Losing It in Fat City : Whether You’re a Ricer or a Wittenbergian, a Stuelkeite or a Structure Houser, Durham’s Got a Diet for you

THERE ARE ONLY A FEW PLACES LEFT IN this country where our culture cracks wide open and you can get a pure, distinctly American experience. The Washington Monument comes to mind; so does Ellis Island in New York Harbor. These places reverberate with a living national mythology.

This is the way Sandy Katz felt when she came to Fat City.

Sandy Katz, 50-ish, has striking green eyes and a bubbly disposition, but she has a figure she describes as zaftig; she weighs, she says, “somewhat more than 200 pounds.” For as long as she can remember, she has been coming to an ungentrified neighborhood in downtown Durham, N.C., to participate in some of the dozens of weight-loss clinics and programs and to soak up the general hopefulness of the diet culture.

Katz discovered Fat City in 1964. In this part of town, almost everyone is overweight, so the usual sociological stigmas of fat disappear. People who spent their lives ashamed go crazy with happiness. Five-hundred-pounders roll into town in the back of pickup trucks, and no one even stares. People wear T-shirts that read “A Waist Is a Terrible Thing to Mind” and “Jesus Dieted for You.” Katz loves Joe Sugar’s Clothing Store (“If you have a figure, we can fit it”), the pizza jigsaw puzzles at the bookstores and the passive-workout equipment that is billed as “Exercise Alternative: Machines That Exercise You.”

Over the years, miracles happened in Fat City. Overweight diabetics who were going blind regained their sight. Sandy Katz went on a program known as the Rice House Diet, consisting mostly of white rice and pineapple, and lost 100 pounds. She fell in love and married another dieter.

Five years later, when her husband died of a heart attack, Katz gained the weight back and returned to Fat City. She soon fell in love with husband No. 2 at the Rice House clinic. Mel Katz owned the largest meatpacking company in Los Angeles. They settled down in Beverly Hills and raised two children. But she felt like a Rubens among Modiglianis. She kept running back to Durham for months at a time, dropping in on all the major weight-loss clinics: Structure House, the Stuelke Institute, Franklin Wittenberg’s Residential Inn. She lost weight, but as soon as she left Fat City, she lost her resolve, too. Eventually, her constant flights east ruined her marriage. “The divorce was all my fault,” Katz sighs. “But what could I do? In America, thin is thin.”

DOWNTOWN DURHAM IS AN ODD PLACE FOR FAT CITY. In North Carolina’s central Piedmont region, equidistant from the Appalachian Mountains and the Atlantic coastline, Fat City occupies only about a square mile in a town defined largely by the presence of Duke University. You can’t go more than a few blocks without seeing a fast-food restaurant; Duke students have made Durham the eighth-largest consumer of junk food among U.S. cities. Still, Durham has become a touchstone of America’s diet-obsessed culture. Dieters drop $100 million into the local economy every year. Two years ago, one of the clinics erected a sign on Interstate 85 announcing Durham as “The Diet Capital of the World.”

The easiest way to imagine Fat City is to think of it as a factionalized place, such as Beirut. But instead of Christians and Muslims scurrying around concertina wire and mortar rubble you have Wittenbergians and Structure Housers and Ricers peering at one another from behind salad-bar embankments. Fat City weight-loss programs are more than just diets. They are dietary Weltanschauungs : How you diet defines how you see the world. To suggest that a Ricer eat a meal at another clinic is a little like encouraging Yasser Arafat to get bar mitzvahed.

It all started innocently enough at Duke University. In 1934, Frederick Hanes, chairman of the department of medicine, decided that he wanted to challenge Johns Hopkins as the country’s premiere medical school. One of the doctors he recruited was a young scientist from Berlin named Walter Kempner, who had been studying kidney disorders and treating malignant hypertension with a white-rice diet. Overweight patients lost so much weight eating white rice three times a day (after several months, he allows them vegetables, fruit and chicken) that when Kempner came to Duke, he founded an obesity-treatment program, with the university’s blessing.

In Fat City, dieters speak of BK, “Before Kempner,” when fat was a fact of life and often a symbol of wealth, and AK, “After Kempner,” when fat was regarded as an aesthetic liability and a medical problem that could be cured by cutting caloric intake. Kempner discovered that Americans ingest far too much animal protein while the rest of the world gets its protein from grains.

