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Tobacco Road
City Becomes Nation's Diet Capital
DURHAM, North Carolina (June 19) - As she sat atop the remains
of the patio chair that crumpled under her weight, Jean Anspaugh
realized it was time - time to leave law school, leave her
home in California and head for the "Diet Capital of
the World."
"I had an epiphany," she said. "I thought
that's it, I can't even feel secure in my own house. That's
it - I'm out of here. I sold everything I owned, just to
go to Durham and lose weight."
Anspaugh's epiphany happened in the 1980s, and today she's
among the thousands who flock every year to Durham, a city
of 187,000 that's best known as a fading tobacco capital
and home to Duke University. But for those desperate to lose
weight, it's a place of pilgrimage, a place so sacred that
some who have succeeded at one of the city's three major
residential clinics have returned to sleep in a hotel for
a night or two - just to be close to Durham.
"This is indeed a mecca," said Dr. Gerard Musante,
a clinical psychologist who founded one of the clinics, Structure
House. "People have come to us from all over the country.
People have come to us from other countries."
Anspaugh, 50, struggled with obesity all her life and at
one point tipped the scales at 300 pounds (136 kilograms).
After dieting, taking diet pills and binding herself in tight
undergarments, she believed Durham was the only answer.
"To me it was the Emerald City," she said.
Over the years, she's lost about 100 pounds (45.4 kilograms)
in multiple visits to Durham since uprooting from Sacramento
20 years ago. Now living in Fairfax, Virginia, she has kept
off about 80 percent of that weight loss.
People whose weight is a major health concern often need
to put everything in their life aside so they can accomplish
their goals, said Dr. Robert Rosati, who works for the Rice
Diet Program, one of Durham's three residential clinics and
the one where Anspaugh was treated.
He believes a key reason for the program's success is "when
you come here, you have made a huge commitment. You have
to uproot yourself, it costs a lot of money.
The Rice center was the first diet program to open in Durham,
in 1939. Three decades later, Duke University opened the
Duke Diet and Fitness Center, followed in 1977 by Structure
House. Each clinic offers a distinct program for weight loss
and emphasizes follow-up support methods so patients can
maintain their success after leaving.
Musante said Durham is where doctors and researchers first
started looking at obesity from a scientific and psychological
perspective.
"Back when we started, people didn't know really where
to go for this problem," he said. "And we were
the only people working on it."
And the residential model is hugely attractive. Teresa Khirallah,
31, of Irving, Texas, arrived weighing 355 pounds (161 kilos),
scared by a warning from her doctor that in 10 years, she
would either be in a wheelchair or dead.
While at the center, Khirallah wore a swimsuit in front of
other people and took a self-defense class - things she would
have been far too embarrassed to try outside of Structure
House. She lost 22 pounds (10 kilograms) in her four-week
stay and then continued to lose after leaving and now weighs
198 pounds (90 kilograms).
"It's almost like your own private life to try out things
that you always wanted to do in a safe environment," Khirallah
said. "Where you could do these things and not worry.
You were able to take risks."
The privacy offered by the clinics, and Durham's relative
anonymity among the celebrity and fashion capitals of the
world, is also a major selling point. Over the years, such
celebrities as James Earl Jones, Harry Wayne Casey of KC
and the Sunshine Band and comedian Buddy Hackett have ducked
into Durham to lose weight.
Andre Leon Talley, the 56-year-old editor-at-large at Vogue
magazine, came to Durham when he realized he was dressing
differently to hide weight gain. The New York City resident
lost 28 pounds (12.7 kilograms) in seven weeks at Duke earlier
this year and hopes to lose another 28 pounds (12.7 kilos)
over the next year.
"It is a wonderful place of well-being," Talley
said. "It's a place of positivity. You can reach the
goals that you set for yourself."
Spending time at one of the diet centers in Durham isn't
cheap. Duke, for example, charges new patients up to $7,245
(euro5,950) for a four-week stay. Each year, the diet centers
generate an estimated $51 million (euro42 million) in local
spending, the equivalent of the money generated by the 4,000
meetings and conventions the city hosts each year.
Experts point out that losing weight doesn't require something
as radical as spending the time and money it takes to enroll
at a residential facility. Small, gradual diet adjustments
can also be effective, said Dawn Jackson Blatner, a registered
dietitian with the American Dietetic Association.
"The idea of doing something radical to kind of shake
it up can really spur people," Blatner said. "Because
the idea is that success can spur success ... but I believe
that small changes can make a big difference (too)."
But those who have experienced success in Durham swear by
the residential approach. Anspaugh even said she dreams of
taking extended stays at each of the city's diet centers.
"I used to know people who came from New York to rent
a hotel in Durham just to be in the same city where they
lost weight," Anspaugh said. "I used to think they
were crazy, but now, I kind of understand. It's something
about being there."
Rice Diet Program: http://www.ricedietprogram.com/
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