It's 5 p.m. at the Duke Rice Diet Program, situated in a pair of white buildings set back among trees at the corner of Cole Mill and Rose of Sharon roads in Durham. It's dinnertime, and Marjorie Jacobs is holding court over a bowl of brown rice and stir-fried bok choy in the dining room. A brunette with a Long Island accent and Anjelica Huston cheekbones, Jacobs sports an American flag button pinned to a gray hooded sweatshirt with an embroidered playboy bunny insignia at the breast. Her conversation is as unselfconscious as her attire. She is effusive about the Rice Diet Program.
"I am an Italian Jew and I came into the world at 6 pounds 3 ounces," she announces. "This place saved my life. My top weight was 336.7 pounds and I have tried everything in the world from Weight Watchers to pregnant horse urine. I came here because I need to be alive."
Like many of the 40 or so diners in the sparsely furnished dining hall, Jacobs is surprisingly forthcoming, sharing her dieting history as generously as she passes samples of food across the table. Jacobs is a veteran of the Rice Diet program. She came to Durham for the first time in 1985 and says it's the only diet that works.
Greensboro author Jean Renfro Anspaugh would agree. In 1988, she sold most of her belongings, dropped out of law school, and, loading her 294-pound body into her car, drove from California to join the program. She never left. Anspaugh found work, relocated, and eventually enrolled in UNC's folklore department, graduating with a master's thesis on Durham's diet culture. Last fall she published Fat Like Us, a collection of candid first-person dieting stories about the Rice Diet experience.
Anspaugh interviewed more than a thousand past and present Ricers. Her collection paints a colorful portrait of the Rice Diet, from the journey to Durham and rites of passage like weighing in and eating a "last supper," to cheating on the diet (what Anspaugh calls "backsliding") and even sexual awakening. The book mirrors Anspaugh's own experience. She is like many patients who have gone through the 60-year-old program. Faced with chronic obesity since age 8, Anspaugh has been dieting for most of her life. "I had tried everything: Weight Watchers, Jenny Craig, Physicians Weight Loss Center, Overeaters Anonymous," she says. "I had always known about Durham, and I knew that one day I would come."
Dieters have been coming to Durham for decades. Until the early '90s, motorists driving into Durham via Interstate 85 were greeted by a sign advertising the Duke Rice Diet, which read "Welcome to Durham: Diet Capital of the World." The appellation acknowledged the diet industry hotbed resting snugly within Duke University's low, stone walls. Between the three Duke-sponsored programs (the Duke Rice Diet, Duke Diet and Fitness Center, and the Center for Living) and Structure House, a privately owned offshoot, dieting added up to big business for Durham County.
It still does. But when the unmistakable billboard came down, Durham's notoriety as a diet center also lost a little weight. People like Marjorie Jacobs are still coming to Durham with a lot on their minds and even more on their frames, and leaving with a lighter load. What's changed is the methods for getting them there, and with a change in methods comes a change in the overall Triangle dieting culture. Anspaugh was encouraged to stay in Durham until she was thin. For Jacobs and other dieters today, the focus is on sending dieters home, but better equipped to manage their weight.
The Rice Diet was created by Walter Kempner, a Jewish kidney specialist recruited by Duke and brought from Germany in the 1930s. Kempner's research at the university led him to the belief that disease can be prevented and cured through diet, and he soon began prescribing a high protein, low sodium diet of mainly white rice and canned fruit. Immediately successful in combating hypertension, high blood pressure and a range of diseases associated with diabetes, the diet gained notoriety, and groups of wealthy people began flocking to Durham to lose weight. They paid about $150 per week for food, eating at a ramshackle house on Mangum Street, renting apartments and spending their days walking around town. The only requirements for participants were that they weighed in each morning and ate all their meals at the Rice House. The program has an impressive list of alumni that includes Buddy Hackett, Wendy Wasserstein, Dom DeLuise, Mario Puzo and, allegedly, Elvis.
Kempner seemed to hold a mystical control over patients. He was a wiry man, who Ricers say always wore a blue blazer and white duck pants, drove around with the top down in his convertible Lincoln--regardless of the weather--and maintained a thick German accent despite decades in the United States. His strict policies, including forcing dieters to collect all of their urine in a 24-hour period, testing it for sodium intake, and posting the results on a community bulletin board, earned him the description, in a 1983 Penthouse magazine article, of "somebody's Nazi grandfather."
Penthouse visited the program during the dieting craze of the '70s and '80s, a period during which Durham was known as the "Lourdes of Lard." One of the magazine's editors arrived to shed some weight and discovered an unexpected bonus: sex. Anspaugh devotes an entire chapter ("Durham as Sexual Paradise") to the subject and says sex is a natural outlet for people who are away from home, placed in a new town and denied their basic coping mechanism.
"You are with people like yourself, you are losing weight and feeling great about yourself," she says. "Transformation brings with it many things ... and I don't know where Durham's commercial sex industry would be if it weren't for diet programs."
Anspaugh's glossary of slang terms--Crisco disco: dieters' night at the Hilton; Cooking your own bacon: losing weight; Century Club: the board at the Rice House displaying the names of recent dieters who have lost one hundred pounds or more--includes its share of sexual innuendo and euphemism. Sin City: concentrations of strip malls and tempting fast food restaurants on Hillsborough Road. Pulling the apron: having sex (after one loses a large amount of weight the skin of the abdomen sags and must be lifted in order to perform).