I expected Kempner’s Rice House to have a graceful historic air--the program costs about $2,000 a month--but the atmosphere of the two-story Georgian house with a sagging front porch is punitive and Spartan--Monticello inbred with a Motel 6. In the main room off the foyer, patients lie on metal cots, waiting to have their blood pressure taken. Off to the left is the dining room; grease cloths cover the Formica tables. To the right is the room where patients weigh in; the scale runs up to 700 pounds.

Here, a tiny doctor--bald, lean and energetic as a dachshund--moves from patient to patient. “Did you lose?” the doctor calls out in a croaky German accent.

“Eight pounds,” the man says sheepishly.

“Blessed be the Lord,” croaks Walter Kempner, 87, who shows up every day in a blue blazer and white loafers to weigh and counsel his Ricers. He adds, “My nouveau riche don’t care for the Rice House decor. But when they lose weight they are proud to eat here.”

The Rice House hasn’t changed in half a century. Kempner does not like change. The literature he hands visitors dates from 1956. He still drives a convertible from the same year. Kempner is known for, among other things, his legendary aphorisms. “It doesn’t matter why you overeat,” he says, “and it’s simply self-indulgence to spend much time or energy exploring the cause. People have to learn how not to eat.” Another Kempnerism: “Fat crosses class lines. Here, my common secretaries mingle with my captains of industry.”

Some dieters complain that he is rigid and ornery, but most patients regard his manner as proof of his genius. “Dr. Kempner is an obsessively private individual,” says Sandy Katz. In three decades, she has never known anyone to socialize with him or to visit the little home on Montague Street he purchased in the 1930s for $4,000, where he lives alone. Kempner maintains strict rules at Rice House. No one is permitted to embrace him. No one may take his picture. Ideal weights for dieters at Rice House are 100 pounds if they are five feet tall, and five extra pounds per inch for men, three extra pounds per inch for women. The rice diet is so low in sodium, chloride and nitrogen that daily urine tests determine whether a patient has been cheating. (Another Kempnerism: “All dieters are liars.”) There is some truth to the notion that many Rice House patients lose weight because they fear disappointing Kempner. “Kempner himself has always eaten whatever he wants, though. He has weighed exactly 137 pounds for the last half-century,” says Robert Petrillo, the man Kempner had been weighing on the scale. “He loves herring in cream and caviar and mousse de chocolat. “ Kempner grew up during World War I, when there was never enough food, so he never developed fat cells, Kempner says.

Petrillo is a 61-year-old psychologist from Yorktown Heights, N.Y. He entered Rice House at 320 pounds last year. “I’m 40 years a shrink,” he says. “I was obese the last 18 years. I was so busy helping others that I was conning myself. See, I was never a sweets guy. I had what you call a portion-control problem. I’d make two pounds of pasta, and I’d eat the entire pot.” In seven months, he lost 165 pounds on the rice diet. “New York is amazed,” he says. “But it’s hard being away. I miss my new driveway. I miss my golden retriever. I have a newborn granddaughter I’ve never seen.” Still, he plans to stay at least another four months.

Petrillo begins to sniffle. He wipes his nose with the sleeve of his gray wool sweater. “I want to lose weight, because in today’s society the only thing you can control is your body,” he continues. “It doesn’t matter if you have thousands of people working for you if you can’t control your own appetites and biological drives.”

OVER THE YEARS, THE RICE DIET ESTABLISHED SUCH A REMARKABLE record of controlling people’s appetites--patients included Dr. Norman Pritikin, author of the famous Pritikin Diet, and Elvis Presley--that Duke University expected Kempner to be nominated for the Nobel Prize for medicine. While Duke waited, it had to tolerate Kempner’s idiosyncrasies. In all his years in Fat City, he never attended a faculty meeting or taught a class. Wealthy patients frequently offered to donate tens of millions of dollars to rebuild Rice House; Kempner regarded these offers about as graciously as Moses regarded the Golden Calf.

Then, in the early 1970s, Duke’s medical school, seeing that Kempner was nearing retirement age, started its own obesity-treatment program. Kempner became an emeritus professor of medicine, but the medical school divorced itself from the operation of Rice House. Other doctors who had worked with Kempner no longer wanted to practice his iron-fisted approach to dieting. They quit and started their own private clinics. Weight-loss programs proliferated in Durham. Out-of-town programs such as Optifast and Nutri/System moved in. It was Fat City’s Big Bang.

