
    KHALIA2 9/12/2018
    Great info! Thanks! Report
    ALEPEQUIJADA 8/24/2018
    Thanks! Report
    JPSCOV66 7/18/2018
    I like the simple way of explanation, and common sense of the Dr. Good info. Will start every day tracking. Thanks Report
    TERRIC853 7/14/2018
    Great article. I love the "small goals" approach. Report
    KMILLER31 6/25/2018
    Great advice here Report
    JUSTFURKIDS 3/23/2018
    A lot of sensible advice here! I tend to become obsessed and this article addresses this issue quite effectively. Thank you! Report
    MNABOY 3/15/2018
    Thanks for stating all the information Report
    JOHNMARTINMILES 12/5/2017
    I knew most of this stuff. I chose to ignore it but I knew it. The reminder is helpful! Report
    MONEYSTRETCHER 11/10/2017
    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
    A lot of good sane information Report
    I love the common sense advice given by an expert! Report
    BOBBILYNNE2
    Great article! This one's a keeper. Report
    CATERPILLAR17
    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
    1SUNBUMM1
    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
    SKIPPY777
    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
    BUB001
    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
    AMAZINGMEE
    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
    I weigh myself once a week on my official weigh-in day and that's it. I had to get strict with myself over that because I used to choose the worst times to hop on the scale, like right after dinner or at the end of the day when I'm going to be 2-3 lbs heavier anyway. Even though your logical mind tells you it's normal to be heavier at the end of the day, I'd still be freaking out like, "Only one more day to go before the week ends and I won't have lost 2 pounds!" Well, I did of course, and it was just illogical panic. I'd find myself actually questioning if I should drink less water, which is really silly! Once a week is the way to go. Put the scale somewhere out of reach until then if you must. Report
    Thank you for posting this article. It blew away all the misconceptions and things that seem to make weight loss difficult and just gave it to us straight. I definitely will be saving this and referring back to it if/when I get discouraged. Report
    I truly enjoyed the doctor's insights. His attainable attitude is a motivator to all people not just those who are considering weight loss. I am one of those individuals who do not weigh myself more than once a week but plan to engage in more frequent weigh ins! Report
    Lots of interesting data and some good advice. I do weigh myself every day to keep my focus on what I have to do that day. Also, this is a lifestyle not a diet, so motivators throughout the day do work well for me.
    Report
    I think that it is good advice, but I'm a proponent of throwing yourself into a healthier life endeavor. The "treatment" does have to continue all day, not like most diseases. My goal permeates every aspect of my life, so it's not a few minutes of my day and forget it. Maybe I'll figure out how to make it all work with less thought as time goes on. Report
    that last bit of advice- about 30 minutes a day only- is compelling... Report
    When I was weighing myself every day, it helped me keep my goals upfront and center. I also record my workouts, and I was able to see the link between consistent workouts and weight loss.

    I was also able to see that were fluctuations on a day to day basis, mostly linked to water intake.

    I think daily weighing can work if you are a detail oriented person - and you are able to use the results as feedback to influence future positive actions and decisions.

    On warning would be for people who are starting a workout program - their weight might go up a few pounds - this is normal, and if they remain consistent with good nutrition and the workouts, the weight will start to come down.

    See this "ask the expert" Q & A - "I just started exercising to lose weight, but I've gained weight. Why did this happen?"
    http://www.sparkpeople.com/communit
    y/ask_the_experts.asp?q=68
    Report
    IRISHBLUEEYES2
    If you want to take the weight off and leave it off for life, go to www.foodaddicts.org . It doesn't cost anything and members who have struggled their whole lives, some 100s of pounds overweight, have maintained their weight loss for years!! It absolutely works! Report
    MSLADY1951
    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."
    Report
    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 day...so, 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
    BELLAMAGOO78
    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
    RDEELEY
    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
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