The erotic power of dieting was not confined to the patients. In a 1993 lawsuit, a Ricer named Sharon Ryan alleged that Walter Kempner engaged in a long-standing sexual relationship with her, whipping her with a riding crop when she strayed from the diet, having sex on the floor of his house and keeping her as his sexual slave for 20 years. The lawsuit was settled out of court after Kempner's death. Anspaugh writes that "Duke did acknowledge that Dr. Kempner had used a riding crop on several patients in the past, but stopped at the request of the university." Anspaugh also records Kempner's response: "I have never had sex on the floor. My house has some nice couches and sofas. I would never have sex on the floor."
The period of asceticism and sexual liberation that Anspaugh describes has been muted in recent years by changes in the Rice Diet culture. Dieters used to stay in Durham for months and sometimes years, trying to reach goal weight. Insurance rarely covers the diet these days, so dieters are less likely to stay for extended periods of time, time that allowed for a dieter's community to flourish. "I think a lot of that culture came from dieters all living together at Duke Towers, which they don't do as much anymore," says Dr. Robert Rosati, current director of the program. "And I think age is a factor. Our average age now is somewhere in the 50s."
When Kempner's influence on the diet lessened, the program began to loosen up. "The fact of the matter is that things have been getting less strict since Kempner started to age," says Rosati. "I would watch him talk to patients with hypertension and diabetes who would ask if they could have one slice of turkey for Thanksgiving. He would say 'No, that could kill you.' And I used to wonder, how does he know that? Well, he couldn't have known that. But he knew human nature. If you tell someone there can be an exception, then there will always be an exception."
Instead of focusing solely on reaching goal weight, Rice Diet staffers attempt to teach patients a few basic things and hope that they leave eating less salt, more vegetarian diets, and staying mindful about what they eat. A typical length of stay for Rice Dieters today is about a month, costing approximately $4,200. The menu has expanded from white rice and canned fruit to include basmati and jasmine rice, some vegetables and a wider variety of fresh fruit--even fish on Fridays. And the program keeps dieters occupied during the day. Where Kempner advocated only walks between meals, the Rice Diet has now packed the time in between meals with daily programs including Tai Chi, meditation, yoga, and classes on reading food labels.
"Maybe we keep people out of trouble," Rosati says.
At the program's current weekly fireside chats, Ricers gather on couches at one end of the house and discuss their concerns and ask questions. Curiously enough, there are a number of pictures of fruit on the walls of the Rice House, including a poster-sized print of eggplants and leeks, and a Picasso-esque bowl with a pear. The avuncular Dr. Rosati, tall and ruddy-cheeked with short graying curls, sits patiently in front of a stone fireplace while the discussion takes on the combined form of group therapy, catch-all reference desk and comedy show. In one session, Rosati begins by telling the group of 20 patients something that sounds like he's said for years: "If you are overweight, you always have something to eat. Yourself. You are like well-informed cannibals. Overweight people are never hungry. You only think you are hungry."
"How could I have been so stupid," a man in a plaid shirt says under his breath.
Everyone laughs and the conversation shifts to hoarding food. Despite small portions, some of the Ricers don't finish their food at a meal, taking something like an apple or mini box of rice puffs home in case they get hungry. The man in the plaid shirt is listing food that he has saved from the Rice House: three grapefruits, 32 boxes of shredded wheat, six raisins. Marjorie Jacobs admits to having an unopened bottle of wine "in case of company." Dr. Rosati tries to dissuade them from the habit.
"Why hoard food, guys?" he asks.
"To entice starving Ricer women up to your room," comes a response, to laughter.
But Rosati cuts through personalities, a joke about having to join two diet programs just to get enough to eat, and laughter-filled accusations over stolen Oreos, offering a theory on relationships with food. "Either it is because of danger or it is out of habit," he says. "I think that somewhere along the line, you started eating because of danger, then it became habitual. At home there is stress, relationships, family, reality, and that is dangerous."
As the conversation shifts to going home, Rosati offers a Rice-Diet-as-castle metaphor: "There are three endings to the story after you find what you're looking for. We know that rice and fruit are good for us. That's the truth. When you find this truth you have three options. One, you can go back to the castle, say 'I've got the truth, and kiss the rest of the world off.'
"Two, you can say, 'Well, the rest of the world isn't buying the truth, but they like detective stories. So, I am going to write detective stories and at some point I will throw in the truth and they will read it and they'll get it,'" he says, suggesting something about the possibility of subverting the mainstream eating culture.
His final recommendation is more pragmatic. "Three, you can go out there, say 'I've got the truth' do the best you can, and go back to the castle every so often to get your strength back.
"I prefer three. I would rather remain engaged with the world," Rosati says.
The challenge for dieters is continuing the program at home. Marjorie Jacobs is worried. "I am going home in a few days and I am very nervous about gaining weight," she announces to the group. "I have been successful this time, but I won't know for sure until I get home."
Dr. Rosati is sympathic, and tells Jacobs to keep in touch on a weekly basis.
"OK guys, all you gotta do is try," Rosati concludes. "Marjorie, call me every Friday. You can confess your sins."