In the following years, revisionist diet theory was dominated by former Duke professor and Kempner protege Dr. Edwin Stuelke. The principles of his Thin for Life program differ drastically from Kempner’s. According to Stuelke, overweight people suffer from an illness. “A 300-pound human being needs as much help as a drunk in the gutter,” Stuelke, a chubby, likable German, would say. “Food must not be used to numb ourselves to life’s miseries.”

His clinic served three diet meals a day and provided medical supervision, but mostly it emphasized the 12-step, spiritually oriented principles of Alcoholics Anonymous. Most Stuelkeites were in heavy caloric denial before they joined the program. “I used every excuse there was,” says Dick Lotwin, a California podiatrist who was a Stuelkeite in the ‘70s. “I had big bones. I had low thyroid, dysfunctional glands, very aggressive fat cells.”

As Stuelkeites proliferated, it became clear that theirs was not a diet program as much as a food-addiction program. Compulsive overeating was a far worse disease than alcoholism because you can never simply stop eating. Stuelkeites accepted the notion that they were powerless over food. They sought spiritual awakening and believed that there was a power greater than themselves that could help them diet. Nowadays, it is rare to find a practicing Stuelkeite in Durham. In 1981, Stuelke closed his clinic and retired to his home town of West Branch, Iowa. People had a hard time keeping up the spiritual premise without a charismatic leader. “Looking back, I am against spirituality or religion in dieting,” says Lotwin, who has moved permanently to Durham. “Does God really care if I eat cheesecake or not?”

The power vacuum in Fat City caused by Stuelke’s departure was immediately filled by a diet clinic called Structure House. Started by clinical psychologist Gerard J. Musante, also from Duke, Structure House promoted a doctrine of behavior modification. Structure Housers scorn the word addiction . They regard excess weight not as a medical or spiritual problem but a psychological one. Standard 700-to-1,000-calorie-a-day diet meals are served; overeating is thought to be prompted by various mental triggers: stress, boredom, fear or conflicts left over from childhood. Resolve these conflicts, Structure Housers believe, restructure one’s lifestyle, and the eating disorder will reverse itself.

This is the prevailing diet theory in Durham today. The clinic benefited from an avalanche of publicity when the late actor James Coco wrote a best-selling book about his experiences there, called “If I Can, You Can.” About 100 people a month enter Structure House for the average monthlong stay; at $4,200 for the first month, it is the most expensive program in town. People spend their days shuttling between private therapy sessions, exercise routines and mental health lectures. There’s a specialist to help smokers quit and another who can prescribe Prozac.

The best place to examine Structure Housers up close is at the Alternative, Fat City’s only discotheque; everyone calls it the Crisco Disco. I go on a warm Saturday night. A deejay is spinning tracks from Depeche Mode, Deee-Lite and the Cure.

“Food was always my best friend; it never talked back to me,” says one overweight woman who asked me to dance. She is wearing a shirt with a Structure House logo--a picture of a head with a stomach in it. Underneath is the phrase “The way to weight management is not through your stomach.”

“Now that I’m here, though,” she continues, whirling under the the strobe lights, “I don’t eat a piece of parsley that doesn’t belong to me. The doctors say I lost so much weight I’m going to need to get plastic surgery because my skin has stretched so much. I’m considering donating my excess skin to burn victims.”

Your basic Structure Houser is the most energetic and intelligent individual in Fat City, and the most neurotic. I hang out at the bar for a while and feel as if I am in the middle of a group therapy session.

“Did you read about the study done at the University of Cincinnati College of Medicine?” one man says. “Children ages 2 to 5 were given a choice of playing with a thin rag doll or a fat one. Fifty-three out of 56 kids went for the thin doll.”

A second man adds: “Being overweight is a very complex problem in our society nowadays. To say, ‘Just control yourself’ is too simplistic. I’m here because I have very low self-esteem. My family was dysfunctional.”

“What if you feel like cheating on your diets?” I pipe up. Everyone stops talking and stares at me. The experience of saying something dumb enough to make people snub you at a disco is depressing.

The second man looks slightly hurt. “Either you are involved or you’re committed,” he says. “Dieting is like a plate of bacon and eggs. The chicken was involved in making that meal. The pig was committed.”

