Durham, North Carolina, is known as both the "Tastiest Town in the South" and the "City of Medicine". Within this unique environment, the Duke Weight Loss programs have a rich and complex history, marked by both remarkable achievements and significant controversy. These programs, evolving from the pioneering work of Walter Kempner to modern approaches, have significantly impacted the landscape of weight management.
The Rice Diet: A Radical Beginning
In 1934, German physician Walter Kempner joined the Duke School of Medicine faculty, bringing with him a group of German refugees fleeing Nazi persecution. Kempner's research focused on metabolic diseases such as hypertension and diabetes. His observation that these diseases were less prevalent in cultures with rice-based diets led him to develop the Rice Diet. This diet was characterized by low salt and fat content, and was designed to promote weight loss.
Kempner presented his initial findings at the 1944 American Medical Association convention. The reported outcomes were startling: drastic reductions in weight, blood pressure, and cholesterol, along with rapid improvement in kidney failure. These results, while impressive, were met with skepticism from some physicians. Critics pointed to the lack of a control group in Kempner's study, as well as the significant number of participants (60 out of 192) who did not experience health improvements or died.
Despite the controversy, the Rice Diet gained widespread acclaim. By 1945, people from around the world were traveling to Durham to participate in the intensive regimen at the Rice House, an inpatient facility. Participants paid approximately $150 per week (equivalent to about $3400 today) for a diet consisting primarily of unsalted white rice and canned fruit, while renting apartments in downtown Durham. The program required participants to limit fluid intake, discontinue existing medications, and provide daily urine samples for sodium level monitoring. Kempner would then post these sodium levels on a community bulletin.
Durham's Dieting Culture: Beyond the Rice House
The popularity of the Rice Diet led to the emergence of "reducing salons" and "health spas" in Durham during the 1950s and 1960s, such as Figurecare of Durham and Slimorama Health salon. Between 1969 and 1989, the number of diet-focused businesses tripled in Durham, generating $6.5 million at its peak in the 1980s. Dieting evolved into a community with its own slang and social events centered around weight loss.
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Controversies and Criticisms: The Dark Side of the Diet
The Rice Diet was not without its drawbacks. It is a highly restrictive diet lacking in essential micro and macronutrients. Participants often had to make significant life changes to adhere to the regimen. For example, former Ricer and author Jean Renfro Anspaugh dropped out of law school and sold her belongings to participate in the diet.
Some patients developed life-threatening electrolyte imbalances and required hospitalization. Kempner was known for his strict and uncompromising approach. There were reports of him whipping and sexually abusing patients who deviated from the diet, leading to a 1993 lawsuit by former patient Sharon Ryan. The lawsuit was settled after Kempner's death in 1997. After nearly 70 years of operation, the Rice House closed in 2013 as its clientele diminished.
Modern Iterations: Carrying on the Legacy
In 2013, businessman and former Rice Diet participant John Aycoth opened the Rice Diet Healthcare Program, a 13,000-square foot facility near downtown Durham. This new program aimed to continue Kempner's legacy. The Rice Diet has treated approximately 18,000 patients from around the world.
Current Duke Weight Loss Programs
Today, Duke University offers a variety of weight loss programs, reflecting a more comprehensive and modern approach to weight management. These include:
LIVE FOR LIFE Health Coaching: This 12-week program pairs participants with health coaches who hold degrees in healthcare fields such as nursing, dietetics, or exercise physiology. The coaches work with participants to achieve physical and emotional well-being, helping them set goals and make sustainable changes.
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Pathways to Change: This pre-bariatric procedure health coaching program supports individuals before and after bariatric surgery. Participants work with a health coach for at least three months before the procedure and continue receiving support for a year afterward.
Log2Lose: This 18-month research project, conducted in collaboration with the University of Wisconsin, focuses on building healthy lifestyle habits. Participants receive a weight management program led by registered dietitians, attend online group classes, and receive personalized support via phone calls. They are encouraged to track their weight and food intake using a mobile app.
Duke Lifestyle and Weight Management Center: This center offers a comprehensive approach to weight loss, with a team of experts who help individuals change eating habits, adopt healthy lifestyle practices, and maintain weight loss. The center provides medical weight loss treatments, nutrition consultations, and behavioral health counseling.
Duke Health & Fitness Center: This center offers fitness and wellness classes, exercise equipment, and medically-based exercise programs. It also provides personal training, nutritional consultations, and massage therapy.
The Duke Diet: A Book for the Masses
Howard Eisenson, M.D., and Martin Binks, Ph.D., of the Duke Diet & Fitness Center, have distilled their methods into a book called "The Duke Diet". The book presents a balanced and personalized approach to weight loss, covering nutrition, fitness, and behavioral strategies. It includes:
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- Two eating plans based on different carbohydrate levels.
- Daily menus and recipes from the Duke kitchens.
- Fitness plans tailored to individual needs.
- Strategies for overcoming barriers to weight loss.