A PERSON CAN ONLY SOAK UP SO much diet culture in five days. I didn’t have time to interview the Rev. Grace Gifford, an ordained minister and massage therapist who specializes in hands-on-healing of overeaters. I skipped a special morning lecture at the Structure House called “Do Genes Cause Flab?” I hadn’t even found the time to peruse “The Owl Was a Baker’s Daughter: Obesity, Anorexia Nervosa and the Repressed Feminine,” a book by Marion Woodman that is a Jungian look at eating disorders and practically required reading in Fat City. But before I left, I wanted very badly to see the passive-workout machines.

It turns out that the only place that has them is the newest clinic in town, which opened three years ago: the Durham Residential Inn and Diet Centre, run by a local businessman named Franklin Wittenberg. Wittenberg charges less than the other clinics for a monthlong stay--about $1,500. He touts his program as the Diet With Dignity. But most inhabitants of Fat City regard Wittenbergians with a mixture of amusement, disbelief and horror. Over at Rice House, Kempner will eject you from the premises if the name is uttered. Says one Ricer: “It’s not a serious weight-loss program at all. It’s just a combination of quainter accommodations and diet meals with no medical or psychological supervision.”

Wittenbergian dieters love to be pampered and indulged. Other clinics have all the charm of converted YMCAs. But when I arrive to have brunch with Franklin Wittenberg, a pianist is playing a Chopin prelude on a white piano in the dining room. Crystal, china and linen napkins grace the tables. The day’s special is a pizza omelet made with egg whites, by far the most enjoyable food I’ve eaten in Fat City.

The Wittenbergians believe that you should keep your weight under control with reasonable meals--they keep patients on an 800-calorie-a-day diet--but dieters realize that they will never be thin and refuse to put their lives on hold waiting for a miracle cure. Many regard fat as a political issue; they are part of what is called the size-acceptance movement. As such, they believe that the idealization of slenderness has caused more physiological danger, moral trauma and emotional disaster than excess weight ever did.

What most Fat City dieters find so puzzling, though, is Wittenberg himself. When I walk into the dining room, he doesn’t bother rising to greet me.

Wittenberg is a man of Orson Wellesian proportions and then some. A 400-pound colossus, his suit size measures a 78 regular. Tiny, rectangular bifocals are perched on his hippopotamic cheeks.

“People say, ‘An obese man running a diet clinic?’ I’m my own worst advertising,” he erupts. “Believe me, it’s a heartache to be fat in a skinny culture. But I understand what they’re going through a lot better than skinny doctors do. I’m right in the trenches with them.”

A multimillionaire, 57-year-old Franklin Wittenberg seems to own most of the property in downtown Durham. He is a major benefactor to the Duke Eye Center, the Duke Jazz Institute and the Chamber of Commerce, which gets space in his nicest office building at a subsidized rent. He owns 1.34 million square feet of warehouse space. He owns the parking lots. He owns the stores. He would have owned the minor league Triple-A team, the Durham Bulls, but the Bulls weren’t for sale. From a dieting perspective, his key acquisition was the old Holiday Inn on West Chapel Hill Street, which he renovated into the current Residential Inn. It seems that Franklin Wittenberg controls one end of Fat City, Walter Kempner the other, and the two are locked in an ongoing battle for each dieter’s soul.

“You wind up here when the other diet programs don’t work,” Wittenberg says. The Wittenbergian philosophy is a smorgasbord of other diet-clinic programs. During 11 years of visits to Durham, Wittenberg tried all the major diet centers, and many of the lesser ones. He borrowed what he liked and discarded what he didn’t. “Other diet clinics turn you off to food,” Wittenberg says. “They start with the attitude that you are guilty and must be punished. Those services are redundant. My patients know how to diet. They’ve been in therapy already. If they need a checkup, we got a jillion doctors to choose from in town.”

In the dining room, former Stuelkeite Lotwin is seated across from Wittenberg. “Franklin eats three diet meals a day here, but he also dines at a couple of restaurants each day,” he says. Lotwin became a Wittenbergian after several years of remaining nondenominational and ballooning to 340 pounds.

“It’s tough for you,” Lotwin continues, patting Wittenberg on the shoulder. “You love food. People can relate to you. You’re really a gourmet.”

“Trying to be thin will drive you crazy,” Wittenberg says. “I got so desperate I was considering an ileal jejunal bypass.”

“That’s where they hook up the incoming to the outgoing,” Lotwin says soberly. “The food never gets absorbed in the gastrointestinal tract.”

“It goes right into turnaround, you know?” Wittenberg continues. “It appealed to me despite the surgical risks. Then one day I thought, ‘Am I crazy? Being thin is not worth it.’ ”

“You try to cut through Franklin’s intestinal wall just to insert a tube,” Lotwin says heatedly, “and the big guy could throw a pulmonary embolism like that.” He snaps his fingers.

As we talk, handsome tuxedoed waiters whisk out four courses: a salad with red onions, the pizza omelet, fresh grapes, strawberries and pineapple, and a parfait of American Glace. Chomp, chomp, chomp. The meal is over in 180 seconds.

Other diet clinics in town don’t resent Wittenberg because of his prodigious appetite. They resent him because he’s an unabashed promoter. “Eat here, live longer,” his advertisements promise people. He displays glowing testimonials in his office from former patients such as the CEO of Dunkin’ Donuts and the president of Bun and Burger International. He tells people he’s going to clone his Residential Inn all over the country.

Over the years, no one ever seemed to be able to capitalize on the concept of Fat City beyond the belt-line of Durham. Even Wittenberg’s plan for a McDonald’s-like expansion has financial problems. His company, Malkara Limited, owes a bank in Charlotte $10 million. The bank wants to foreclose on several of his properties, including the Residential Inn and Diet Centre.

After lunch, Wittenberg wedges himself behind the wheel of his mastodonic maroon Cadillac to give me a tour of Durham. The ride is a lecture on Wittenberg’s plans for expansion combined with a catechism of his accomplishments: He says diet clinics are his third and final career. The other two were equally controversial and resplendent. In his 20s, he became a millionaire buying automobiles that were considered dogs on the American market and remarketing them to countries such as Yugoslavia and Greece. In his 30s, he started a company that manufactured some of the world’s first mass-produced electronic calculators for $99 each. To do that, he had to move to Hong Kong.

Wittenberg pulls over to the shoulder and draws a yellowing photo from his wallet. “You know who that fellow is?” he asks, staring at it sadly. It is a photo of himself at age 40, a handsome man, 175 pounds. “In Hong Kong,” he says, “I had a Chinese chef on my yacht and two Filipino women cooking at my condo. I ate my way through every four-star restaurant in Hong Kong. The stress of a business career was terrible. Gourmet food was my only tranquilizer.”

When he started on the three-star restaurants, he couldn’t stand himself anymore. He weighed nearly 400 pounds. “It was so painful asking stewardesses if they had seat-belt extensions. I was universally unacceptable,” he says. “I thought, ‘How do I stop feeling like a chronic invalid?’ It was a constant obsession of not living up to society’s standards.”

Like Dick Lotwin and so many other dieters, Wittenberg moved here permanently. In 1983, he liquidated his businesses and poured his capital into Durham. He lost 60 pounds in eight weeks on a Duke program; he has dipped as low as 240. “That’s practically anorexic in Durham,” he says.

When we get back to the Residential Inn, I remind him that I still haven’t seen the passive-exercise machines.

“Everyone wants to see them,” Wittenberg says, smiling. “That’s why I keep it for last.” He fumbles at his key ring and opens a locked corner room. Inside, there are six large machines with neon-blue padding. Wittenberg flips a switch, and the Buttock Machine starts to twitch. He flips another, and the Hip Machine quivers side to side.

“Overall, I’ve been lucky in life,” Wittenberg says, lying down on the Waist-Tummy Machine and hooking himself up. “This is my pay-back. What do I need with more money? My clinics can help people out there in dreadful pain, suffering and mental anguish.” As if in sympathy, the machine begins to convulse. “This movement simulates 350 pushups in 20 minutes,” he says. “It’s so enjoyable you can almost fall asleep and still get a workout.”

After the workout, I ask Wittenberg about Katz, whom I had spotted in the lobby downstairs. “She not only stays with us now, but she’s eating all her meals here, too,” he says. “Deep down, Sandy still considers herself a Ricer. But I keep telling her she’d be better off marrying a Wittenbergian.”